TORONTO - A new study raises concerns about the spread of drug-resistant gonorrhea in Ontario.
A strain of the bacteria that responds poorly to the last class of drugs available to treat gonorrhea is on the rise in the province, according to data presented Tuesday at an infectious diseases conference in Chicago.
The strain wasn't seen in the province in 2005, but by May of this year made up 11 per cent of a representative sample of gonorrhea isolates tested by the provincial laboratory.
The majority of cases that have been spotted were in men in Toronto. But the strain has been seen elsewhere in the province, said Dr. Vanessa Allen, who made the presentation.
Allen, a medical microbiologist with Public Health Ontario, said new approaches to treating and controlling the sexually transmitted disease need to be adopted before the bacteria outsmarts all the drugs available to treat the infection.
“The more aggressive we can be, the more chance we have of eradicating this drug-resistant clone,” she said in an interview from Chicago.
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“There's a very imminent threat that there will be nothing left to treat this infection with. And unless we're very careful now, I really think that we're at risk of getting there sooner rather than later.”
On Monday, the Canadian Medical Association Journal warned the threat of widespread multi-drug resistant gonorrhea demands an urgent public response.
Known as “the clap” in bygone days, gonorrhea is difficult to control because many people who are infected don't have symptoms. Curing the infection does not provide lifetime protection, as is seen with some diseases; a person can be reinfected with gonorrhea.
The bacteria are spread by sexual contact and infection can occur in multiple sites in the body.
In women, untreated gonorrhea can cause pelvic inflammatory disease which can lead to chronic pelvic pain and infertility. Babies born to women with gonorrhea may suffer from blindness or life-threatening blood infections. The bacteria can also cause infertility in men.
If the bacteria move to the blood or joints, infection can be fatal. Infection with gonorrhea increases one's risk of being infected with HIV; and HIV-positive people with gonorrhea can transmit HIV more easily to sexual partners.
In the era of antibiotics, gonorrhea infections have been easily treated. But the bacteria have rapidly and relentlessly developed resistance to all classes of the drugs that have been thrown at them, forcing public health experts like Allen to contemplate the spectre of a return to the days when gonorrhea could not be treated.
“Whether this clonal complex (strain) will replace all the other strains, or the other strains will develop resistance spontaneously on their own, I think the pressure of this antibiotic has demonstrated that resistance develops rapidly,” she said.
“So yes, there's a fear that the major of strains will become multi-drug resistant. And I think that's a very real fear and that's what they saw in Japan. And we're headed that way.”