STD Awareness: Gonorrhea’s Latest Dubious Honor

Wanted: Scientists who can develop novel antibiotics

A few years ago, the Centers for Disease Control and Prevention (CDC) put out a “greatest hits” list of antibiotic-resistant pathogens. More recently, in late February, the World Health Organization (WHO) followed suit with a dirty-dozen list of 12 “superbugs,” which was composed mostly of potentially fatal microbes that are becoming increasingly impervious to the drugs that once easily killed them. These are the bacteria WHO believes represent the greatest microbial threat to human health, and the list was compiled in the hopes of providing direction — and motivation — to pharmaceutical researchers who are desperately needed to develop new antibiotics.


Investing in antibiotic development now will save lives later.


A quick primer on antibiotic resistance: Antibiotics kill living organisms called bacteria, but like all living organisms, bacteria can evolve. Just as giraffes evolve longer and longer necks that allow them to eat more and more leaves, so too do bacteria evolve resistance to antibiotics. For example, a resistant bacterium can evolve the ability to spit out the drug before it has a chance to kill it, or it can evolve structural changes to its cell wall that make it impossible for the drug to attach to it.

One superbug, classified as an “urgent threat” by the CDC and a “high priority” by WHO, stands out from the pack. Unlike the other bacteria in these lists, an untreated infection with this bug isn’t thought to be deadly — but it still wreaks enough havoc to merit special attention from such esteemed bodies as the CDC and WHO. That bug is Neisseria gonorrhoeae, and you have one guess what disease it causes. (If you said gonorrhea, you guessed right.) Continue reading

STD Awareness: The Surprising Sexual Transmission of Non-STDs

What is a sexually transmitted disease, or STD? If someone catches their partner’s cold during sex, is that cold an STD? According to the Office on Women’s Health, an STD is “an infection passed from one person to another person through sexual contact.” Unless the cold was passed through sexual contact, rather than mouth-to-mouth contact, it would not be considered an STD. Others say that, for an infection to be considered an STD, its sexual transmission must make it significantly more common in the population. So, a disease like the common cold would probably be just as common even if people never had sex.


MRSA, meningitis, and the virus that causes pinkeye can be transmitted sexually.


However, there are some infections, such as hepatitis C or bacterial vaginosis, whose status as official STDs is controversial. While researchers argue with one another over where to draw the line between an STD and a non-STD, let’s take a look at some bacteria and viruses that can be transmitted sexually, even though they’re not officially categorized as “STDs.”

MRSA: Methicillin-Resistant Staphylococcus aureus

MRSA bursting out of a dead blood cell. Image: Frank DeLeo, NIAID

MRSA bursting out of a dead blood cell. Image: Frank DeLeo, NIAID

You’ve probably heard of MRSA, which is pronounced “mersa” and stands for methicillin-resistant Staphylococcus aureus — a strain of bacteria that is resistant to every antibiotic in the penicillin family, as well as others. S. aureus, or “staph” for short, is the same bacteria responsible for TSS, or toxic shock syndrome, which has most infamously been associated with the use of highly absorbent tampons. But mostly, staph is a common cause of skin infections, which could be deadly in the pre-antibiotic era, but these days usually don’t raise too many eyebrows.

Unfortunately, with the emergence of MRSA, which is difficult to treat with the usual drugs, we might once again have to worry about minor skin infections blossoming into life-threatening conditions. Additionally, MRSA has found a way to hop from person to person via sexual contact, and sexually transmitted MRSA has been documented in both heterosexual and MSM (men who have sex with men) populations. Untreated, it can lead to a form of gangrene in which tissue blackens as it dies. Continue reading

STD Awareness: Fully Antibiotic-Resistant Gonorrhea Is on the Horizon

shot-in-armWe’ve been anticipating its arrival for years now, but earlier this fall, the Centers for Disease Control and Prevention (CDC) finally made an announcement: Cases of gonorrhea resistant to the last drugs we use to cure it are emerging.

Over the years, gonorrhea has evolved resistance to every drug we’ve thrown at it — sulfonamides, penicillins, tetracyclines, macrolides, fluoroquinolones, and narrow-spectrum cephalosporins. The last line of defense we have is a one-two punch of a pair of antibiotics: azithromycin and ceftriaxone. By using two drugs, we can delay the inevitable evolution of antibiotic resistance by attacking the bacteria in two vulnerable locations, rather than just one, making it more difficult for the bug to mount a defense and pass on its superior survival skills to subsequent generations.


Prevention is paramount: Stop the spread of antibiotic resistance by practicing safer sex!


Unfortunately, we could only stave off the inevitable for so long. At their conference in September, the CDC announced a cluster of gonorrhea infections that are highly resistant to azithromycin, and that fall prey only to high doses of ceftriaxone. As gonorrhea’s tolerance to ceftriaxone increases, the infection will get more and more difficult to cure.

This cluster of drug-resistant cases was identified in Honolulu in April and May of this year, with five infections showing “dramatic” resistance to azithromycin, as well as reduced vulnerability to ceftriaxone. The good news is that these cases were cured with higher-than-usual doses of antibiotics, but the bad news is that dosages can only climb so high before a drug is no longer considered to be an effective treatment. Continue reading

STD Awareness: Gonorrhea’s Ever-Growing Resistance to Antibiotics

gonococci

Gonococci, the bacteria that cause gonorrhea.

Ever since the advent of effective antibacterial therapies less than a century ago, humans with access to these drugs can easily cure gonorrhea. Most of us in the developed world have forgotten that this disease was once a leading cause of infertility in women and blindness in babies — sulfa drugs and antibiotics not only erased these infections from our bodies, they also erased memories of gonorrhea’s dangers from our collective consciousness.


There are two drugs remaining to treat gonorrhea, and resistance to them is climbing higher as the years march on.


Unfortunately, thanks to their talent for genetic gymnastics, gonococci, the bacteria that cause gonorrhea, have been evolving resistance to every drug we’ve thrown at them — to tetracycline, to penicillin, and more recently to fluoroquinolones. One class of antibiotics remains to treat gonorrhea: cephalosporins. In 2013, Centers for Disease Control and Prevention (CDC) Director Tom Frieden warned that we could find ourselves in a “post-antibiotic era” – unless we take precautions. And, just two weeks ago, the latest study from the CDC’s Gonococcal Isolate Surveillance Project sounded the alarm that the post-antibiotic era is drawing ever closer, especially when it comes to gonorrhea.

Azithromycin and ceftriaxone, the two drugs that are used in combination to deliver a one-two punch to invading gonococci, are the best antibiotics remaining in our arsenal. Azithromycin is taken by mouth, while ceftriaxone is administered by a shot, and when taken together they team up to target different weak points in gonococci’s armor. Azithromycin interferes with the bacteria’s ability to make proteins, shutting the cells down, while ceftriaxone causes the cell wall to fall apart. However, the gonococci can acquire resistance. For example, in the case of azithromycin, a resistant bacterium can spit out the drug before it has a chance to kill it, or it can change the shape of its protein-making apparatus such that the drug can’t attach to it.  Continue reading

STD Awareness: Which STDs Are Resistant to Antibiotics?

pillsYou’ve probably heard of MRSA, which is pronounced “mersa” and stands for methicillin-resistant Staphylococcus aureus — a strain of bacteria that is resistant to methicillin, as well as pretty much every other antibiotic out there. MRSA is an example of evolution by natural selection — what didn’t kill its ancestors made them stronger, spawning a drug-resistant strain.


There are drug-resistant strains of gonorrhea, trichomoniasis, and syphilis.


Evolution is the force behind life’s diversity. Normally, diversity is a good thing — but when it comes to microbes that cause diseases like gonorrhea, trichomoniasis, and syphilis, these organisms’ ability to evolve new defenses against our antimicrobial drugs isn’t good for us.

STDs have plagued us for millennia, but it wasn’t until the 20th century that we finally developed antibiotics, which gave us a powerful tool against many of our most formidable sexually transmitted foes. Suddenly, scourges like gonorrhea and syphilis could be quickly and easily treated with a dose of penicillin.

Problem solved, right? Nope. Enter evolution by natural selection. Continue reading

STD Awareness: Mycoplasma genitalium

Image of Mycoplasma genitalium adapted from American Society for Microbiology.

“I’m not small, I’m just streamlined!” Image of Mycoplasma genitalium adapted from American Society for Microbiology.

In November and December of last year, headlines touting a “new” STD made an ever-so-minor flurry across the Internet. CNN referred to it as “mycoplasma genitalium, or MG” — Mycoplasma genitalium is the name of the teardrop-shaped bacteria that can cause several diseases in the urinary or reproductive tracts, such as urethritis and pelvic inflammatory disease.

M. genitalium is the smallest living organism known to science, having “devolved” from more complex organisms — but that doesn’t mean it can’t pack a punch! While these bacteria have surely been around for millennia, we only discovered them in the 1980s. Since then, we’ve known that M. genitalium fits the profile of a sexually transmitted pathogen — the only reason it made the news last year was that a team of British researchers published further evidence that this bug is indeed sexually transmitted and capable of causing disease.


Genital mycoplasmas can be cured — but a doctor needs to know what she’s looking for in order to prescribe the correct antibiotic!


An infection with M. genitalium could more generally be called a “genital mycoplasma.” The term “genital mycoplasmas” refers to a category of several different species of sexually transmitted bacteria, most notably Mycoplasma genitalium, but also less common species, such as Mycoplasma hominis, Ureaplasma urealyticum, and Ureaplasma parvum. M. genitalium is considered an “emerging pathogen,” because it is only over the past couple of decades that technology has allowed us to study these bacteria, along with other genital mycoplasmas.

Risk factors for infection include multiple sexual partners and not using condoms during sex. It is thought that most people with an M. genitalium infection don’t have immediate symptoms — 94 percent of infected men and 56 percent of infected women won’t notice anything amiss. That doesn’t mean it can’t do damage. Continue reading

The Best of 2015: A Year of Blogging

Every week, we publish new material on the blog — a feat that would not be possible without the dedication and talents of our amazing volunteer bloggers! It is our not-so-humble opinion that the blog publishes high-quality, informative, insightful, and sometimes downright fun pieces, and the entire Planned Parenthood Arizona family is so proud to have it as a showcase. To commemorate another successful year of blogging, we asked our bloggers to pick their favorite posts from 2015.

holding hands from backRebecca usually writes about contraception, but in 2015 she conceptualized the new Teen Talk series, aimed at our younger readers but still plenty relevant to people of all ages. One of her favorite pieces was about the decision to abstain from sexual activity. While we live in a culture in which a lot of us feel pressure to have sex — even before we’re ready — we all have the right to make our own choices about sex, including the choice not to have it! For some of us, saying no can be hard, but can also be liberating. The issue of abstinence is highly fraught in our culture, but we love Rebecca’s deft and respectful handling of the topic.

gloria thumbnailAnne is our newest blogger, and we have been blessed by her lively prose! Anne’s favorite post was called Abortion: Don’t Ask, Don’t Tell, in which she wrote about the growing movement to fight stigma by “shouting our abortions” — rather than whispering about them or staying quiet. Given that 1 in 3 women has had an abortion yet the topic remains so taboo, the issue is largely shrouded in secrecy and silence. Anne shares her own story — and speaks powerfully about why it’s so important to shatter that silence once and for all. If “coming out” was so successful for the LGBTQ community, will it also help foster compassion and spread visibility for the many people who have had abortions?

breastfeedingCynthia was another new addition to the blogging team this year, and her debut post was also her favorite. In August, to celebrate National Breastfeeding Month, Cynthia shared her sweet story of breastfeeding and bonding. She wrote about how breastfeeding her son was the most “rewarding, challenging, frustrating, amazing, and empowering” thing she’s ever done. Breast milk has myriad benefits for both mother and baby, and Cynthia covered many of them in an informative post interwoven with her personal experiences and insights.

Stadium thumbnailMatt continues to write insightful posts about the intersection between the personal and the political. In August, Matt helped herald the football season with his look at how expanding the University of Arizona’s stadium shrunk abortion access in the state. As he so eloquently wrote, “Abortion was never meant to be a bargaining chip. It was sacrificed in 1974 to give more football fans a seat at the game. It’s time undo the damage and give more abortion supporters a seat in the legislature.” Whether you’re a Wildcats fan or simply interested in learning more about this chapter in reproductive-justice history, we think you’ll be fascinated (and enraged) to learn about the stadium deal.

cropped CDC library disease agents gonococciAnna is a graduate student in health sciences who has carved out a niche for herself as our unofficial STD blogger. One topic she keeps coming back to is antibiotic-resistant gonorrhea, which is classified as an “urgent threat” by the Centers for Disease Control and Prevention. Thanks to the bacteria’s ability to evolve so quickly, we only have one good antibiotic left to cure this serious infection — and no new ones on the horizon. Find out how the bacteria that cause gonorrhea are able to evade our pharmaceutical arsenal, whether they’re having “bacteria sex” with one another or grabbing genes from their cousins. These bugs have a unique talent for altering their genes, which would be admirable if it weren’t so worrying!

Harvey Milk Day thumbnailMichelle celebrated Harvey Milk Day with a touching tribute to this pioneering LGBTQ leader, who would have blown out 85 candles on his birthday cake last May — if his life hadn’t been cut short in a senseless and tragic assassination in 1978. As one of the first openly gay politicians ever to be elected to public office, Milk sponsored an anti-discrimination bill, fought to establish daycare centers for working mothers, helped to increase low-cost housing options, and consistently advocated for the rights of all marginalized communities. Check out Michelle’s piece to learn more about Harvey Milk, what he accomplished, and why his legacy is so important to celebrate!

condom and hand thumbnailJon joined us early this year — first as an intern, and then as a volunteer blogger. We loved the piece he wrote about the place birth control has in his life, especially in a world in which the birth control burden can too often fall on women’s shoulders alone. Jon used condoms to take responsibility for his part in preventing pregnancy, and to boost the effectiveness of his partners’ birth control pills. With typical use, condoms and oral contraceptives can combine to be more than 98 percent effective! For Jon, birth control helped him plan his future, complete his education, and forge relationships — and condoms were an essential component of that toolkit.

standwithpp pic thumbnailKelley actually isn’t a Planned Parenthood volunteer — they’re our public policy manager! That didn’t stop them from contributing some strong pieces to the blog. For Trans Awareness Month, Kelley shared their journey to living authentically — a post that was both heartfelt yet humorous, personal yet universal. In Arizona, Kelley can be fired for their sexual orientation, gender identity, and gender expression — but feels lucky to have found a supportive home with Planned Parenthood. No matter what month it is, Planned Parenthood supports the trans community because we stand for autonomy over one’s own body, identity, and decisions.