WA researchers are working to prevent the next global pandemic through the diagnosis and treatment of sexually transmitted infections.

Most STIs are treated using antibiotics which, when prescribed incorrectly or not taken properly, lead to an increase in anti-microbial resistant strains of infections, like gonorrhoea.

Antimicrobial resistance, often shortened to AMR, occurs in a wide range of infections, but with WHO reporting up to 82 million cases of gonorrhoea each year globally, this particular STI is a specific area of concern. 

WHO predicts that by 2050 AMR infections overall could overtake cancer as the leading cause of death globally.

Charlene Kahler is the head of the Department of Microbiology and Immunology at UWA and the deputy director of the Marshall Center for Infectious Diseases Research. She said research into new drugs for the treatment of STIs is desperately needed, but there are challenges. 

“It’s really difficult to develop drugs in a research environment and then translate it into the commercial world. There is hesitancy from investors in the early stages of this kind of drug development,” she said. 

Australian Medical Association pathology representative Dr Jonathan Chambers said that current reports have found that almost 40% of gonorrhoea cases are resistant to historical treatments. 

AMR occurs in different STIs, like chlamydia, but the higher rate of resistance found in strains of gonorrhoea is of particular concern.

Gonorrhoea infection rates are significantly higher in Indigenous Australian populations with people facing barriers to healthcare, like distance to a clinic and having to return to clinics multiple times for diagnosis and treatment. 

Regional Western Australia, specifically the Kimberley region, had nine-times the number of gonorrhoea cases reported in metropolitan areas, per 100,000 people.

In response to COVID-19 PCR testing machines became more readily available, with the Western Australian Department of Health rolling out 23 PCR testing machines across regional areas of the state during the pandemic which are still used currently to perform STI tests.

While these machines are used for rapid testing for gonorrhoea to avoid lengthy wait times for results, and secondary appointments for treatment, Dr Chambers said there are concerns that tests may not be being performed to National Association of Testing Authorities’ standards.

Diagnosis is of growing importance because, once detected, resistant strains of gonorrhoea have historically been treated with a combination of two antibiotics, but in 2018 some of the first cases resistant to both medications were found in Australia.

Although PCR tests are currently being used in regional WA the testing which detects whether or not a patient’s strain of gonorrhoea is AMR or not is still being done centrally by larger labs which means results are delayed.

“There is a delay in determining AMR status and in some cases this may mean that an individual is given the incorrect antibiotic and will remain infectious,” she said.

The UWA research team is focussing on AMR strains of sexually transmitted infections, including gonorrhoea, and working to provide more targeted treatments that will reduce the spread of these strains.

Dr Kahler said: “We want to ensure that no infection is missed and that, when an infection is found, the correct antibiotic is administered.”

If you would like to know more about the signs and symptoms of STIs or find out where you can get tested visit https://www.healthywa.wa.gov.au/Articles/F_I/Gonorrhoea for more information.