Lethal Aeromonas veronii Sepsis in the Course of Medicinal Leech Therapy

Sproll, Christoph; Lommen, Julian; Balasiu, Adriana; Schorn, Lara; Kübler, Norbert R.; Henrich, Birgit; Kram, Rainer; Petersdorf, Sabine

doi:10.3390/antibiotics11091180

Cited by 5 publications

(1 citation statement)

References 29 publications

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“…First, we need to take the occupational history of farmers, recent trauma, and exposure to soil, wood, or dirty ditches. Second, a significantly higher mortality rate was observed in patients with NF who also had chronic kidney disease, chronic liver dysfunction, diabetes mellitus, or cancer [ 5 , 6 , 24 , 28 , 29 ]. About 55–57% of patients with Aeromonas NF had chronic liver dysfunction [ 5 , 14 ].…”

Section: Discussionmentioning

confidence: 99%

Rational Use of Antibiotics and Education Improved Aeromonas Necrotizing Fasciitis Outcomes in Taiwan: A 19-Year Experience

et al. 2022

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Background. Aeromonas necrotizing fasciitis (NF) causes high rates of amputation and mortality, even after aggressive surgical debridement and antibacterial therapy. This study investigated the effects of rational use of antibiotics and education by infectious disease (ID) physicians on Aeromonas NF treatment outcomes. Methods. Retrospective review for conducted for four years (period I, without an ID physician, December 2001 to December 2005) and 15 years (period II, with an ID physician, January 2006 to March 2021). In period II, the hospital-wide computerized antimicrobial approval system (HCAAS) was also implemented. A pretest-posttest time series analysis compared the two periods. Differences in clinical outcomes, demographics, comorbidities, signs and symptoms, laboratory findings, Aeromonas antibiotic susceptibility, and antibiotic regimens were compared between the two periods. Results. There were 19 patients in period I and 53 patients in period II. Patients had a lower rate of amputation or mortality in period II (35.8%) compared with period I (63.2%). Forty-four patients (61.1%) had polymicrobial infections. In the emergency room, the rate of misdiagnosis decreased from 47.4% in period I to 28.3% in period II, while effective empiric antibiotic usage increased from 21.1% in period I to 66.0% in period II. After the ID physician’s adjustment, 69.4% received monotherapy in period II compared to 33.3% in period I. Conclusions. Because Aeromonas NF had a high mortality rate and was often polymicrobial, choosing an antibiotic regimen was difficult. Using the HCAAS by an experienced ID physician can improve rational antibiotic usage and clinical outcomes in Aeromonas NF.

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Section: Discussionmentioning

confidence: 99%

Rational Use of Antibiotics and Education Improved Aeromonas Necrotizing Fasciitis Outcomes in Taiwan: A 19-Year Experience

et al. 2022

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Increasing multidrug resistance in leech borne infections. Should we adjust antibiotic treatment regime in plastic surgery? A systematic review

Wagner,

Ulrich

2024

Eur J Plast Surg

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Background A growing number of reports of serious wound infections during medical leech therapy over the last decades caused by the leech gut symbiont Aeromonas spp. led to the standard use of single antibiotics. With more published data about raising multidrug resistance of Aeromonas species in leech guts, there is probably a need for adjustment of existing treatment regimens. Methods We screened PubMed, Scopus, and Web of Science databases using relevant keywords including the last five decades addressing this issue. The review process was based on the PRISMA guidelines. Two independent reviewers screened the abstracts; extracted data were pooled and analyzed for antimicrobial resistance. Meta-analysis was not conducted, based on the poor quality of the included studies. Result A total of 43 studies were included in this review. All of the studies were reports or case series—except one—and the quality was combined overall good. Evidence was not found for using special antimicrobial agents as first line therapy. Conclusions Concluding this work, the survey revealed a growing number of more resistant or partially multi-resistant bacterial strains against different commonly used antibiotics, most probably based on increasing resistance in the environment. Taking these data into account, we advise combining leech therapy with minimal dual antibiotic drug administration with ciprofloxacin and co-trimoxazol in the first place and leech gut sampling before inset for antibiotic drug resistance monitoring, and increased awareness during and after leech therapy. Level of Evidence: Not ratable

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Meropenem/piperacillin/tazobactam

2023

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Lethal Aeromonas veronii Sepsis in the Course of Medicinal Leech Therapy

Cited by 5 publications

References 29 publications

Rational Use of Antibiotics and Education Improved Aeromonas Necrotizing Fasciitis Outcomes in Taiwan: A 19-Year Experience

Rational Use of Antibiotics and Education Improved Aeromonas Necrotizing Fasciitis Outcomes in Taiwan: A 19-Year Experience

Increasing multidrug resistance in leech borne infections. Should we adjust antibiotic treatment regime in plastic surgery? A systematic review

Meropenem/piperacillin/tazobactam

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