China, known as ground zero for the Covid pandemic, may be fueling a global rise in a new infectious disease: super gonorrhea.

Up to 98 percent of bacteria samples taken from patients with the STD across 13 Chinese provinces had the ability to sidestep frontline antibiotics, according to a new CDC report. 

Gonorrhea had been effectively evading medications for years, but the chief worry among researchers is that China is reporting rates of a strain resistant to one of the last remaining effective antibiotics 40 times higher than those in the US, UK, and Canada.

Gonorrhea-causing bacteria have excelled at working around antibiotics, so much so that the only remaining recommended treatment is ceftriaxone.

Gonorrhea is caused by bacteria that is increasingly able to evade treatment with standard antibiotics, making it a growing global public health threat

Gonorrhea has been on the up in the US since 2012, with rates in men per 100,000 in men rising considerably higher than in women

In 2022, researchers affiliated with the CDC in China collected more than 2,800 bacteria samples from patients with gonorrhea. 

Over 97 percent of the samples were resistant to the drug ciprofloxacin, commonly known as Cipro, while 78 percent resisted treatment with penicillin, another ubiquitous antibiotic.

Roughly 17 percent of samples were resistant to azithromycin and cefixime, while eight percent were immune to the current standard of care, ceftriaxone.

The percentage of gonorrhea bacteria strains resistant to ceftriaxone has risen from 2.9 percent to 8.1 percent, which is much higher than what is reported in other countries.

For instance, in the UK in 2022, only 0.21 percent of strains showed reduced susceptibility to ceftriaxone.

The above map shows rates of gonorrhea across all 50 U.S. states, the district of Columbia and territories in 2020, the latest available

CDC data showed that in the US, only about 0.2 percent of strains had higher resistance to ceftriaxone between 2016 and 2020. 

In Canada, from 2017 to 2021, the rate of resistance to ceftriaxone stayed relatively stable at about 0.6 percent.

The researchers said: ‘These findings underscore the urgent need for a comprehensive approach to address antibiotic-resistant N. gonorrhoeae in China, including identifying factors contributing to this high resistance rate.’

China was only the second country to document a case of ceftriaxone-resistant gonorrhea in 2016, after Japan identified one in 2009. 

With rates of antibiotic resistance on the rise, new drugs to fight infections will always be needed. 

Gonorrhea is spread via sexual contact with the penis, vagina, mouth, or anus of an infected partner.

It can also be spread perinatally from mother to baby during childbirth. 

In most cases, it’s not a deadly conditition though if left untreated can become a more severe inflammatory issue leading to pain in the pelvic area and even infertility.  

Historically, penicillin has been the first-line treatment, but due to widespread resistance, its use has dropped off.

Then, ciprofloxacin and other fluoroquinolones took penicillin’s place as the first line of defense, until they too were rendered ineffective when resistance became more widespread.

Antibiotic resistance can occur when bacteria mutates over time. Overusing or misusing antibiotics speeds this up.  

Now, ceftriaxone is the go-to treatment. 

But given the pace at which strains can mutate and overcome certain medications, that one may need to be replaced by another in the near future. It may also require developing a totally new drug. 

Globally, all types of antibiotic-resistant infections kill around 700,000 people annually. 

That figure is projected to rise to 10 million annual deaths by 2050 unless urgent action is taken to combat the spread of these pathogens.

Researchers said: ‘International collaboration and information sharing are critical to prevent the further cross-border spread of resistant strains and to identify alternative treatment options for gonorrhea.’

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