The Penicillin Eaters

While routinely examining a vaginal swab from a woman infected with gonorrhea, Dr. Ian Phillips of London's St. Thomas's Hospital made an alarming discovery: the swab contained a strain of gonococci, or gonorrhea-causing bacteria, unlike any that Phillips had ever seen before in his laboratory. The bean-shaped bugs not only were totally resistant to penicillin--the medication generally employed against this common and often dangerous venereal disease--but actually seemed to thrive in its presence.

Phillips' find was not unique. The new strain of bacteria had shown up in several other laboratories in Britain, and doctors at Travis Air Force Base in California encountered penicillin-proof gonococci in a young Air Force noncom who had just returned from the Philippines. Another example was reported in Maryland. By last week Atlanta's Center for Disease Control had verified 33 cases of gonorrhea in the U.S. that did not respond to conventional penicillin therapy. Alarmed by these reports, the World Health Organization (WHO) alerted VD experts everywhere to give top priority to learning more about the menacing new microbes.

WHO's Jitters. There was good reason for WHO's jitters. Though gonorrhea has already reached epidemic proportions--an estimated 3 million cases a year in the U.S. alone and perhaps 100 million worldwide--doctors have usually been able to treat it effectively and inexpensively with a large dose of penicillin. In recent years some gonococci strains with a measure of resistance had emerged, but even those stubborn bacteria eventually succumbed to still bigger dosages of the antibiotic. Not the new strains; for the first time, gonococci are figuratively gobbling up penicillin. Their secret weapon: an enzyme called penicillinase ("penicillin destroyer") that breaks apart the antibiotic.

No one knows for sure how the gonococci acquired their disturbing new capability, but University of Washington Microbiologist Stanley Falkow, who in 1975 predicted the emergence of such a strain, thinks that it was through nature's own genetic engineering. He suggests that the gonococci incorporated bits of the master molecule DNA containing the genetic instructions for making the enzyme from other kinds of microbes that already have these genes.

However the new strain evolved, its existence vastly complicates the treatment of gonorrhea. Other antibiotics--notably spectinomycin--have proved effective. But they are often expensive (about $4 a dose for spectinomycin, v. only 50-c- for penicillin), could also meet bacterial resistance and, unlike penicillin, do not also knock out that other scourge, syphilis. At the very least, the new gonococci will require several visits to the doctor, as opposed to the old, cheap, one-shot treatment. Says Dr. Ronald St. John of the CDC's venereal disease division: "If this new strain becomes widespread, then a lot of money will be needed to cure it."

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