ARCHIVED - Infectious Diseases News Brief - January 11, 2013

Gonorrhea May Become Incurable, Experts Fear

A new strand of the sexually transmitted disease gonorrhea has been found to be antibiotic resistant, possibly rendering the disease incurable. The strand was found in several North American patients. Researchers examined the effectiveness of cefixime, the only oral cephalosporin antimicrobial that is advised for treatment of gonorrhea infections. They found that this medicine had a failure rate of nearly seven percent for a group of patients treated in Toronto. Background information in the study states: "Because of Neisseria gonorrhoeae resistance to all prior first-line antimicrobial agents, cephalosporin antibiotic therapy with adjuvant azithromycin or doxycycline is recommended for treatment of gonorrhea. An increase in the minimum inhibitory concentration [MIC; lowest concentration of an anti-microbial agent that will prevent the growth of an organism] of N gonorrhoeae to cefixime, and to a lesser extent, an intramuscularly administered cephalosporin, ceftriaxone, has been identified in cultured isolates worldwide. The World Health Organization has sounded alarms for the threat of untreatable gonorrhea." The alert issued by the World Health Organization was announced in June of 2012 and stated that there is an impending threat for an untreatable form of antibiotic resistant gonorrhea that could potentially initiate an epidemic. The study was lead by Vanessa G. Allen, M.D.,M.P.H., of Public Health Ontario, Toronto, Canada and aimed to identify if certain strains of gonorrhea with decreased resistance to cefixime are linked to clinical failures. The primary result measured was cefixime treatment failure, described as the repeat positive finding of gonorrhea before and after treatment, identified by identical molecular typing and clear denial of being subjected to gonorrhea again while being treated. The investigators found that 6.7 percent of patients with gonorrhea still had the disease after their round of cefixime, which is the last antibiotic health professionals can use to successfully cure gonorrhea. Out of the 133 participants who went back to the clinical for a test to see if their gonorrhea was cured, nine still tested positive for the disease, approximately one in fifteen people.

Source: Medical News Today 10 January 2013

Public Health Notice: E. coli O157:H7 illnesses in Atlantic Canada and Ontario

The Public Health Agency of Canada has been working with its health and food safety partners on an investigation into 16 cases of E. coli O157:H7 illness. There are six cases in New Brunswick, five in Nova Scotia and five in Ontario. The majority of cases have recovered or are recovering. Investigations into outbreaks of food-borne illness can be complex. Since early January 2013, the Agency has been leading a committee to investigate these illnesses that includes public health and food safety experts from the Canadian Food Inspection Agency, Health Canada and Provincial Health Authorities. The committee meets regularly to share and review the latest information and determine what actions should be taken to protect Canadians.

Based on the ongoing epidemiological and microbiological investigations conducted to date, it is likely that the people involved all got sick from the same source. E. coli O157 food-borne illnesses are not uncommon in Canada. In recent years, an average of about 440 cases of this type of E. coli infection was reported annually in Canada.

Source: Public Health Agency of Canada, January 9, 2013