Drug-Resistant STD (Gonorrhea)

[exlurker]

A reminder -- and another reason -- to be careful, please:

http://www.washingtonpost.com/wp-dyn...041201497.html

Excerpts from article:

Thursday, April 12, 2007
Antibiotic-resistant gonorrhea is spreading rapidly across the United States, federal health officials reported today, raising alarm about doctors' ability to treat the common sexually transmitted infection.
New data from 26 U.S. cities found the number of resistant gonorrhea cases is rising dramatically, jumping from less than 1 percent of all gonorrhea cases to more than 13 percent in less than five years, the Centers for Disease Control and Prevention reported.
The spread of resistant gonorrhea prompted the CDC to advise doctors to immediately stop using Cipro and other antibiotics in its class, which have been the first line of defense against gonorrhea, and resort to an older class of drugs to ensure patients are cured and do not spread the stubborn infection.
"We've lost the ability to use what had been the most reliable class of antibiotics," said John M. Douglas Jr., who heads the CDC's division of sexually transmitted diseases prevention. "This is necessary to protect both public and private health."
. . . "Gonorrhea has now joined the list of other superbugs for which treatment options have become dangerously few," said Henry Masur, president of the Infectious Disease Society of America.
Gonorrhea's resistance was probably caused by the same problem that led to resistance of other organisms -- the casual use of antibiotics in the United States and overseas, which cause pathogens to mutate, Douglas and others said.
Resistant strains of the bacteria that cause gonorrhea were first detected in Asia. Resistant gonorrhea then apparently spread to Hawaii and California, before emerging elsewhere around the United States . . . . The resistance appears to be widespread around the country, with particularly sharp increases occurring in some cities. In Philadelphia, the rate jumped from 1.2 to 26.6 percent. In Miami, it increased from 2.1 to 15.3 percent. . . .
The news comes as the rate of new gonorrhea infections has started rising in some Western states. . . .

[AlethiaSi]

I heard about this today on the radio.... pretty scary isn't it?

[texas*princess]

yikes... that's scary!

[UGAalum94]

I was reading about this yesterday.

I've got a science/health question, but I may have so angered AKAMonet that she may never speak to me again after the thread about naming kids.

I think the stat. in the story was that one in four of the cases no longer response to the old drug that we'd been using from the 1980s. So doctors are being directed to use a new treatment.


Why don't we still use the drug that does work for 75% of the people, and only go to the new drug in the cases of people from whom the first drug didn't work?

Is the problem with using the same medicine that works for three fourths of the people that is somehow "helps" develop more drug resistant strains? How?

[AKA_Monet]

Originally Posted by Alphagamuga

I was reading about this yesterday.

I've got a science/health question, but I may have so angered AKAMonet that she may never speak to me again after the thread about naming kids.

I think the stat. in the story was that one in four of the cases no longer response to the old drug that we'd been using from the 1980s. So doctors are being directed to use a new treatment.


Why don't we still use the drug that does work for 75% of the people, and only go to the new drug in the cases of people from whom the first drug didn't work?

Is the problem with using the same medicine that works for three fourths of the people that is somehow "helps" develop more drug resistant strains? How?

A Dr. always remains objective and does not take disagreements personally... Physicians have to do residency and rounds where they get "immunized" to being demeaned by Chief Residents. Wherease, Ph.D.'s, like me, in graduate school are contantly bombarded with being defacated on with experimental logic by professors and other scientists. You should see the stuff is top tiered journals and how Nobel Laureates clown other scientists. So, I get over it if I start taking things personally-takes me awhile, but I do get over it.

To answer your question, that is exactly what they do. There is a first line of treatment. If that doesn't work, then they give a second line of treatment. What is in the "arsenal" is the the last line of treatment which is "vancomycin". If that doesn't work, then you are pretty much assed out...

As to why a bug becomes resistant to all the drugs is under intense research scrutiny. But since last year's congress as well as the President cut the NIH budget in half, then not too much research is happening in that field. Hayle, for bioterrorism it is, but that's thru the defense department. So, no, they are not going to find cures for dangerous diseases. It's kinna like "V for Vendetta"...

Anyhow, as I understand it, a bug changes "virulence" because of genetic adaptation, I think. Most bacteria (as well as viruses) have a high rate of mutation. Eventually, it gets to the genes that control virulence and resistance. Once they become mutated, the bug changes "behavior" and the antibiotic no longer works. The general mechanisms where I got my Master's of Molecular Biology was through a "Multi Drug Resistance" and "pumping out of the bug". Others are changing the Operator of the Origin of Replication. But I have not kept up with that literature in a long time.

[neosoul]

hey AKA_Monet, Vancomycin is the strongest antibiotic out there isn't?

[Rudey]

Originally Posted by neosoul

hey AKA_Monet, Vancomycin is the strongest antibiotic out there isn't?

If you've got this drug resistant std, stand next to a microwave and repeatedly blast your genitals on "high".

-Rudey

[UGAalum94]

Originally Posted by AKA_Monet

A Dr. always remains objective and does not take disagreements personally... Physicians have to do residency and rounds where they get "immunized" to being demeaned by Chief Residents. Wherease, Ph.D.'s, like me, in graduate school are contantly bombarded with being defacated on with experimental logic by professors and other scientists. You should see the stuff is top tiered journals and how Nobel Laureates clown other scientists. So, I get over it if I start taking things personally-takes me awhile, but I do get over it.

To answer your question, that is exactly what they do. There is a first line of treatment. If that doesn't work, then they give a second line of treatment. What is in the "arsenal" is the the last line of treatment which is "vancomycin". If that doesn't work, then you are pretty much assed out...

As to why a bug becomes resistant to all the drugs is under intense research scrutiny. But since last year's congress as well as the President cut the NIH budget in half, then not too much research is happening in that field. Hayle, for bioterrorism it is, but that's thru the defense department. So, no, they are not going to find cures for dangerous diseases. It's kinna like "V for Vendetta"...

Anyhow, as I understand it, a bug changes "virulence" because of genetic adaptation, I think. Most bacteria (as well as viruses) have a high rate of mutation. Eventually, it gets to the genes that control virulence and resistance. Once they become mutated, the bug changes "behavior" and the antibiotic no longer works. The general mechanisms where I got my Master's of Molecular Biology was through a "Multi Drug Resistance" and "pumping out of the bug". Others are changing the Operator of the Origin of Replication. But I have not kept up with that literature in a long time.

Thank you both for your detailed answer and your generosity of spirit towards disagreement.

I must have misread the original article I was looking at. I got the impression that they were recommending a switch for all treatment to a new and different drug, not just an additional step.

[AKA_Monet]

Originally Posted by neosoul

hey AKA_Monet, Vancomycin is the strongest antibiotic out there isn't?

Yes, for now it is. I think in the next few years, there will be newer ones out. Part of the evolution of drugs.

[AKA_Monet]

Originally Posted by Alphagamuga

I must have misread the original article I was looking at. I got the impression that they were recommending a switch for all treatment to a new and different drug, not just an additional step.

The way I understand it they doctors give the 1st level antibiotic, like penicillan, because if that kills the bug then do not need to worry about resistance. They want to use the low level drugs because the mutation rate is so rapid when a bug becomes resistant.