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Gonorrhea rates increased in the U.S. 1991-2006

GONORRHEA-RATES-INCREASED-IGonorrhea rates increased in the U.S. 1991-2006

By Tim Sandle

Digital Journal reported that a CDC study confirmed that gonorrhea incidence and the presence of drug-resistant gonorrhea strains increased in 17 US cities from 1991 to 2006. The study tracked the emergence of resistant gonorrhea strains from Hawaii and California—the first states to report the drug-resistant strains—and then analyzed the spread across the country. Analysis revealed that gonorrhea incidence rose sharply in cities with higher levels of resistant strains. Data indicated a 7-percent spike in gonorrhea incidence where 10 percent of the cases were drug-resistant.

CDC reported 336,742 gonorrhea cases in 2008 and approximately 820,000 in 2013. This estimate could be low since some cases did not have obvious symptoms. Gonorrhea was the second most reported disease in the United States.

Penicillin was an effective gonorrhea treatment for many years, but diagnoses of resistant strains began to emerge in the 1970s. The second-generation treatment was fluoroquinolones, and the third-generation antibiotics were cephalosporins. Common treatment today is ceftriaxone with azithromycin or doxycycline. Treatment would become complicated if the bacteria become resistant to cephalosporins.

Approximately 30 percent of females who had gonorrhea also had chlamydia; some chlamydia strains also showed signs of drug resistance. CDC urged vigilance in monitoring antibiotic resistance and encouraged the development of new treatments. The US Preventive Services Task Force (USPSTF) recommended gonorrhea screening for all women with increased risk of contracting the disease, which included all sexually active women younger than age 25. USPSTF also recommended testing and treatment for sexual partners of those diagnosed with gonorrhea. Using condoms or dental dams during intercourse and oral or anal sex was effective in reducing gonorrhea transmission.

The full report, “Ciprofloxacin Resistance and Gonorrhea Incidence Rates in 17 Cities, United States, 1991–2006),” was published online in the journal Emerging Infectious Diseases (2014; doi:10.3201/eid2004.131288).

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