Sex bug renders drugs ineffective

Scientists have found more drug-resistant cases

A superstrain of the sexually transmitted disease gonorrhoea that is resistant to current drugs is becoming increasingly common, say scientists.

Statistics from Scotland show an increasing number of patients are carrying a strain of gonorrhoea that is resistant to the quinolone drug ciprofloaxacin.

In Scotland, doctors use the drug to treat some gonorhoeal infections, including those picked up abroad.

But scientists are warning that a new first-choice drug may have to be found as the proportion of cases resistant to treatment has risen from 0.5% in 1991 to 5% in 1999.

The disease can be passed during sex

This strain of drug-resistant infection has already swept through parts of Asia - and scientists believe many of the Scottish cases may originate from that part of the world.

Gonorrhoea, a painful and unpleasant infection of the genitals and sometimes the anus, can prove fatal if untreated.

It is usually passed between partners during penetrative sex. It is possible to be infected but not see any symptoms.

If left untreated gonorrhoea can lead to pelvic inflammatory disease in women which can cause infertility or ectopic pregnancy, where the baby begins to grow in the fallopian tubes, not the womb.

In men, gonorrhoea can cause inflammation of the testicles and the prostate gland, which causes pain. Without treatment the urethra may become narrower.

Drug-resistant cases increase

Resistance to ciprofloaxacin is now a major problem in the western Pacific region and south-east Asia.

In both areas the incidence of gonorrhoea and resistance to treatment increased substantially.

In Hong Kong, ciprofloaxacin had to be withdrawn as a first line treatment because so many people were becoming resistant to the drug.

Now the strain of gonorrhoea has become more common here, picked up by travellers and as the bacteria mutates to fight the treatment.

Scientists reviewed data from 4,415 episodes of gonorrhoeal infection between 1991 and 1999, and found the number of drug-resistant cases rose by 4.5%.

Potential timebomb

Dr Hugh Young, director of the Scottish Neisseria Gonorrhoeae Reference Laboratory, which monitors the disease in Scotland, warned: "If ciprofloaxacin resistance continues to increase at the present rate there is a real danger that resistant isolates (samples) will become endemic and quinolenes might not be suitable as first-line treatment of gonorrhoea for very much longer.

"If it continues to increase at the same rate, in a couple of years we could have a problem."

He added it was essential to continue monitoring trends in Scotland so doctors should continue using ciprofloaxacin.

Miss Iona Martin, a researcher at London's Imperial College School of Medicine, department of infectious diseases & microbiology, said ciprofloaxacin was a first-line treatment in around 50% of gonorrhoea cases across the UK.

She added: "Bacteria are clever. They evolve themselves to become resistant to drugs."

Miss Martin is part of a research team monitoring the incidence of gonorrhoea in London. This year they reported a 20% increase in cases.

The research is published in The Lancet.