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Gonorrhea Is Becoming Untreatable, U.N. Health Officials Warn

212 points| bootload | 9 years ago |npr.org | reply

183 comments

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[+] zackmorris|9 years ago|reply
Keep in mind that media outlets are unlikely to point out the fact that antibiotic resistance is mainly caused by antibiotic overuse on farms for livestock (due to the conflict of interest when so many ad dollars come from food).

Yes, humans failing to finish their run for the time prescribed for them, and use of antibiotics for viral infections have been a problem too. But those are completely dwarfed by farm use.

Funding for new antibiotic research should come from taxes on big agribusiness and there should be more regulation on antibiotic use for livestock.

[+] Houshalter|9 years ago|reply
Well something between 50-80% of antibiotics are used in agriculture. Which is huge, but it's within the same order of magnitude. I'm not sure there is evidence that the majority of antibiotic resistance is caused by agriculture.

I know for example my brother takes a low dose of antibiotics everyday to treat acne. Lots of people do. That can't possibly be good for preventing resistance.

Also the germs animals have are different than those in humans. Do cattle spread gohnerrea? And the antibiotics they use are different than those used in human medicine as well. The biggest problem is it is becoming resistant even to the last line antibiotics we have, and that can't be from agriculture.

[+] flashman|9 years ago|reply
I highly doubt, jokey rural stereotypes aside, that antibiotic resistant gonorrhea is being transmitted from livestock to humans.
[+] vibrio|9 years ago|reply
There haves been increasing regulatory scrutiny given to the prophylactic use of antibiotic in animals (perhaps later than would have been optimal) http://www.fda.gov/AnimalVeterinary/GuidanceComplianceEnforc...

Some of the biggest challenges in antibiotics are economics not technical e.g., http://emerald.tufts.edu/med/apua/news/news-newsletter-vol-3... The only recent company built on antibiotics (Cubist) was purchased for a revenue stream and its R&D was disassembled by Pharma in the last year or so. You can bet that a good amount of organization knowledge has been lost. There are some start ups out there, but as far as I understand, there is little will to provide of equity or strategic funding for early development programs/companies. With the timelines in this industry, that doesn't bode well for 'breakthroughs' in the near future. With the recent idiocy and avarice of some of the "actors" in the industry (e.g., pharma bro, epi-pen). I am bracing for a backlash on pricing, even on needed products) which would further decrease the economic will for companies/funds to invest in early stage programs. Some comments here tout that the the wonders of science will solve this given time. Maybe so, but it's also possible that the burden of economics (and lowest-common denominator politics) could quench the wonders of science for the near term.

[+] noufalibrahim|9 years ago|reply
There was an article I read (can't find the link now) about how people discard unused antibiotics improperly and how bacteria in the wild become resistant over time.
[+] adevine|9 years ago|reply
I highly doubt that this is true for gonorrhea.
[+] scubadude|9 years ago|reply
A figure I saw recently is 80% of antibiotic use in Australia is in livestock.
[+] witty_username|9 years ago|reply
> big agribusiness

Are small agribusiness(es?) exempt? Why should they?

[+] throwanem|9 years ago|reply
Do cows often get gonorrhea? I mean sure, you hear stories about lonely farmers, but...
[+] agumonkey|9 years ago|reply
How much of "modern" western societies are built on the reality distortion field of big corps advertising ? Felt like a sibling to VR and AR.
[+] necessity|9 years ago|reply
Any citation on that?
[+] S_Daedalus|9 years ago|reply
This is true for so many issues, including water usage, greenhouse gasses, and broader forms of pollution.
[+] ChuckMcM|9 years ago|reply
And then there are these stories : http://www.medicalnewstoday.com/articles/287745.php talking about how there are all sorts of Antibiotics we don't even know about (yet). Or drugs that also kill bacteria (http://phys.org/news/2016-02-major-breakthrough-antibiotic-r...) or even this (https://www.theguardian.com/commentisfree/2015/nov/20/antibi...)

Basically as we get to understand exactly how cells work and how bacteria do what they do, and how they change. We won't need to scrounge around in the dirt to find something, hopefully, that will kill bacteria. We'll engineer what ever we need to kill what ever cells we want to kill.

[+] lvs|9 years ago|reply
No, what you're encountering is the rift between new-media science bloggery and the real rate of scientific progress. In new-media science land, a university news office press release is akin to a solved problem. Antibotics? Done! Quantum computing? Solved! Room temperature superconductors? No problem!

The press releases are abominations compared to the underlying research, and the new media companies are embellishing even further for clickbait. It's shameful because it's not reality, which means it's a close cousin of lies.

Will progress be made? Yes, but until then global medical systems and agricultural sectors need to use sound antibiotics guidelines to avoid a looming catastrophe. No press release crap is saving patients who have MRSA right now!

[+] coldtea|9 years ago|reply
So, basically, nothing to worry, technology will save us in the end.

And it might -- long term.

Only, as things are now, between an antibiotic stopping working and finding a replacement, there could be tens of millions of deaths...

Aside from wishful thinking there's nothing that guarantees that we'll find the next cure as soon as an old one becomes obsolete.

[+] notadoc|9 years ago|reply
We have an antibiotic crisis and are approaching a post-antibiotic era unless governments around the world aggressively reduce usage and incentivize new production, regardless of what the pseudo-science or soft-science clickbait articles tell you that is the truth.
[+] jorblumesea|9 years ago|reply
All of those are long term solutions or ideas, none will be to market in 5 years.
[+] quickben|9 years ago|reply
You are basing your decisions on hope, which is as opposite of a rational approach as it gets.
[+] brbrodude|9 years ago|reply
You should check out Nassim Taleb's "Black Swan"..
[+] S_Daedalus|9 years ago|reply
That's a fantasy which we are about to run headlong into, as a species, in part thanks to people who won't face the grim reality and be responsible. This, "Tech will save us!" attitude among the a vast number of people who remain utterly ignorant of the reality of how that might happen, is literally going to kill us all if we're not careful.
[+] lostlogin|9 years ago|reply
Someone I know described visiting a small rural pharmacy in Nepal and talking to the pharmacist. Many locals can't afford courses of antibiotics for sick family members so they buy just a dose or two. This was allowed on even fairly hardcore, last line antibiotics which required special government ministry approval back home. If different countries have such different practices, things are not going to go well.
[+] memracom|9 years ago|reply
Rather than weakening the attacker (killing the bacteria) we could look for ways to strengthen the organism (boost the body's own defense mechanisms). The health industry as a whole, has been weakened by the discovery of antibiotics and designer molecules, and as a result now spends too many resources on looking for killer chemicals (antibiotics and other drugs).

But there are other ways. One way is to follow the thread of research opened up by William B. Coley who developed Coley's Toxins, a cocktail of bacterial toxins that sparked the body's own defense mechanisms and in many cases, caused cancer tumors to turn to jelly within days and start being reabsorbed by the body. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1888599/ has more about him.

Or the way of genome therapy where researchers are studying the active genomes in both healthy and sick (or cancerous) cells to understand what knobs and buttons exist in the human organism that we might be able to adjust by means of various therapies, sometimes even benign ones. There is evidence that one of the many hundred subtypes of cancer will respond to everyday blood pressure medication. This is a relatively benign drug that, in the right conditions, will kill cancer cells. Of course, the right conditions include that the patient has certain specific genes. But genomic techniques ca discover these genomic markers and help us sort out the mechanisms by which cells resist attacks from hostile bacteria. The ultimate outcome for cancer would be that your doctor takes a biopsy of the cancer cells, their active genomes are analyzed and this information is used to build a molecular machine that manufacture a custom drug that will cure your cancer.

Look at the molecular machinery of the Polymerase Chain Reaction which makes copies of DNA molecules https://en.wikipedia.org/wiki/Polymerase_chain_reaction

And there is Reverse Transcription which converts RNA molecules to DNA molecules https://en.wikipedia.org/wiki/Reverse_transcription_polymera...

Not to mention the Ribosome which is the molecular machine in your cells which manufactures protein molecules https://en.wikipedia.org/wiki/Ribosome

[+] dogma1138|9 years ago|reply
>The health industry as a whole, has been weakened by the discovery of antibiotics and designer molecules, and as a result now spends too many resources on looking for killer chemicals (antibiotics and other drugs).

What!? antibiotics are for the most part the most important discovery in medical history, period. They by far saved more lives than virtually any other treatment and make many other treatments possible.

[+] kendallpark|9 years ago|reply
This is a category mistake. Treating bacteria (foreign pathogens of an entirely different species) and treating cancer (which are rogue cells belonging to individuals) are not the same thing.

What you're describing is the normal pharmacological approach to cancer treatment. Because these are the individual's own cells sharing the vast majority of its characteristics with normal, healthy cells, you have to go deep into the handful of mutations that occur that cause unmitigated cell proliferation (leading to cancer). These are targeted for treatment.

Bacteria are a foreign species and have all sorts of foreign biochemistry that can be taken advantage of. The health industry is not doing anyone a disservice by going after the low hanging fruit. Why climb through the 3rd story window when you can waltz through the front door?

Boosting the body's defense mechanisms could carry more risk that just attacking the organism. Boosting chemotaxis (WBC migration) to an area will increase inflammation which has it's own set of potentially dangerous risks. Sensitizing the adaptive immune system's to bacterial antigens runs the risk of autoimmune attack on similar-looking antigens in the host.

This isn't like D&D where you can take one point from "bactericidal" and put it into "immune boost." There are big systems in play and hardly anything can be reduced "one weird trick."

> Look at the molecular machinery of the Polymerase Chain Reaction which makes copies of DNA molecules

Antifolates, topoisomerase inhibitors, imidazoles, rifamycins are classes of antibiotics that target pathogen DNA/RNA synthesis.

> Not to mention the Ribosome which is the molecular machine in your cells which manufactures protein molecules https://en.wikipedia.org/wiki/Ribosome

Aminoglycosides, tetracyclines, oxazolidinones, peptidyl transferase, macrolides, lincosamides, and streptogramins are all classes of antibiotics that target bacterial ribosomal units.

> And there is Reverse Transcription which converts RNA molecules to DNA molecules

Using reverse transcriptase pharmacologically would undoubtedly be dangerous, difficult, unnecessary, and ineffective. You'd basically have to engineer a virus that knows how to use reverse transcriptase that also targets the right pathogen and rewrites a portion of its DNA.

[+] dfischer|9 years ago|reply
Crazy - I never actually took a step back and wondered if we could boost our defense as a strategy.

In a geeky way, we keep drinking health potions to recover HP but if we had a shit ton of armor then we wouldn't need the HP potions to begin with. :)

[+] HisGraceTheDuck|9 years ago|reply
These are all excellent points and we should definitely be pursuing all available avenues. I don't think this is and either/or proposition - we should look into anything that can help.

Things like genome therapy are unfortunately a long way off so we need to look for antibiotics in the meantime.

[+] Mz|9 years ago|reply
You are really overcomplicating this. The gut is about 70% of the immune system. Gut health and old fashioned lifestyle approaches that limit the transmission of germs is simple, easy, inexpensive and has been around for millenia.

It also smacks of religion and "boring, uptight" lives. So, it is nigh impossible to sell the idea.

Perhaps that will get easier as people start dropping like flies from horrifying diseases. But, for now, no one wants to hear it.

[+] DavidWilkinson|9 years ago|reply
Super-gonorrhoea due to antibiotic over-use and treatment non-adherence.

Drug-resistant HIV due to natural mutation and an increase in infection vectors (courtesy PrEP).

Killer venereal diseases: we missed you, but not that much.

[+] hackaflocka|9 years ago|reply
Does oral sex transmit Gonorrhea?

Are there any sex acts that are immune to it?

Is there anything safe (sex-wise) that one can do to prevent it?

[+] mcjon77|9 years ago|reply
Yes, gonorrhea (as well as chlamydia and syphilis) can be transmitted via oral sex. In fact, I know of someone who contracted oral gonorrhea (at first she thought it was a bad sore throat) and passed it to a guy who contracted genital gonorrhea.
[+] stevula|9 years ago|reply
Yes, oral-genital transmission (and vice versa) is common. It can even infect the mucous membranes of the eye in some cases.
[+] siscia|9 years ago|reply
Maybe I am saying something completely out of the world.

But when bacteria become too dangerous why we don't simply vaccinate against them?

[+] cfontes|9 years ago|reply
Vaccines are expensive to research and require a very long period of trials before being release to the public, while this happens people will die by the millions without antibiotics.

Also because bacteria can mutate making your vaccine useless, so you need to research again.

[+] vibrio|9 years ago|reply
sure. did you get your flu vaccine last year? will you get another next year, and the year after? You should, but there is a limit to the number of the vaccines that are feasible either scientifically, clinically, or economically.
[+] alanh|9 years ago|reply
And there are still those who deny evolution…
[+] milesf|9 years ago|reply
Here's a novel thought: Monogamy. Wait to have sex until you're married, then have only one sexual partner your entire life. That'll deal with the problem, and every other sexually transmitted disease out there.

It's almost too simple to work, but I've heard that over time - thousands of years in fact - it is a strategy humans have used to build not just safe sex, but many other benefits as well http://www.theglobeandmail.com/life/relationships/the-power-...

[+] SwellJoe|9 years ago|reply
No, thank you.

That is not a novel thought. It is as old as religion.

Abstinence based sex education has been shown to be ineffective, leading to greater pregnancy and STI transmission. Evidence says your idea won't help. And, well, it's also boring. I'll take my chances with responsible non-monogamy.

[+] DINKDINK|9 years ago|reply
A bit impracticle given real world data shows that "About 60 percent of men and 40 percent of women will have an affair at some point in some marriage "Monogamy Myth", Therapist Peggy Vaugn"

aka ~50% of couples who think they are monogamous are actually non monogamous (non consensually)

[+] sk5t|9 years ago|reply
Is drug abuse a problem in your country? Maybe you should try banning them, with harsh penalties for offenders. Easy!
[+] ksenzee|9 years ago|reply
Nobody ever cheats on their spouse, so this is guaranteed to work.
[+] Maskawanian|9 years ago|reply
And then you find that you are sexually incompatible with the person you married.
[+] Kenji|9 years ago|reply
If officials from the U.N. or from the WHO warn about something, I sleep particularly well at night, knowing that it's probably blown out of proportion by several orders or magnitude. Remember the bird flu? My employer at the time bought truckloads of sanitizers, plastic bins and related stuff. A complete waste of money. These people have lost every last shred of credibility for me.
[+] notadoc|9 years ago|reply
You understand the point of warnings is for action to be taken to hopefully prevent a further problem, right?

Have street "Stop" signs lost their credibility with you too?

[+] Fomite|9 years ago|reply
The WHO are also the people who eradicated smallpox.