Hide And Seek With Gonorrhoea

Gonorrhoea isn’t going away. In 2022 there were 136 cases reported for every 100,000 people in New Zealand, and young people are disproportionately represented.

The largest percentage of cases are reported in men aged 20-29 years and women aged 15-29 years. Gay and bisexual men, who make up an estimated 2% of the population, represented over 30% of the recorded cases.

There are many reasons for the high rates in young people, one of the most pervasive is the stigma attached to sexually transmitted infection (STI).
 

Gonorrhoea is a particularly concerning STI because Neisseria gonorrhoeae, the bacteria responsible for gonorrhoea infection has developed a resistance to most of the currently available antibiotics.

University of Waikato biochemist Dr Joanna Hicks says, “untreatable gonorrhoea was a likely reality that we will be facing in the future, and current trends suggest young people will bear the burden.”

The World Health Organisation is so concerned at the increasing antimicrobial resistance of gonorrhoea and the growing rates of infection, that they’ve listed the bacteria as a “high priority pathogen” for ongoing research.
 

Dr Hicks has spent most of her career researching Neisseria gonorrhoeae. Her research has recently been boosted with an Explorer Grant from the New Zealand Health Research Council (HRC).
 

The Explorer Grant project Avoiding detection: How does gonorrhoea survive within host cells? builds on ongoing projects that her team are working on, including a study led by immunologist Dr William Kelton, who is an associate investigator on this new project.
 

Dr Hicks said the Explorer will enable her team to investigate some new avenues to uncover the secret intracellular life of the bacteria. 
 

“It’s a mastermind bacteria. It’s extraordinarily resilient with an ability to survive and hide in a variety of different cells, including human immune cells.” 
 

People often have little to no symptoms, and when left untreated gonorrhoea can cause serious complications. Women are most likely to be asymptomatic and the outcomes can be dire – from ectopic pregnancy to infertility.
 

“The particular concern is there’s no vaccine and gonorrhoea has developed extensive antimicrobial resistance. Right now, there are dwindling treatment options, and infection rates are rising. Our work is important in advancing the development of new and more effective treatments.”
 

The current project will zero in on the bacteria’s FitAB toxin-antitoxin system. “This is basically the genetic material within certain strains of Neisseria gonorrhoeae that enable the bacteria to survive when exposed to stressors like antibiotics, and to persist and hide in human cells, until more favourable conditions return.” 
 

Dr Hicks will be using a number of laboratory techniques new to New Zealand. It will also be a world first to use dual RNA sequencing approaches to learn about the changes that occur in both the human host cell and the Neisseria gonorrhoeae bacteria during infection.

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