Posted in Health, news, sex

Rare STD Evading Doctors and May Become Next Superbug

A sexually transmitted disease (STD) may be gaining strength and increasing resistance to antibiotics.

Mycoplasma genitalium (MG) was first identified in the 1980s.  Many may not realize they have it, having no symptoms at all. However some may report burning with urination, penile discharge, vaginal discharge, or bleeding after sex.  Medical providers may confuse these symptoms with chlamydia, the most commonly reported STD, thereby offering a different antibiotic treatment and not ensuring an MG cure.  And antibiotics given incorrectly breed resistance.

If STD’s such as MG evade treatment they can fester causing pelvic inflammatory disease, urethritis, and eventually male and female infertility.

Since many do not realize they have it, or fail to elicit symptoms, prevalence rates are under-reported.  In 2016, Getman et al found the prevalence to be approximately 16.1% for females and 17.2% for males in the 946 test subjects seeking care at an STD clinic. But they reported then that macrolide (azithromycin) resistance of the bacteria was found in 50.8% of females and 42% of males.

The treatment for MG, according to the CDC, is a 1 gram one time dose of azithromycin. However they note increasing resistance and suggest if suspected to take a Zpack (azithromycin- an initial 500-mg dose followed by 250 mg daily for 4 days).  And if resistance is still seen to add Moxifloxacin (400 mg daily x 7, 10 or 14 days) which thus far has shown a 100% cure rate.

The treatment for chlamydia is also a 1 gram one time dose, with use of doxycyline 100mg twice daily for 7 days if not cured.

So how is resistance being bred?

When one believes he/she has an STD, most medical providers will not wait for the cultures to come back to treat as results can take days.  So many will prescribe the 1 time dose of azithromycin empirically.  However if a medical provider is only testing for gonorrhea and chlamydia, they may not know if the patient is cured of MG.  The MG bacteria that withstood the original dose of azithromycin may flourish and become resilient to the antibiotic in the future.

To prevent resistance, providers need to check for cure after the medication is given to ensure the infection is gone.  If not, a second antibiotic needs to be instituted immediately to prevent the resistant bacteria from spreading.

Macrolide resistance has also been  noted when treating gonorrhea, another STD with superbug potential.

What is a Superbug?

A superbug is a pathogen, most commonly bacteria, that can survive antibiotics that most species would buckle under.  It’s resistance could be caused by a variety of factors.  Maybe it has a mutation that makes it stronger.  Maybe its genetic material shields it from the toxic medicine.  Maybe it’s luck.  So shortly after it celebrates surviving the antibiotic assault, it divides to reproduce, making more bacteria.  If this progeny bacteria maintain the same genetic material as its parent, or if included, mutation, they can be now be resistant to the antibiotics as well.

 

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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

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Nationally Syndicated Radio Host, Board Certified Family Medicine Physician, Author

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