NEWS The sexually transmitted disease gonorrhoea have increased in the past ten years. No one knows exactly why gonorrhoea is spreading—but experts suspect a mix of better testing and changing sexual habits. At the same time, we face reduced treatment options due to antimicrobial resistance.
Tomas Gustafsson is infectious disease physician at Sunderby Hospital and researcher at the Department of Clinical Microbiology at Umeå University.
ImageFrida jakobssonresistance is increasing against the current first line treatment ceftriaxone, which is very troublesome
“Over the years, the bacteria that cause gonorrhoea has developed resistance to antibiotic after antibiotic and resistance is increasing against the current first line treatment ceftriaxone, which is very troublesome”, says Tomas Gustafsson, infectious disease physician at Sunderby Hospital and researcher at the Department of Clinical Microbiology at Umeå University.
Gonorrhoea is caused by the bacterium neisseria gonorrhoeae (gonococci). It spreads through sexual contact, and it is the second most common sexually transmitted disease (STD). The incubation period is short – from a couple of days to a few weeks.
The most common symptoms of gonorrhoea are burning or discomfort when urinating and discharge from the urethra, vagina or rectum but can also give throat symptoms. However, many—especially women—may have no symptoms, which makes it easy to spread unknowingly.
“The disease is quite contagious. The best way to avoid gonorrhoea is to use a condom which also gives protection against other STDs and HIV, but also to get tested if you have symptoms and participate in contact tracing” says Tomas Gustafsson.
Gonorrhoea is rarely fatal, but if left untreated it can give rise to endometritis, pelvic inflammatory disease (PID), prostatitis and sometimes septic arthritis.
“If gonorrhoea is not treated, it can even lead to infertility in women because the infection can cause lasting damage to the reproductive organs”, says Tomas Gustafsson.
Gonorrhoea has developed resistance to nearly all antibiotics historically used to treat it, and in recent years antibiotic resistance has increased rapidly.
Tomas Gustafsson splits his time between treating patients as an infectious disease physician and conducting research at Umeå University. This dual role gives him a unique perspective on the growing challenge of antibiotic resistance.
“I see the consequences of resistant infections firsthand in the clinic,” he says. “That experience is what pushed me to explore new treatment options in the lab.”
While working with an antibiotic candidate which originally focused on other bacteria, he decided to test it against gonococci. Since then, the focus has mostly shifted towards development of methods to facilitate the drug-development process against gonococci, which are often much more challenging to work with than other bacteria.
“We are trying to patch up some holes in the drug development pipeline to prevent it from running dry.”
What is the dream goal with your research?
“I guess I share it with most researchers involved in antibiotic development… to see an antibiotic candidate you have worked on, enter the clinic and be used to cure patients. That would be great!”
Disc diffusion test with an investigational compounds with activity against gonococci.
ImageTomas GustafssonSweden's most common sexually transmitted disease after chlamydia. In 2024, the number of reported cases was 4000 (1500 in 2015). Gonorrhoea is most common among young adults. Gonorrhoea has become increasingly difficult to treat due to the development of antibiotic resistance. During the Middle Ages and into the 19th century, bloodletting was one of the methods used for combating the disease.
