Aeromonas Septicemia After Medicinal Leech Use Following Replantation of Severed Digits

Levine, Steven M.; Frangos, Spiros G.; Hanna, Bruce A.; Colen, Kari L.; Levine, Jamie P.

doi:10.4037/ajcc2009110

Cited by 17 publications

(10 citation statements)

References 13 publications

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“…These infections can require extended course of intravenous antibiotics via central venous access . Sepsis from Aeromonas infection has been reported after replantation . If leeches are utilized, appropriate antibiotic coverage is mandatory.…”

Section: Discussionmentioning

confidence: 99%

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Medicinal leeches for surgically uncorrectable venous congestion after free flap breast reconstruction

et al. 2014

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Section: Discussionmentioning

confidence: 99%

“…29 Sepsis from Aeromonas infection has been reported after replantation. 30 If leeches are utilized, appropriate antibiotic coverage is mandatory. All patients in our cohort were administered appropriate prophylactic antibiotic therapy at the time of leech therapy initiation.…”

Section: Discussionmentioning

confidence: 99%

Medicinal leeches for surgically uncorrectable venous congestion after free flap breast reconstruction

et al. 2014

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“…of colonies per leech -SD anaerobic bacteria which are potentially pathogenic to human beings [6][7][8][9]15]. Clinical observations demonstrate that the endosymbiotic flora of the leech is capable of transmission into the patient during attachment and feeding [6].…”

Section: Discussionmentioning

confidence: 99%

Preventing Infective Complications following Leech Therapy: Elimination of SymbioticAeromonasspp. from the Intestine ofHirudo verbanaUsing Antibiotic Feeding

Litwinowicz

Błaszkowska

2014

Surgical Infections

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Background: Hirudotherapy is often used successfully in modern medicine, especially in plastic and reconstructive surgery. However, Aeromonas infections are the most common complications of post-operative leech application. Hence, prophylactic antibiotic administration is recommended before and during leech therapy. It has been confirmed that patient safety and achieving the desired therapeutic effect depend mainly on the microbiologic purity of the animals used. The aims of this study were to find a safe and practical way to eradicate symbiotic Aeromonas spp. occuring in the intestine of Hirudo verbana. Methods: Leeches were fed artificially with 1.5 mL of sterile defibrinated sheep blood supplemented with ciprofloxacin (CIP) or cefotaxime (CTX), at bacteriostatic concentrations of 0.2 mcg/mL or 1.5 mcg/mL, and bactericidal concentrations of 20 mcg/mL or 50 mcg/mL, respectively. Bacteria were isolated from the leech intestines before and after feeding at different time intervals: 1, 7, 14, 21, and 28 d. Results: Biochemical identification of bacterial isolates from water samples and intestines of H. verbana using the API-NE20 test showed that A. veronii biovar sobria was predominant. Bacteria belonging to the genus Aeromonas were detected in all control leeches. The results showed that optimum eradication of bacteria from leech intestines was obtained using 20 mcg/mL of CIP and 50 mcg/mL of CTX, which decreased the number of Aeromonas spp. to undetectable levels for two weeks after feeding in all treated leeches. A statistically significant reduction in the number of bacterial colonies (p < 0.0001) was observed in leeches treated with bacteriostatic concentrations of CIP or CTX; no bacterial growth was found on the plates after only seven days of feeding with antibiotics. All water samples in which the leeches were kept before treatment were contaminated with Aeromonas spp., whereas these samples were negative after antibiotic feeding of animals. Conclusions: All leeches were ready to take a blood meal after treatment, suggesting the possibility of using ciprofloxacin-treated or cefotaxime-treated leeches instead of chemoprophylaxis in patients undergoing hirudotherapy.

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“…Levine et al, reported a case of Aeromonas hydrophila septicemia after leech therapy, which was resistant to standard prophylactic antibiotic therapy (16). …”

Section: Discussionmentioning

confidence: 99%

Leech Therapy in Nearly Total Amputation of Fingers Without Vascular Repair; A Case Report

TarazJamshidi

Bagheri

Mirkazemi

et al. 2014

Iran Red Crescent Med J

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Introduction:In the absence of microvascular replantation or in crash injury cases in which obtaining an acceptable function is not possible, amputation of the injured finger seems to be the best treatment modality. Some studies recommended leech therapy for this kind of injury after vascular repair to decrease venous congestion.Case Presentation:In this case report, the authors presented a case of leech therapy after near total amputation of the fingers. A 25-year-old patient was admitted following a sawing injury with crashed bundles of the third, fourth and fifth fingers. Microvascular surgery was not performed because of crush injury.Discussion:After a simple repair and pin fixation, the patient was treated using leech therapy. The result was satisfactory. The third and fourth fingers were salvaged. It seems that in cases where a small part of the skin is still attached to the amputated part, even with complete crash of both bundles, leech therapy can help salvage the amputated fingers.

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Aeromonas Septicemia After Medicinal Leech Use Following Replantation of Severed Digits

Cited by 17 publications

References 13 publications

Medicinal leeches for surgically uncorrectable venous congestion after free flap breast reconstruction

Medicinal leeches for surgically uncorrectable venous congestion after free flap breast reconstruction

Preventing Infective Complications following Leech Therapy: Elimination of SymbioticAeromonasspp. from the Intestine ofHirudo verbanaUsing Antibiotic Feeding

Leech Therapy in Nearly Total Amputation of Fingers Without Vascular Repair; A Case Report

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