Following the spread of gonococcal fluoroquinolone resistance, the
cephalosporin antibiotics have been the foundation of recommended treatment
for gonorrhea. The emergence of cephalosporin-resistant gonorrhea would
significantly complicate the ability of providers to treat gonorrhea successfully,
since we have few antibiotic options left that are simple, well-studied, well-
tolerated and highly effective. It is critical to continuously monitor antibiotic
resistance in Neisseria gonorrhoeae and encourage research and development of
new treatment regimens.Centers for Disease Control. (2015b). Antibiotic-resistant gonorrhea basic information.
CDC. http://www.cdc.gov/std/gonorrhea/arg/basic.htm
- Antibiotic resistance (AR) is the ability of bacteria to resist the effects of the
drugs used to treat them. This means the germs are not killed and they will
continue to reproduce. Neisseria (N.) gonorrhoeae, the bacteria that cause the
STD gonorrhea, has developed resistance to nearly all of the antibiotics used
for gonorrhea treatment: sulfonilamides, penicillin, tetracycline, and
fluoroquinolones, such as ciprofloxacin. We are currently down to one last
effective class of antibiotics, cephalosporins, to treat this common infection.
This is an urgent public health threat because gonorrhea control in the United
States largely relies on effective antibiotic therapy.
Given the bacteria’s ability to adapt and survive antibiotics, it is critical to
continuously monitor for antibiotic resistance and encourage research and
development of new treatment regimens for gonorrhea.
Surveillance
Surveillance for antimicrobial resistance in N. gonorrhoeae in the United
States is conducted through the Gonococcal Isolate Surveillance Project
(GISP). Each year, 25–30 sites and 4–5 regional laboratories across the
United States participate in GISP and collect thousands of N. gonorrhoeae
samples from men with urethral gonorrhea at STD clinics. Isolates from
these samples are then used by researchers to determine the bacteria’s
susceptibility to a given set of antibiotics. Since 1989, data from this project
have directly contributed to updating CDC’s STD Treatment Guidelines for
gonorrhea.
Clinicians are asked to report any N. gonorrhoeae specimen with decreased
cephalosporin susceptibility and any gonorrhea cephalosporin treatment
failure to CDC through their state or local public health authority. Bacteria
have decreased susceptibility to a given antibiotic when laboratory results