Three new cases of antibiotic-resistant Neisseria gonorrhoeae (the bacteria responsible for gonorrhoea) have been confirmed in England. Gonorrhoea is the second most common bacterial STI in the UK after chlamydia but that doesn’t mean its symptoms are mild. The painful STI needs to be diagnosed and treated immediately in order to avoid spreading it and serious complications such as infertility. The new strain, however, is resistant to the usual antibiotic used to treat gonorrhoea.
A woman in her 20s in London and a heterosexual couple in their 20s living in the Midlands have all been diagnosed with a strain of N. gonorrhoeae with resistance to the antibiotic ceftriaxone.
The three recent cases are in addition to the initial confirmed case confirmed in a heterosexual man living in London in December 2021.
Ceftriaxone is the main antibiotic used to treat gonorrhoea in the UK and being infected with a strain resistant to this antibiotic means the infection can’t be treated easily.
Dr Katy Sinka, STI Section Head at UK Health Security Agency, said: “After a couple of years without any cases of this hard to treat form of gonorrhoea, we have now seen four cases in the last two months.
“It’s too soon to say whether this will be the start of a longer-term trend, but we do know that STIs are on the rise in general.”
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About one in 10 infected men and five in 10 infected women won’t experience any obvious gonorrhoea symptoms.
That’s why testing is so important and the condition can go untreated for a long time. Some people won’t get any symptoms until months after infection.
STI testing is free and available through online self-sampling services or by contacting local sexual health services.
A statement from the UKHSA said: “UKHSA actively monitors, and acts on, the spread of antibiotic resistance in gonorrhoea and potential treatment failures and, when ceftriaxone resistant strains are identified, implements prompt public health action to limit further spread.”
While testing is the only real way to tell you’ve got the STI, it’s still really important to know the symptoms of gonorrhoea.
According to the NHS, the symptoms of gonorrhoea in women can include:
- an unusual vaginal discharge, which may be thin or watery and green or yellow in colour
- pain or a burning sensation when passing urine
- pain or tenderness in the lower abdominal area – this is less common
- bleeding between periods, heavier periods and bleeding after sex – this is less common
In men, the symptoms of gonorrhoea can include:
an unusual discharge from the tip of the penis, which may be white, yellow or green
Both men and women can develop a gonorrhoea infection in the rectum, throat or eyes by having unprotected anal or oral sex.
If infected semen or vaginal fluid comes into contact with the eyes, you can also develop conjunctivitis.
Infection in the rectum can cause discomfort, pain or discharge. Infection in the eyes can cause irritation, pain, swelling and discharge, and infection in the throat usually causes no symptoms.
Even if you have no obvious symptoms, treating gonorrhoea as soon as possible is very important.
The infection can lead to serious long-term health problems. In women and other people with a uterus or ovaries, gonorrhoea can spread to the reproductive organs and cause pelvic inflammatory disease (PID).
PID can then lead to long-term pelvic pain, ectopic pregnancy and infertility.
In men and other people with testes, it can cause a painful infection in the testicles and prostate gland, which may lead to reduced fertility in some cases.
You can read more about gonorrhoea on the NHS website.
If you don’t have the resistant strain of gonorrhoea, the infection can normally be treated with a single antibiotic injection (usually in the buttocks or thigh). With effective treatment, most symptoms should improve within a few days.
Those diagnosed and being treated for gonorrhoea should avoid having sex until they have been told by their doctor or medical professional that they no longer have the infection.
Previous successful treatment for gonorrhoea does not make you immune to catching it again, so the best thing to do is use appropriate contraception and take other precautions.
This includes:
- using male condoms or female condoms every time you have vaginal sex, or male condoms during anal sex
- using a condom to cover the penis or a latex or plastic square (dam) to cover the female genitals if you have oral sex
- not sharing sex toys, or washing them and covering them with a new condom before anyone else uses them
If you’re worried you may have an STI, visit a sexual health clinic for advice.
