Emergence of drug-resistant STIs makes testing critical. At-home testing is easy and helps reduce patient barriers to testing.
A large part of my clinical career has been focused on the diagnosis and treatment of sexually transmitted infections (STIs). One STI in particular has been in the news this year. In early 2023, the Massachusetts Department of Public Health reported the first two known cases of multi-drug resistant gonorrhea in the United States.
Gonorrhea is the second most commonly reported STI in the country, second only to chlamydia. The highest reported rates of infection are among sexually active teenagers, young adults, and African Americans. Infections range from being completely asymptomatic (not showing any symptoms) to infections that result in complications like infertility (inability to have children). It is mainly diagnosed using a nucleic acid amplification test (NAAT) on specimens including urine, throat swabs, and rectal swabs. This is because people can get gonorrhea in their genitals, mouth, or anus through different types of sexual contact.
Gonorrhea treatment has always posed challenges due to increasing rates of drug resistance. The main drug we use to treat it in the clinic is an injectable antibiotic called Ceftriaxone. The strain reported from Massachusetts was resistant to five classes of antibiotics – and crucially, Ceftriaxone was less effective at treating it. Fortunately, these two patients could be treated using higher doses of Ceftriaxone. Unfortunately, it’s only a matter of time before we encounter a strain that is fully resistant to treatment using Ceftriaxone.
New Massachusetts STI screening guidelines
The current scare has already resulted in changes in STI screening guidelines in Massachusetts. Clinicians now need to swab any symptomatic patient (patient showing symptoms) for gonorrhea culture in addition to conducting NAAT testing. NAAT testing is typically done by asking the patient for a urine sample to check for gonorrhea in their genitals. For patients who have a penis, this now includes getting a urethral swab. We also need to test patients more frequently when they are positive for gonorrhea and undergoing treatment: at two weeks and then at three months. Overall, this means a lot more testing than before.
Drug-resistant STIs emphasize the need for reducing patient barriers to testing. At home-based testing can play a key role in filling this need. Primary.Health Medical can provide chlamydia and gonorrhea testing to benefit your patients.
Disclaimer: This blog content and linked materials are not intended as individual medical advice, diagnosis or treatment, and should not be considered as such. Any readers with medical concerns should contact a licensed healthcare provider. This blog is provided for informational purposes only.