Let’s talk about Gonorrhoea

Gonorrhoea is increasingly becoming one of the most prevalent STIs in the 16-25 age group. The main symptom of this infection is a burning sensation whilst urinating; however, around 50% of people with this STI have no symptoms. Worryingly, it is also becoming the hardest infection to treat.

Gonorrhoea used to be easily cured with a simple shot of penicillin, but the heavy use of this drug has meant that this bacteria has since developed resistance to it. The list of drugs that fail to treat gonorrhoea is rapidly increasing, and the possible targets to treat it decreasing. Soon we may find that gonorrhoea will be an incurable disease.

Primarily, first-line antibiotics are used to treat gonorrhoea. If these fail, then a more potent drug is administered or a higher dose is prescribed. Guidelines set by the WHO (World Health Organisation) suggest that the first-line antibiotic should be changed when it fails to treat 5% of cases. Now, however, it has been found that even the third-line antibiotic for gonorrhoea is on the brink of failing.

How do bacteria become resistant?

As you are reading this, there is a race going on. Pharmaceutical companies are speeding to develop new drugs, which will combat bacterial diseases. However, they are at a major disadvantage. Bacteria are able to replicate exponentially. With such a high rate of growth, mistakes are made in the bacterial genome, producing mutations. These mutations can be beneficial for bacteria, as they can in some instances lead to the development of antibiotic resistance. Selection pressures (i.e. an antibiotic) will cause all but the bacteria with an advantageous mutation to die. The bacteria then pass their genetic superiority on to their daughter cells.

To make matters worse, bacteria can also undergo a process called horizontal conjugation, or ‘bacterial sex’. Through direct contact, they are able to share genetic information with each other, allowing one resistant bacterium to pass its resistance on to others. Thus, it seems that bacteria have multiple systems in place to win this fight.

The HPA (Health Protection Agency) have recently published findings, which suggest that gonorrhoea is becoming resistant to most of the antibiotics that are used to treat it. Tetracycline and ciprofloxacin have both been added to the list of drugs that gonorrhoea has now developed resistance for.  Throughout the history of treating it, this infection has repeatedly managed to evade treatment. According to Dr Magnus Unemo, from the Swedish Research Laboratory for Pathogenic Neisseria, ‘This bacterium has shown a remarkable capacity to develop resistance mechanisms to all drugs introduced to control it.’

What else is being done to cure/prevent gonorrhoea?

Scientists are currently looking to develop new treatments by studying the way gonorrhoea wards off antibiotic treatments. Gonorrhoea has an additional outer cell membrane made up of phospholipids and lipopolysaccharides. This outer membrane provides an extra defensive barrier against antibiotics, which pharmaceutical companies are trying to target to cause cell death. But if we can’t cure gonorrhoea, then we must prevent it from spreading in the first place.

At a time where STI’s are developing resistance to the drugs used to treat them, maintaining a safe sexual lifestyle becomes even more important. As most of you will know, the most reliable way to protect against an STI is to use a condom. There is a government scheme that gives 16-25 year olds access to free condoms. You can get a C-card from Cripps Health Centre, located on University Park campus, and the Student Services Centre on Jubilee and Sutton Bonington campus. The C-card will allow you to pick up a box of free condoms from Cripps Health Centre and the student service centres.

Deepa Divakaran

ScienceThis Issue

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