What is ‘super gonorrhea’? Researchers identify new case in male patient

(NEXSTAR) – Medical researchers in Europe say a strain of so-called “super gonorrhea” was recently detected in a patient who returned from a trip to Cambodia in April.

The 50-year-old male patient, from Austria, had admitted to having unprotected sex with a female sex worker during his time in Cambodia, according to a case study outlined in the Eurosurveillance medical journal, which is published by the European Centre for Disease Prevention and Control. The man later visited a urology specialist, complaining of painful urination and discharge.

A urethral swab determined the patient had contracted an extensively drug-resistant (XDR) strain of Neisseria gonorrhoeae, which initially resisted a course of antibiotics (ceftriaxone and azithromycin) for two weeks, despite symptoms clearing up. The patient was prescribed another round of antibiotics (amoxicillin-clavulanic acid), after which a urethral sample tested negative for N. gonorrhoeae.

Researchers noted, however, that the patient’s urethral, rectal and throat samples tested negative for N. gonorrhoeae after the initial round of antibiotic treatment; he was only diagnosed with N. gonorrhoeae after a PCR test came back positive.

After his second course of antibiotics, a PCR urine test was not available, researchers said.

The term “super gonorrhea,” according to the World Health Organization (WHO), refers to strains of gonorrhea that have “high-level resistance” to current antibiotic treatments. Officials with WHO say these resistant strains can develop and spread thanks to genetic mutations in the bacteria N. gonorrhoeae, or through the overuse of antibiotics (or poor quality of antibiotics used in treatment), among other factors.

Both WHO and the U.S. Centers for Disease Control and Prevention (CDC) further noted that gonorrhea, in general, has become better at evading treatments over the years.

“Antimicrobial resistance (AMR) in gonorrhea actually appeared shortly after the introduction of antimicrobials at the beginning of the 20th century,” Dr. Teodora Wi, WHO Medical Officer, said in 2018, amid reports of a strain of “super” gonorrhea detected in the U.K. “Resistance has continued to expand since then.”

Untreated cases of gonorrhea — “super” or not — can have long-term health consequences, such as infertility, chronic pain, ectopic pregnancy, the loss of pregnancy, or even maternal death, among other adverse medical conditions, according to the WHO and the CDC.

In total, WHO estimated in 2012 that approximately 78 million people had been infected with N. gonorrhoeae that year. Sexually active individuals are encouraged to use protection to reduce the changes of contracting an STI, and to contact a healthcare provider for treatment if infected.