Super gonorrhoea: Experts warn drug-resistant strain of the STI could pose 'major global threat'

Man holding his crotch with a burning red colour
Experts are concerned the super strain could pose a serious threat if it continues to be transmitted. Photo credit: Getty Images

A super strain of the sexually transmitted infection (STI) gonorrhoea could potentially pose a "major global threat", scientists are warning, following the news that an Austrian man contracted a drug-resistant variety of the bacterial infection in Cambodia. 

The unidentified man, aged in his 50s, reportedly became infected after engaging in unprotected sexual intercourse with a sex worker while holidaying in the south-east Asian nation in April. 

As reported by the Daily Mail, the man began experiencing a burning pain during urination and discharge from his penis after returning home to Austria, a landlocked country in the southern part of Central Europe.

It's understood the man was diagnosed with gonorrhoea after seeking treatment and was prescribed standard antibiotics - however, while the drug cleared up his symptoms, he continued to test positive for the infection.

Doctors have since called his strain "extensively drug resistant" and different to previously diagnosed variations, noting it could effectively render the infection untreatable if it continues to spread, the Daily Mail reports.

In a case report on the super strain, published in the medical journal Eurosurveillance on June 16, lead author Dr Sonja Pleininger of the Austrian Agency for Health and Food Safety said such variations "pose a major global public health threat".

"If such strains manage to establish a sustained transmission, many gonorrhoea cases might become untreatable," she continued. 

New medications targeting the bacteria, alongside the creation of an effective vaccine, are crucial to limiting the impact of drug-resistant strains, the authors added. 

The report noted the man was eventually treated with a week-long course of amoxicillin/clavulanic acid, also known as co-amoxiclav or amox-clav - an antibiotic medication used for the treatment of a number of bacterial infections. He later tested negative for the STI.

According to the case report, the Cambodian sex worker was unable to be traced - meaning others could be currently carrying - and transmitting - the drug-resistant strain.

Gonorrhoea is an infection caused by a sexually transmitted bacterium that infects both males and females. Gonorrhoea most often affects the urethra, rectum or throat. In females, gonorrhoea can also infect the cervix. Gonorrhea is most commonly spread during vaginal, oral or anal sex.

According to the New Zealand Sexual Health Society, symptoms can include vaginal or urethral discharge, lower abdominal or testicular pain, abnormal bleeding, swelling and dysuria, or painful urination.

As per a report by the Institute of Environmental Science and Research (ESR) released earlier this month, reported cases of syphilis, gonorrhoea and chlamydia have slightly declined in New Zealand. However, Māori, Pacific peoples, young people and men who have sex with men (MSM) continue to be disproportionately affected with significantly higher rates of STIs.

In the 12 months to September 30, 2021, there was a decrease in cases of gonorrhoea across Aotearoa with 139 reported infections per 100,000. Gonorrhoea is most commonly reported in MSM aged 20 to 29, however ESR also found rates of the infection are consistently higher among Māori and Pacific peoples.

If untreated, the STI can lead to serious complications including infertility and potentially life-threatening pelvic inflammatory disease in women. In pregnant women, it can also cause permanent blindness in newborns.

Although most strains are still treatable, super strains have continued to crop up over recent years. Cases of a type of gonorrhoea resistant to ceftriaxone have been rising in the Asia-Pacific region and in February, British health authorities warned they had detected four genetically similar cases in the previous few months.

Gonorrhoea has been gathering resistance to a number of antibiotics over the past few decades, a phenomena called antimicrobial resistance. Although British doctors formerly prescribed the antibiotic ciprofloxacin, the drug was no longer recommended as of 2005 due to the bacteria resisting the treatment. Another antibiotic, cefixime, was also dropped in 2011 for the same reason.

As per the report, the strain the Austrian man tested positive for had resisted azithromycin, one of the two frontline antibiotics used to treat gonorrhoea in Europe. It was also resistant to ceftriaxone as well as cefixime, cefotaxime, ciprofloxacin and tetracycline, a series of other antibiotics used to fight the infection.

In 2018, experts warned a historically resistant strain of the STI was almost guaranteed to begin circulating in New Zealand after it was detected in south-east Asia, the United Kingdom and Australia.

And in July 2017, at least three people worldwide were diagnosed with untreatable "superbug" strains of gonorrhoea, which they were likely transmitting to others through sexual intercourse, the World Health Organization (WHO) said at the time.