Stock Photo - This illustration depicts a three-dimensional (3D) computer-generated image of a number of drug-resistant Neisseria gonorrhoeae diplococcal bacteria. Note that extending from the organisms? exterior were type IV pili, or hair-like appendages, which in this case, are used to promote motility for these bacteria, and improve surface adherence. The artistic recreation was based upon scanning electron micrographic imagery. Neisseria gonorrhoeae causes gonorrhea, a sexually transmitted disease that can result in discharge and inflammation at the urethra, cervix, pharynx, or rectum. N. gonorrhoeae is showing resistance to antibiotics usually used to treat it. These drugs include: cefixime (an oral cephalosporin), ceftriaxone (an injectable cephalosporin), azithromycin, tetracycline. Gonorrhea is the second most commonly reported notifiable infection in the United States, and is easily transmitted. It causes severe reproductive complications and disproportionately affects sexual, racial, and ethnic minorities. Gonorrhea control relies on prompt identification and treatment of infected persons and their sex partners. Because some drugs are less effective in treating gonorrhea, CDC recently updated its treatment guidelines to slow the emergence of drug resistance. CDC now recommends only ceftriaxone plus either azithromycin or doxycycline as first-line treatment for gonorrhea. The emergence of cephalosporin resistance, especially ceftriaxone resistance, would greatly limit treatment options and could cripple gonorrhea control efforts.