Jun 2, 2018, 02:16 AM by System

Data from 77 countries show that antibiotic resistance is making gonorrhoea – a common sexually-transmitted infection – much harder, and sometimes impossible, to treat.

"The bacteria that cause gonorrhoea are particularly smart. Every time we use a new class of antibiotics to treat the infection, the bacteria evolve to resist them," said Dr Teodora Wi, Medical Officer, Human Reproduction, at WHO.

WHO reports widespread resistance to older and cheaper antibiotics. Some countries – particularly high-income ones, where surveillance is best – are finding cases of the infection that are untreatable by all known antibiotics.

"These cases may just be the tip of the iceberg, since systems to diagnose and report untreatable infections are lacking in lower-income countries where gonorrhoea is actually more common," adds Dr Wi.

Each year, an estimated 78 million people are infected with gonorrhoea*. Gonorrhoea can infect the genitals, rectum, and throat. Complications of gonorrhoea disproportionally affect women, including pelvic inflammatory disease, ectopic pregnancy and infertility, as well as an increased risk of HIV.

Decreasing condom use, increased urbanization and travel, poor infection detection rates, and inadequate or failed treatment all contribute to this increase.

Monitoring drug resistance

The WHO Global Gonococcal Antimicrobial Surveillance Programme (WHO GASP), monitors trends in drug-resistant gonorrhoea. WHO GASP data from 2009 to 2014 find widespread resistance to ciprofloxacin [97% of countries that reported data in that period found drug-resistant strains], increasing resistance to azithromycin [81%], and the emergence of resistance to the current last-resort treatment: the extended-spectrum cephalosporins (ESCs) oral cefixime or injectable ceftriaxone [66%].

Currently, in most countries, ESCs are the only single antibiotic that remain effective for treating gonorrhoea. But resistance to cefixime – and more rarely to ceftriaxone – has now been reported in more than 50 countries. As a result, WHO issued updated global treatment recommendations in 2016 advising doctors to give 2 antibiotics: ceftriaxone and azithromycin.

Development of new drugs

The R&D pipeline for gonorrhoea is relatively empty, with only 3 new candidate drugs in various stages of clinical development: solithromycin, for which a phase III trial has recently been completed; zoliflodacin, which has completed a phase II trial; and gepotidacin, which has also completed a phase II trial.

The development of new antibiotics is not very attractive for commercial pharmaceutical companies. Treatments are taken only for short periods of time (unlike medicines for chronic diseases) and they become less effective as resistance develops, meaning that the supply of new drugs constantly needs to be replenished.

The Drugs for Neglected Diseases initiative (DNDi) and WHO have launched the Global Antibiotic Research and Development Partnership (GARDP), a not-for-profit research and development organization, hosted by DNDi, to address this issue. GARDP’s mission is to develop new antibiotic treatments and promote appropriate use, so that they remain effective for as long as possible, while ensuring access for all in need. One of GARDP’s key priorities is the development of new antibiotic treatments for gonorrhoea.

"To address the pressing need for new treatments for gonorrhoea, we urgently need to seize the opportunities we have with existing drugs and candidates in the pipeline. In the short term, we aim to accelerate the development and introduction of at least one of these pipeline drugs, and will evaluate the possible development of combination treatments for public health use," said Dr Manica Balasegaram, GARDP Director. "Any new treatment developed should be accessible to everyone who needs it, while ensuring it’s used appropriately, so that drug resistance is slowed as much as possible."

Gonorrhoea prevention

Gonorrhoea can be prevented through safer sexual behaviour, in particular consistent and correct condom use. Information, education, and communication can promote and enable safer sex practices, improve people’s ability to recognize the symptoms of gonorrhoea and other sexually transmitted infections, and increase the likelihood they will seek care. Today, lack of public awareness, lack of training of health workers, and stigma around sexually transmitted infections remain barriers to greater and more effective use of these interventions.

There are no affordable, rapid, point-of-care diagnostic tests for gonorrhoea. Many people who are infected with gonorrhoea do not have any symptoms, so they go undiagnosed and untreated. On the other hand, however, when patients do have symptoms, such as discharge from the urethra or the vagina, doctors often assume it is gonorrhoea and prescribe antibiotics – even though people may be suffering from another kind of infection. The overall inappropriate use of antibiotics increases the development of antibiotic resistance in gonorrhoea as well as other bacterial diseases.

“To control gonorrhoea, we need new tools and systems for better prevention, treatment, earlier diagnosis, and more complete tracking and reporting of new infections, antibiotic use, resistance and treatment failures,” said Dr Marc Sprenger, Director of Antimicrobial Resistance at WHO. “Specifically, we need new antibiotics, as well as rapid, accurate, point-of-care diagnostic tests – ideally, ones that can predict which antibiotics will work on that particular infection – and longer term, a vaccine to prevent gonorrhoea.”

Notes to editors

This press release is based on two papers included in a special supplement of PLOS Medicine to be published just before the STI & HIV World Congress (http://www.stihivrio2017.com) taking place in Rio de Janeiro, Brazil, 9–12 July 2017:

At the STI & HIV World Congress, WHO will host a session on “Tackling antimicrobial resistance in Neisseria gonorrhoeae: Need for a comprehensive and collaborative approach”.

More about gonorrhoea

* Each year, an estimated 35.2 million people are infected in the WHO Western Pacific Region, 11.4 million people in the WHO South-East Asian Region, 11.4 million in the WHO African Region, 11.0 million in the WHO Region of the Americas, 4.7 million in the WHO European Region and 4.5 million in the WHO Eastern Mediterranean Region.</s>Consistent and correct condom use can prevent gonorrhoea. Shutterstock The World Health Organization has warned that cases of untreatable, antibiotic-resistant gonorrhoea are on the rise due to unsafe oral sex and a decline in condom use.

Data from 77 countries showed that when someone contracts the common sexually-transmitted infection — which infects roughly 78 million people each year — it is now "much harder, and sometimes impossible, to treat," according to the WHO. This is because it is rapidly developing a resistance to available antibiotics.

This is because the infection is rapidly developing a resistance to antibiotics.

Gonorrhoea is spread by unprotected vaginal, oral, and anal sex. It can infect the genitals, rectum, and throat. The BBC reported that the WHO is most concerned about the throat, stating that "thrusting gonorrhoea bacteria into this environment through oral sex can lead to super-gonorrhoea," the untreatable form of the disease.

Complications disproportionally affect women, according to WHO, including "pelvic inflammatory disease, ectopic pregnancy and infertility, as well as an increased risk of HIV." "The bacteria that cause gonorrhoea are particularly smart," said Dr Teodora Wi, a medical officer in human reproduction at WHO.

The rise in the infection is due to "decreasing condom use, increased urbanisation and travel, poor infection detection rates, and inadequate or failed treatment all contribute to this increase," according to WHO.

It added that there are no "affordable, rapid, point-of-care diagnostic tests for gonorrhoea," and since many people infected do not have symptoms, cases often go undiagnosed and untreated.

Two papers, set to be published before the STI & HIV World Congress in Rio from July 9 to 12, will show that while in many instances the resistance is to older and cheaper antibiotics, in some countries cases of the infection are untreatable by all known antibiotics.

"These cases may just be the tip of the iceberg, since systems to diagnose and report untreatable infections are lacking in lower-income countries where gonorrhoea is actually more common," WHO said.

In most countries, there is only a single antibiotic that remains effective for treating gonorrhoea, but resistance to it now been reported by the WHO in more than 50 countries.

The quest for new antibiotic treatment

According to the BBC, the outlook is "fairly grim" with only three new candidate drugs "in various stages of clinical development." The WHO said the development of new antibiotics is "not very attractive for commercial pharmaceutical companies" because they are taken for short periods, become less effective as resistance develops, and constantly need replenishing.

In order to address the issue, the WHO and The Drugs for Neglected Diseases initiative (DNDi) have launched a Global Antibiotic Research and Development Partnership (GARDP), a not-for-profit research and development organisation with a mission of "developing new antibiotic treatments and promoting appropriate use while ensuring access for all in need."

Dr Manica Balasegaram, GARDP director, said: "To address the pressing need for new treatments for gonorrhoea, we urgently need to seize the opportunities we have with existing drugs and candidates in the pipeline.

"In the short term, we aim to accelerate the development and introduction of at least one of these pipeline drugs, and will evaluate the possible development of combination treatments for public health use."

The WHO added: "Today, lack of public awareness, lack of training of health workers, and stigma around sexually transmitted infections remain barriers to greater and more effective use of these interventions."

The organisation added that the infection can be prevented through "safer sexual behaviour, in particular, consistent and correct condom use."</s>Analysis of data from 77 countries by the World Health Organization (WHO) found antibiotic resistance exists against almost all antibiotics currently used to treat the sexually transmitted infection (STI) gonorrhoea.

In the past, gonorrhoea infections were treated effectively with a one-off dose of antibiotics.

Nowadays, gonorrhoea needs to be treated with both an antibiotic injection and a dose of antibiotic tablets.

And increased resistance to antibiotics, coupled with a lack of new treatments in the pipeline, raises concerns that the infection could be untreatable in the future.

This is concerning, as untreated gonorrhoea in women can cause complications that can lead to infertility and miscarriage.

In this study, a WHO group outlined a new strategy to support the research and development of new treatments for gonorrhoea. Preventing the spread of the STI is also of paramount importance.

Gonorrhoea is the second most common STI in the UK.

It's caused by the bacteria Neisseria gonorrhoeae, and can be transmitted easily through unprotected vaginal, oral or anal sex, infecting the genitals, back passage, and sometimes the eyes or throat.

Usual symptoms include an abnormal discharge from the vagina or penis, pain when passing urine, and bleeding in between periods in women.

Treatment involves an antibiotic injection and a single dose of antibiotic tablets.

But many people get no symptoms, so gonorrhoea can go unnoticed and untreated, which can lead to serious complications.

Around 10-20% of women can get pelvic inflammatory disease from gonorrhoea, which can then affect their fertility.

Gonorrhoea in pregnancy can also be transmitted to the infant, which can lead to newborn conjunctivitis and even threaten a baby's eyesight.

Where did the study come from?

The study was produced by the WHO Global Gonococcal Antimicrobial Surveillance Programme (WHO GASP), a group of researchers responsible for monitoring trends in drug-resistant gonorrhoea.

What is the new evidence?

The group analysed data from 77 countries, and found there is increasing resistance to all the drugs currently used to treat gonorrhoea – to both the first-choice antibiotic, and to the second-choice antibiotic used when the first one fails.

Bacteria have the ability to respond and adapt to antibiotics, with the potential to become effectively immune to the antibiotic's effects.

Even more worryingly, they can develop resistance to many different antibiotics, which now seems to be the case for the bacteria that causes gonorrhoea.

There also aren't many drugs currently being developed for the treatment of gonorrhoea. This raises the concern that the spread of drug-resistant gonorrhoea could outpace the development of new drugs, and may even result in doctors not being able to treat the STI.

In order to address this, the Global Antibiotic Research and Development Partnership (GARDP) initiative was launched in 2016 by the World Health Organization and Drugs for Neglected Disease (DNDi).

GARDP is a not-for-profit research organisation that sets up programmes around the world that aim to develop short- and long-term treatments for STIs, among other things.

As part of their initiative to improve research and development for new treatments for gonorrhoea, GARDP convened a panel of international experts from various institutions in different regions, including India, South Africa and China.

Together, they have outlined a research and development strategy that could help target the development of new treatments for gonorrhoea.

GARDP seeks to work with various experts to bring one new treatment for gonorrhoea to the market by 2023.

This is discussed in the research and development strategy, which outlines four components.
• component 1: accelerate the development of a new chemical entity
• component 2: evaluate the potential of existing antibiotics and their combinations
• component 4: support the development of simplified treatment guidelines and foster conservation

Explained simply, this means that GARDP hopes to:
• Accelerate the development and registration of new molecules and drugs for the treatment of gonorrhoea, particularly those in the later stages of clinical trials that may be close to entering the market.
• Conduct further research through randomised controlled trials to test whether the drugs currently used have the ability to treat gonorrhoea effectively. The drugs will be tested in populations with high numbers of sexually transmitted infections, as well as countries known to have various forms of antibiotic resistance.
• Explore the use of combinations of antibiotics in fixed doses, which will help reduce costs and hopefully lead to more people taking the drugs as prescribed.
• Support the development of evidence-based guidelines to ensure any new treatments are globally accessible, but mainly to make sure they're used and prescribed in an appropriate manner to reduce the emergence of more antimicrobial resistance to the drugs – it would be counterproductive to produce a new antibiotic to which gonorrhoea then becomes resistant.

The increase in antimicrobial resistance towards drugs used to treat gonorrhoea is reaching a critical stage, especially given how common the infection is worldwide, with an estimated 78 million new cases in 2012.

This study raises concerns around an important topic while also proposing strategies to help address the slow pace of research and development of new drugs.

The prevention of gonorrhoea is equally, if not more, important. The most effective way to prevent gonorrhoea is to always use a condom during sex, including anal and oral sex.

Read more advice about sexually transmitted infections and how to prevent them.</s>LONDON, (Reuters) - - At least three people worldwide are infected with totally untreatable "superbug" strains of gonorrhoea which they are likely to be spreading to others through sex, the World Health Organization (WHO) said on Friday.

Giving details of studies showing a "very serious situation" with regard to highly drug-resistant forms of the sexually-transmitted disease (STD), WHO experts said it was "only a matter of time" before last-resort gonorrhoea antibiotics would be of no use.

"Gonorrhoea is a very smart bug," said Teodora Wi, a human reproduction specialist at the Geneva-based U.N. health agency.

"Every time you introduce a new type of antibiotic to treat it, this bug develops resistance to it."

The WHO estimates 78 million people a year get gonorrhoea, an STD that can infect the genitals, rectum and throat.

The infection, which in many cases has no symptoms on its own, can lead to pelvic inflammatory disease, ectopic pregnancy and infertility, as well as increasing the risk of getting HIV.

Wi, who gave details in a telephone briefing of two studies on gonorrhoea published in the journal PLOS Medicine, said one had documented three specific cases - one each in Japan, France and Spain - of patients with strains of gonorrhoea against which no known antibiotic is effective.

"These are cases that can infect others. It can be transmitted," she told reporters. "And these cases may just be the tip of the iceberg, since systems to diagnose and report untreatable infections are lacking in lower-income countries where gonorrhoea is actually more common."

The WHO's programme for monitoring trends in drug-resistant gonorrhoea found in a study that from 2009 to 2014 there was widespread resistance to the first-line medicine ciprofloxacin, increasing resistance to another antibiotic drugs called azithromycin, and the emergence of resistance to last-resort treatments known as extended-spectrum cephalosporins (ESCs).

In most countries, it said, ESCs are now the only single antibiotics that remain effective for treating gonorrhoea. Yet resistance to them has already been reported in 50 countries.

Manica Balasegaram, director of the Global Antibiotic Research and Development Partnership, said the situation was "grim" and there was a "pressing need" for new medicines.

The pipeline, however, is very thin, with only three potential new gonorrhoea drugs in development and no guarantee any will prove effective in final-stage trials, he said.

"We urgently need to seize the opportunities we have with existing drugs and candidates in the pipeline," he told reporters. "Any new treatment developed should be accessible to everyone who needs it, while ensuring it is used appropriately, so that drug resistance is slowed as much as possible."</s>Describing it as a “serious situation,” the World Health Organization has issued a grim warning about the dramatic rise of antibiotic resistant gonorrhoea around the world. The agency is now calling for the quick development of drugs to treat the sexually transmitted disease.

Data collected from nearly 80 countries shows that antibiotic resistance is making gonorrhoea much tougher, and at times impossible, to treat. The disease is becoming increasingly immune to older and cheaper antibiotics, and treatment-resistant strains are now appearing even in countries where monitoring practices are top notch. WHO, with help from a global team of researchers, is set to release these findings in a special edition of PLoS Medicine prior to the STI & HIV World Congress that will be held in Rio from July 9-12.

“The bacteria that cause gonorrhoea are particularly smart,” said WHO medical officer Teodora Wi in a statement. “Every time we use a new class of antibiotics to treat the infection, the bacteria evolve to resist them.”

Each year, the sexually transmitted disease afflicts an estimated 78 million people worldwide. Gonorrhoea is caused by the Neisseria gonorrhoeae bacterium, and it infects both men and women. Symptoms include a greenish yellow or whitish discharge from the penis and vagina, burning while urinating, swollen glands in the throat (due to oral sex), and other unpleasant manifestations. The disease is particularly tough on women, and it’s frequently accompanied by pelvic inflammatory disease, infertility, ectopic pregnancy (when the fetus develops outside the uterus), and an increased risk of contracting HIV. WHO says the disease is spreading on account of decreased condom use, increased urbanisation and travel, poor detection measures, and inadequate or failed treatments.

Data collected by WHO from 2009 to 2014 shows widespread resistance to the commonly used antibiotics ciprofloxacin and azithromycin, along with emerging resistance to the current last-resort treatment involving injectable ceftriaxone. Superbugs that couldn’t be treated with the last line of defence have been reported in France, Japan, and Spain. The agency is now advising doctors to prescribe a double-whammy treatment involving both azithromycin and ceftriaxone. This is a rather grim prescription, given that azithromycin-resistant gonorrhoea is now being reported in 81 per cent of countries, and ceftriaxone-resistant gonorrhoea has taken root in 66 per cent of countries. Ultimately, WHO says we need to develop a vaccine, because gonorrhoea will always remain a step ahead of our efforts to curb it with antibiotics.

WHO is also calling for the rapid development of new drugs to treat the disease. Disturbingly, the research and development pipeline for gonorrhoea is relatively empty, with only three new candidate drugs currently in clinical development, according to WHO. Part of the problem has to do with Big Pharma’s reluctance to develop drugs that treat gonorrhoea, which are only taken for short periods of time (unlike meds for chronic diseases), and become less effective over time as resistance develops.

“To address the pressing need for new treatments for gonorrhoea, we urgently need to seize the opportunities we have with existing drugs and candidates in the pipeline,” said Manica Balasegaram, who directs the not-for-profit Global Antibiotic Research and Development Partnership (GARDP). “In the short term, we aim to accelerate the development and introduction of at least one of these pipeline drugs, and will evaluate the possible development of combination treatments for public health use. Any new treatment developed should be accessible to everyone who needs it, while ensuring it’s used appropriately, so that drug resistance is slowed as much as possible.”

In addition to developing new drugs and re-evaluating existing antibiotics, WHO says it’s critical to develop treatments that are easier to administer, and produce more simplified treatment guidelines.

This latest development is another discouraging reminder that our antibiotics are failing. Last year, the Institute and Faculty of Actuaries in Britain claimed that a new era of antimicrobial resistance is already upon us, and that 50,000 people are already dying each year in the US and Europe from untreatable infections. Should nothing be done to offset this trend, as many as 10 million people could die each year by the mid-point of the 21st century, making antimicrobial resistance more deadly than cancer.

Antibiotics that treat gonorrhoea may be failing, but there’s still a way to fight back: practise safe sex. [World Health Organization, CBC News]</s>Oral sex might be loads of fun and seemingly safer than the main practice, but it is most likely to help the spread of dangerous disease pathogens, WHO warns.

The increased incidence of this activity and the relatively quick decline in condom use is one of the main factors responsible for contracting diseases such as gonorrhoea.

And its becoming harder to treat because of the rapid development of the bacteria’s resistance to antibiotics, with experts said the situation was “fairly grim” with few new drugs on the horizon.

With about 78 million people pick up the STI each year and its potential to cause infertility in severe cases, the data analysed by the World Health Organization from 77 countries indicates that gonorrhoea’s resistance to antibiotics was widespread.

Dr Teodora Wi, from the WHO, said there had even been three cases – in Japan, France and Spain – where the infection was completely untreatable, BBC News reports.

She said: “Gonorrhoea is a very smart bug, every time you introduce a new class of antibiotics to treat gonorrhoea, the bug becomes resistant.”

Worryingly, the vast majority of gonorrhoea infections are in poor countries where resistance is harder to detect.

“These cases may just be the tip of the iceberg,” she added.

Gonorrhoea often infect the genitals, rectum and throat, but it is the last that is most concerning health officials.

Dr Wi said antibiotics could lead to bacteria in the back of the throat, including relatives of gonorrhoea, developing resistance.

She said: “When you use antibiotics to treat infections like a normal sore throat, this mixes with the Neisseria species in your throat and this results in resistance.”

Thrusting gonorrhoea bacteria into this environment through oral sex can lead to super-gonorrhoea.”

“In the US, resistance [to an antibiotic] came from men having sex with men because of pharyngeal infection,” she added.

A decline in condom use, which had soared because of fears of HIV/Aids, is thought to help the infection spread.

Dr Manica Balasegaram, from the Global Antibiotic Research and Development Partnership, said: “The situation is fairly grim.

“There are only three drug candidates in the entire drug [development] pipeline and no guarantee any will make it out.”

But ultimately, the WHO said vaccines would be needed to stop gonorrhoea.</s>Gonorrhoea is at risk of becoming an untreatable disease, England’s chief medical officer has said.

Dame Sally Davies has written to all GPs and pharmacies to ensure they are prescribing the correct drugs after the rise of a highly drug-resistant strain of the infection.

The warning comes after a national public health alert was triggered in September by an outbreak of highly drug-resistant gonorrhoea in the north of England.



“Gonorrhoea is at risk of becoming an untreatable disease due to the continuing emergence of antimicrobial resistance,” Davies writes.

“Gonorrhoea has rapidly acquired resistance to new antibiotics, leaving few alternatives to the current recommendations. It is therefore extremely important that suboptimal treatment does not occur.” The letter is also signed by the chief pharmaceutical officer, Dr Keith Ridge.

At least 16 cases of “super-gonorrhoea” have been detected by Public Health England (PHE) since March, the British Association for Sexual Health and HIV reported in September.

The strain, which is resistant to the first-line antibiotic azithromycin, was first reported in Leeds in March and has spread, with cases reported in patients from Macclesfield, Oldham and Scunthorpe. All of the cases were reported to involve heterosexual patients, and some people have reported partners from other parts of England.

The EU’s infectious diseases monitor has been warning about the growing threat of drug-resistant gonorrhoea for some years.

Without treatment, gonorrhoea can lead to serious long-term health problems, including infertility and potentially life-threatening pelvic inflammatory disease in women. In pregnant women it can also cause permanent blindness in a newborn.

Almost 35,000 cases of gonorrhoea were reported in England last year and it is the second most common bacterial sexually transmitted infection (STI) in the UK after chlamydia. The majority of cases affect people under the age of 25.

Infected patients may experience discharge or pain while urinating, but about 10% of men and almost half of women do not suffer any symptoms. 



Research published this year suggested that some GPs are prescribing antibiotics that no longer work for people with gonorrhoea, raising the chances that drug-resistant forms will spread.

The study led by PHE, published in the journal BMJ Open, found that many GPs were still giving their patients ciprofloxacin, even though it has not been recommended for treatment since 2005.

In 2007 ciprofloxacin was on 42% of prescriptions for gonorrhoea, and even as recently as 2011 it was still prescribed in one in five cases.

Dr Andrew Lee, PHE’s consultant in communicable disease control, said: “Investigations are ongoing into a number of cases of antimicrobial resistant gonorrhoea, these are seen from time to time around the country and those affected have been effectively treated with alternative antibiotics. We know that the bacterium that cause gonorrhoea can mutate and develop new resistance, so we cannot afford to be complacent.

“Individuals can significantly reduce their risk of any STI by using condoms with all new and casual partners and getting tested regularly. Public Health England will continue to monitor, and act on, the spread of antimicrobial resistance and potential gonorrhoea treatment failures, to make sure they are identified and managed promptly.”</s>Health officials are warning about untreatable “superbug” strains of gonorrhoea that has spread to at least three people worldwide. The World Health Organization (WHO) said its likely being spread to others through sex.

“The bacteria that cause gonorrhoea are particularly smart,” Teodora Wi, a human reproduction specialist at WHO, said in a news release. “Every time we use a new class of antibiotics to treat the infection, the bacteria evolve to resist them.”

The sexually transmitted disease can infect patients’ genitals, rectum and throat, and is estimated to strike 78 million people per year. Gonorrhoea is often asymptomatic and if left untreated could cause pelvic inflammatory disease, ectopic pregnancy and infertility, as well as increased risk of HIV.

The three cases, which were detailed in the journal PLOS Medicine, were confirmed in Japan, France and Spain. No known antibiotic has been effective in treating these patients.

“These cases may just be the tip of the iceberg, since systems to diagnose and report untreatable infections are lacking in lower-income countries where gonorrhoea is actually more common,” Wi said.

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WHO analyzed data from 77 countries and reported widespread resistance to older and cheaper antibiotics, with decreasing condom use, increased urbanization and travel, poor infection detection rates and inadequate or failed treatment all contributing to an increase in instances.

“To control gonorrhoea, we need new tools and systems for better prevention, treatment, earlier diagnosis and more complete tracking and reporting of new infections, antibiotic use, resistance and treatment failures,” Dr. Marc Sprenger, director of antimicrobial resistance at WHO, said in a news release. “Specifically, we need new antibiotics, as well as rapid, accurate, point-of-care diagnostic tests – ideally, ones that can predict which antibiotics will work on that particular infection – and longer term, a vaccine to prevent gonorrhoea.”</s>Oral sex is causing the spread of a dangerous gonorrhoea superbug, experts have warned.

The untreatable strain of gonorrhoea is rapidly spreading across the world putting millions of lives at risk, the World Health Organisation has warned.

Experts said that incurable gonorrhoea has started to spread after becoming resistant to antibiotics, which has been partly caused by oral sex and a decline in condom use.

The sexually transmitted bacteria can live at the back of the throat and, because of this, has been evolve immunity to antibiotics used to treat common throat infections.

The WHO issued a warning after it confirmed that three people have died from the superbug, which spreads through sex.

Now experts from the WHO have said it is 'only a matter of time' before last-resort gonorrhoea antibiotics would be of no use at all.

'Gonorrhoea is a very smart bug,' said Teodora Wi, a human reproduction specialist at the Geneva-based U.N. health agency.

'Every time you introduce a new type of antibiotic to treat it, this bug develops resistance to it.'

She added that the rapid spread of the antibiotic resistant bacteria has been caused in part by oral sex.

'When you use antibiotics to treat infections like a normal sore throat, this mixes with the Neisseria species [gonorrhoea bacteria] in your throat and this results in resistance,' she told the BBC.

A decline in condom use is also thought to have helped the infection to spread, she added.

Dr Wi said medics have now documented three specific cases - one each in Japan, France and Spain - of patients with strains of gonorrhoea against which no known antibiotic is effective.

'These are cases that can infect others. It can be transmitted,' she said.

'And these cases may just be the tip of the iceberg, since systems to diagnose and report untreatable infections are lacking in lower-income countries where gonorrhoea is actually more common.'

The WHO found there was widespread resistance to the first-line medicine ciprofloxacin and increasing resistance to azithromycin.

In most countries, last-case antibiotics are now the only single antibiotics that remain effective for treating gonorrhoea.

Yet resistance to them has already been reported in 50 countries.

Manica Balasegaram, director of the Global Antibiotic Research and Development Partnership, said the situation was 'grim' and there was a 'pressing need' for new medicines.

The pipeline is very thin, with only three potential new gonorrhoea drugs in development and no guarantee any will prove effective in final-stage trials, he said.

'We urgently need to seize the opportunities we have with existing drugs and candidates in the pipeline,' he said.

'Any new treatment developed should be accessible to everyone who needs it, while ensuring it is used appropriately, so that drug resistance is slowed as much as possible.'</s>Gonorrhoea is becoming untreatable, WHO warns

Gonorrhoea infections are increasing, but doctors are running out of antibiotics that can fight the increasingly resistant bacteria causing the sexual disease, the World Health Organisation (WHO) warned on Friday.

Gonorrhoea is a sexually transmitted infection (STI) caused by bacteria called Neisseria gonorrhoeae or gonococcus.

It is mainly found in discharge from the penis and in vaginal fluid and can easily pass between people through unprotected vaginal, oral or anal sex.

Two-thirds of the countries that report resistance data to the WHO have seen cases in recent years in which their antibiotics of last resort no longer worked against gonococci bacteria.

“These cases may just be the tip of the iceberg since systems to diagnose and report untreatable infections are lacking in lower-income countries where gonorrhoea is actually more common,” WHO expert, Teodora Wi, said in Geneva.

The UN health agency estimates that 78 million people are infected annually with the disease.

Britain and the U.S. reported increases of more than 10 per cent in 2015.

Cases among gay men in France doubled between 2013 and 2015.

Rates are highest in the African region, where one in 10 men is infected annually.

The main reasons for the increase are decreasing condom use, increased mobility as well as poor disease monitoring and inadequate treatment, according to the WHO.

Gonorrhoea can infect the genitals, rectum and throat. It can lead to inflammation of the pelvis and to infertility.

Currently, only three new drugs are being developed, because pharmaceutical companies know that the bacteria will soon become resistant to any new antibiotic.

To control gonorrhoea, doctors not only need new medicines, but also a rapid diagnostic tool and a vaccine, which are yet to be developed, WHO Antimicrobial expert, Marc Sprenger, said.

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According to the World Health Organization, antibiotic resistance is on the rise in strains of gonorrhoea. It says that there is a need to prevent the spread of these bacteria, recommending usage of condoms and an increase in research and development funding.