March 12, 2014 4:30 PM EDT

Rates of gonorrhea are higher when more people carry drug-resistant strains of the sexually transmitted disease, according to a forthcoming report by the Centers of Disease Control and Prevention.

The study, which will be published in the April 2014 issue of the Emerging Infectious Diseases journal, examined the rates of gonorrhea in 17 cities over 16 years, between 1991 and 2006. The study found that although gonorrhea was more prevalent in cities with lower resistance to drugs, in cities where there was a higher resistance, rates of gonorrhea were elevated.

There are an estimated 820,000 cases of gonorrhea in the United States each year, according to the CDC. Resistance to antimicrobial drugs used for treatment, namely cephalosporin, has been increasing in the U.S. over the past several years. The CDC currently recommends two doses of antibiotics when treating the sexually transmitted disease. Sarah Kidd, a medical epidemiologist at the CDC who was not involved in the study, told The Verge that “the emergence and spread of cephalosporin-resistant gonorrhea in the United States appears imminent.”

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