Drug-resistant gonorrhea is increasingly common worldwide, complicating the sexually transmitted infection’s (STI) treatment and in three identified cases making it impossible to treat with all available antibiotics, MedPage Today reports. In response, the World Health Organization (WHO) has issued a call to observe various measures to impede the development and spread of drug-resistant gonorrhea.

In September 2016, the Centers for Disease Control and Prevention (CDC) stepped up its own warnings about drug-resistant gonorrhea in the United States after health officials identified a highly drug-resistant cluster of gonorrhea infections in Hawaii. All those cases ultimately proved treatable, but their emergence, following numerous other warning signs in recent years, indicated an increasing likelihood that untreatable gonorrhea might begin to circulate in the near future.

The only recommended treatment for gonorrhea is dual therapy with a single shot of ceftriaxone plus oral azithromycin or doxycycline. Gonorrhea has developed resistance to all previous antibiotics used to treat the STI, including the classes of sulphonamides, penicillins, tetracyclines, macrolides, fluoroquinolones and early-generation cephalosporins. Scientists are developing new antibiotics for gonorrhea, but whether a new treatment will hit the market in time to ward off the spread of otherwise untreatable gonorrhea is an open question.

Taking the pulse of global drug-resistant gonorrhea development, WHO researchers recently analyzed global surveillance of the STI from 77 countries with available data, spanning 2009 to 2014. They published their findings in PLOS Medicine.

Sixty-six percent of the nations reported cases of gonorrhea that had decreased sensitivity to the class of antibiotics known as cephalosporins, which includes ceftriaxone. Seventy-two nations monitored ciprofloxacin resistance while 58 monitored azithromycin resistance, with a respective 97 percent and 81 percent reporting having identified cases of gonorrhea resistant to those antibiotics.

WHO officials believe that these figures underestimate the severity of the status quo with regard to drug-resistant gonorrhea because the data are culled from high-income nations that have more reliable surveillance and reporting systems in place. Lower-income nations lack such proper systems, have a high incidence of gonorrhea and, critically, are more likely to treat the infection with ill-advised antibiotics.

Drug-resistant gonorrhea is typically treatable with higher doses of antibiotics. However, three infections identified in Japan, France and Spain withstood such intense treatment and appeared untreatable.

Recent evidence has suggested that a meningitis vaccine might hold promise as the basis for research into a gonorrhea vaccine.

To read the study abstract, click here.