Important note: Information in this article was accurate in 2002. The state of the art may have changed since the publication date.
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Wall Street Journal - March 5, 2002
Marilyn Chase, Staff Reporter
Cases of the antibiotic-resistant bacteria have cropped up in Seattle, San Francisco, San Diego and Orange County, Calif., according to a survey by researchers from the U.S. Centers for Disease Control and Prevention. The work was presented Monday night at a San Diego conference on sexually transmitted diseases.
"As with most STDs in our modern age of air travel, we wouldn't be surprised to see this trend move toward the East Coast," warned Ronald Valdiserri, the CDC's deputy director of sexually transmitted disease prevention, in an interview. So far, 14% of gonorrhea cases in Hawaii are Cipro-resistant, and West Coast rates, although lower, rose to 0.4% in 2000 from 0.1% in 1998.
Cipro, made by Bayer AG of Germany, is part of the fluoroquinolone family of antibiotics. The drug became the first line of treatment for inhalation anthrax following the terrorist mail attacks.
Drug resistance is a global trend resulting from the overuse of antibiotics. Cipro and other fluroquinolones have been top-line treatments since the 1980s, when gonorrhea grew resistant to tetracycline. Cipro-resistant gonorrhea is also resistant to related drugs like levofloxacin and ofloxacin.
While sexually transmitted diseases exist around the world, the resistant strain appears to be emanating from the Far East. In the resistance study by CDC researchers Susan Conner and Susan Wang, half of the patients interviewed acknowledged having sexual relations while traveling in the Pacific Rim or had a partner who had done so.
Dr. Valdiserri urged travelers to be mindful of the risks abroad, recommending abstinence or use of condoms. He also urged doctors to ask about travel when examining patients with STD symptoms. "If a businessman has been in Southeast Asia, don't start them on Cipro," he said. "Use cephalosporin antibiotics, and do tests for drug sensitivity." Cephalosporins include Suprax, made by Lederle Pharmaeuticals, and Rocephin, made by Roche Holdings AG.
The CDC estimates that 650,000 new cases of gonorrhea occur each year in the U.S., half of which aren't reported. Although national rates are stabilizing, disease strongholds in poor urban areas and the South still show alarming rates of increase. Untreated gonorrhea can cause infertility and fuel transmission of the AIDS virus.
Write to Marilyn Chase at marilyn.chase@wsj.com
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