Gonorrhea is becoming increasingly resistant to drugs and “could become untreatable” | Gonorrhea

Gonorrhea is becoming increasingly resistant to antibiotics and may become untreatable in the future, health officials warned after a report showed a rise in cases of the extremely powerful disease in England.

Last year, 85,000 cases of gonorrhoea were diagnosed in England, the highest level since records began in 1918. If left untreated, the disease can lead to serious health problems such as pelvic inflammatory disease and infertility.

The vast majority of cases can be treated, but recently an increasing number of people have been diagnosed with resistance to ceftriaxone, the “first-line antibiotic” normally used to treat the infection.

Most of those affected were in their twenties, heterosexual and had contracted the disease abroad, although some had never been abroad, according to the UK Health and Safety Agency (UKHSA). The health authority confirmed that there had been a transmission of ceftriaxone-resistant gonorrhoea in England.

The UKHSA will publish a report on Thursday highlighting the worrying rise in antibiotic-resistant gonorrhoea infections in England and urging people to protect themselves by using condoms.

Between June 2022 and May 2024, 15 cases of ceftriaxone-resistant gonorrhoea were detected in England, according to the UKHSA.

Five of these cases were extremely strong strains that health officials said resulted in “highly drug-resistant” gonorrhea, meaning the infections were resistant to first- and second-line treatments and other antibiotics.

Due to the severity of the drug-resistant infections, some of the 15 patients had to be hospitalized and given a cocktail of drugs to prevent the gonorrhea from spreading to other parts of the body.

Before 2022, only nine cases of ceftriaxone-resistant gonorrhoea were detected in England.

Dr Helen Fifer, a consultant microbiologist at the UKHSA, said: “Gonorrhoea is becoming increasingly resistant to antibiotics, meaning there is a risk that it will become untreatable in the future. If left untreated, gonorrhoea can lead to serious health problems, including pelvic inflammatory disease and infertility.

“Condoms are the best protection, but if you haven't used one with a new or casual partner, get tested to detect the infection and prevent onward transmission.”

For people who have condomless sex with new or casual partners, regular testing for sexually transmitted diseases such as gonorrhoea is “essential” to maintaining their sexual health, the UKHSA said.

The tests are free and can be done at local sexual health clinics and university and college medical centers, or you can have a self-collection kit sent to you by mail.

Prof Matt Phillips, President of the British Association for Sexual Health and HIV (BASHH), said: “The rise in antibiotic-resistant gonorrhoea infections in England is a worrying trend that must be addressed immediately.

“Antibiotic resistance in sexually transmitted diseases is an increasingly serious public health threat that can cause physical and psychological harm and place additional strain on other parts of the NHS.”

BASHH, along with industry partners, has repeatedly called for a sexual health strategy in England, Phillips said. “This must be a priority if our sexual health professionals are to effectively meet these growing and changing sexual health needs.”

The emergence of drug-resistant gonorrhoea comes against a backdrop of general concern about the increasing number of sexually transmitted infections (STIs) in England.

In 2023, 401,800 new cases of sexually transmitted diseases were diagnosed – a 4.7% increase since 2022. Almost half of these were chlamydia cases, with 194,970 diagnoses in 2023.

In addition to 85,223 cases of gonorrhea, there were 9,513 cases of infectious syphilis – the highest number since 1948.

While the majority of syphilis cases were diagnosed in gay and bisexual men, the UKHSA said there was a larger “proportional increase” in syphilis diagnoses among heterosexual men and women.