Common STD Grows Resistant to Treatment in North America

BIV

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The most commonly acquired sexually transmitted infections (STIs) in the U.S., chlamydia and gonorrhea, are usually cleared out swiftly and easily with a dose of oral antibiotics. But one of these infections is growing bold and finding ways to evade treatment.

More than 321,000 cases of gonorrhea are reported each year in the U.S. alone--and the actual number of annual infections is probably much higher because many people do not experience symptoms. The infection has lost much of its social stigma since antibiotics were enlisted to fight it off earlier last century. But left untreated today, it can still cause pelvic inflammation, severe pregnancy complications and female infertility. Its presence increases the odds of an infection with HIV, and babies born to women with untreated gonorrhea are at risk of blindness.

Although antibiotics have reduced this infection to little more than a modern-day inconvenience for most, the bacterium (Neisseria gonorrhoeae) has been steadily evolving to knock out medical weapons. Sulfonamides ceased to be effective in treating it in the 1940s; penicillins and tetracyclines lost effectiveness in the 1970s and '80s; and fluoroquinolones were taken off the treatment table in 2007.

The last simple treatment, a class of antibiotics called cephalosporins, appears to be weakening against gonorrhea infections worldwide. And that drug resistance has now reached North America in sizable numbers, according to a new study, published online January 8 in JAMA, The Journal of the American Medical Association.

Resistance to the commonly prescribed oral antibiotic cefixime (a cephalosporin) was first detected several years ago in Japan. Since then, public health officials have been watching the phenomenon spread to Europe and now to North America.

For the new study, researchers led by Vanessa Allen, of Public Health Ontario, examined people who were treated for gonorrhea with cefixime at a clinic in Toronto. The clinic required people to come in for a follow-up appointment two to four weeks later to make sure their infection had been cleared; it also surveyed patients about whether they might have been exposed to the infection since their initial visit. These practices allowed the researchers to gather data on how often the drug failed to work.

Of 133 patients who received treatment and returned for their follow-up appointment for testing, 6.77 percent had failed to respond to treatment, which corresponds to about one in 15 infections. Drug-resistant gonorrhea has officially arrived in North America.

Other experts in the field call "its arrival deeply troubling; clinicians now face the emergence of cephalosporin-resistant N. gonorrhoeae without any well-studied, effective backup treatment options," observed a team of researchers led by Robert Kirkcaldy, of the Division of STD Prevention at the CDC, in an essay published in the same issue of JAMA. And, they noted, as there are no proven alternative treatment waiting in the drug development wings, " the antibiotic pipeline is running dry."

And our ability to track this spreading resistance has actually been hampered by the advent of rapid genetic screening. Traditional tests grew cultures of the bacteria in the lab, which could then be analyzed for strain variety and resistance profiles. Genetic testing, however, just detects the presence of the infection without revealing further details. A survey completed in 2007 showed that even then only about 5 percent of U.S. laboratories tested for gonorrhea via culture. And follow-up tests after treatment are not technically recommended for most cases.

The clinic used in the study might present a higher-than-average rate of gonorrhea infection in general because many of its patients are men who have had sexual encounters with other men, a population that, so far, has shown a higher rate of infections with genetic propensity to resist antibiotic treatment.

Previous research had pinpointed the presence of genes in U.S. cases that would indicate a possible resistance to cefixime. But this study was able to establish the rate at which the drug actually failed to treat the infection.

In light of growing drug-resistance worldwide, the U.S. Centers for Disease Control and Prevention (CDC) recently recommended clinicians no longer prescribe a single antibiotic treatment. Instead, they now advise that patients receive an injection of ceftriaxone as well as a week-long course of oral azithromycin or doxycycline. Kirkcaldy and his colleagues also recommend that, "all patients treated for gonorrhea should be given risk reduction counseling, offered condoms and retested for gonorrhea three months after treatment," they noted in their essay.

"Clinicians must remain vigilant for cephalosporin treatment failures and report suspected cases to the local or state health department," Kirkcaldy and his colleagues wrote. "Patients with persistent or recurrent symptoms shortly after treatment should be retested for gonorrhea by culture."

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http://news.yahoo.com/common-std-grows-resistant-treatment-north-america-220300738.html

 
Dec 8, 2004
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This is why whenever I get an infection I always ask for the oldest drug available (if it will work)... typically sulfa drugs... for that reason.
 

Creasy Bear

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The root cause of antibiotic overuse... and the resulting antibiotic-resistant diseases... is the public's utter, idiotic inability to get through their thick skulls the fact that you can't kill a virus with an antibiotic.

Don't blame the doctors... they're just beat down by the dumb whiney fucks to the point where they'll give them whatever the fuck they want just to make them go away.
 

Motor Head

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The root cause of antibiotic overuse... and the resulting antibiotic-resistant diseases... is the public's utter, idiotic inability to get through their thick skulls the fact that you can't kill a virus with an antibiotic.

Don't blame the doctors... they're just beat down by the dumb whiney fucks to the point where they'll give them whatever the fuck they want just to make them go away.
Years ago I got a puncture wound to my leg. No big deal, got a little low grade infection and it was a little warm. So I go to the doctor thinking he might want to give me an oral antibiotic. Keep in mind this was a puncture wound from a medium sized nail that went in maybe a quarter inch. Here's what happened.

1. Doctor looks at the wound, puts his finger on it and says "oh no, that's got a fever in it and the tissue is red" He determines it's likely cellulitis. He grabs another doctor, that doctor looks at it for one second and agrees.
2. I'm whisked up to a hospital room in the adjoining building. I'm giving two shots of antibiotics and told that I will need to go on a wide spectrum antibiotic and will need to wait for lab tests before I can leave the hospital.
3. An epidemeologist is called, he comes in takes a look at it. Sort of shrugs and then sits and watches the football game that was on the TV in my room. We made small talk while watching the game.
4. The wound is cleaned and they take some swabs of it for cultures.
5. IV is flowing and is systematically burning out a vein about every 18 hours for the next 4 days.
6. A reconstructive cosmetic surgeon visits me, takes a look at my wound, goes "yeah, that's not too bad" and he sits with me and watches TV for about 15 minutes.
7. 4 fucking days later, they say - Ooops, it's just a simple staph infection. The nurse says it's a common staph that everybody carries.

My insurance company is hit for over $30K. Not only did my doctor overreact he also made it a feeding frenzy for his buddies to make their Porsche payments that month.

No I don't mean to imply that Dr. ThreeHolePuncher is of the same ilk that I've dealt with here, but in the olden days when I had shitty insurance or no insurance, the doctor would have given me an oral antibiotic, told me to keep an eye on it for worsening conditions and given me a lollipop and a "good luck bro".
 

LiddyRules

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You'd imagine abortions to be easy at this point.
 

fletcher

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Years ago I got a puncture wound to my leg. No big deal, got a little low grade infection and it was a little warm. So I go to the doctor thinking he might want to give me an oral antibiotic. Keep in mind this was a puncture wound from a medium sized nail that went in maybe a quarter inch. Here's what happened.

1. Doctor looks at the wound, puts his finger on it and says "oh no, that's got a fever in it and the tissue is red" He determines it's likely cellulitis. He grabs another doctor, that doctor looks at it for one second and agrees.
2. I'm whisked up to a hospital room in the adjoining building. I'm giving two shots of antibiotics and told that I will need to go on a wide spectrum antibiotic and will need to wait for lab tests before I can leave the hospital.
3. An epidemeologist is called, he comes in takes a look at it. Sort of shrugs and then sits and watches the football game that was on the TV in my room. We made small talk while watching the game.
4. The wound is cleaned and they take some swabs of it for cultures.
5. IV is flowing and is systematically burning out a vein about every 18 hours for the next 4 days.
6. A reconstructive cosmetic surgeon visits me, takes a look at my wound, goes "yeah, that's not too bad" and he sits with me and watches TV for about 15 minutes.
7. 4 fucking days later, they say - Ooops, it's just a simple staph infection. The nurse says it's a common staph that everybody carries.

My insurance company is hit for over $30K. Not only did my doctor overreact he also made it a feeding frenzy for his buddies to make their Porsche payments that month.

No I don't mean to imply that Dr. ThreeHolePuncher is of the same ilk that I've dealt with here, but in the olden days when I had shitty insurance or no insurance, the doctor would have given me an oral antibiotic, told me to keep an eye on it for worsening conditions and given me a lollipop and a "good luck bro".
After working the better part of a decade in a medical billing office I can say that this shit happens all the fucking time. Its amazing how many PCPs want to hook a nursing home resident up with an uncovered PET scan just because. There are a shit ton of money grabbers out there wearing white coats.
 

Creasy Bear

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After working the better part of a decade in a medical billing office I can say that this shit happens all the fucking time. Its amazing how many PCPs want to hook a nursing home resident up with an uncovered PET scan just because. There are a shit ton of money grabbers out there wearing white coats.
Oh fuck yeah... nigger gotta make his porsche payments. A lot of it is defensive medicine too. My wife says she order tons of unnecessary and expensive shit just to cover her ass... CT scans, MRIs, ultrasounds, etc... just so a malpractice lawyer can't say she "withheld necessary medical care" or any such malarky.
 

CougarHunter

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Mar 2, 2006
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I don't take antibiotics, but I got a pretty nice stash from OTC sources.