When Super Bugs Fight Back: The reality of antimicrobial resistant gonorrhoea

The bug that causes gonorrhoea won’t stop fighting back. Gonorrhoea is a sexually-transmitted infection (STI) caused by the bacteria Neisseria gonorrhoeae and it is now a global public health threat. There are an estimated 78 million reported cases worldwide each year.

N. gonorrhoeae has become known as a “super bug” because it continues to evolve and develop resistance to antibiotics. As a result, there is a real possibility that this “super bug” will make the STI gonorrhoea untreatable in the future.

N. gonorrhoeae: No plans of surrender

Gonorrhoea – it’s hard to spell, but with unprotected sex, it can be easy to catch. Some people who have gonorrhoea don’t show any signs. Others may have pain, itching, discomfort, or bleeding.

The reality is that the bug N. gonorrhoeae shows no signs of surrendering. The bacteria are persistent in developing resistance to the current antibiotics used to treat it. This is called antimicrobial resistance (AMR) and it has become a major problem around the world since it is becoming harder for us to protect ourselves from these kinds of super bugs.

There are treatments that are still effective against resistant forms of N. gonorrhoeae. The current recommended treatment is a dual therapy of two antibiotics, ceftriaxone and azithromycin. However, since there’s no vaccine for gonorrhoea, keeping N. gonorrhoeae at bay remains a challenge.

Reading between the lines with science

To fight back against this serious public health problem, scientists at the Public Health Agency of Canada’s National Microbiology Laboratory (NML) are attempting to “read between the lines” of the bacteria with advanced research tools like whole genome sequencing.

The genes of N. gonorrhoeae are similar to the pages in a diary detailing their life stories. At the NML, researchers have been able to expose many of the bacteria’s molecular secrets.

The NML has even developed a new molecular-based test for this super bug. The test has helped to identify different types of N. gonorrhoeae directly from urine. It also helps predict which types of N. gonorrhoeae are resistant to particular antibiotics right from its DNA.

In 2017, the NML, working with scientists in Quebec, identified Canada’s very first-reported case of ceftriaxone-resistant gonorrhoea. This case was related to international travel. Thankfully, federal and provincial public health teams worked together to ensure that this highly-resistant STI did not spread in Canada.

Dealing with this super bug: The task of AMR stewardship

Even though N. gonorrhoeae has no plans to surrender, it’s important to keep fighting back with research to discover its weaknesses.

Scientists at the NML continue to provide expertise, including data analysis to actively guide public health decision-making to help prevent, treat and control gonorrhoea in Canada.

As AMR continues to be a complex public health threat in Canada and around the world, it’s important to know that there are a number of ways we can help in the fight to prevent it. You can find information on AMR prevention, antibiotic-resistant illnesses and bacteria, and STIs on Canada.ca.

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