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

Abstract

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.

Ideating iDNA: Lessons and limitations from leeches in legacy collections

“…Outside of serious infection from resident gut flora of aquatic leeches [58, 59, 60] there has been no prior evaluation of the microbiome of terrestrial haemadipsid leeches notwithstanding their frequent ectoparasitism of humans [61, 62, 63]. Metagenomic data obtained here for pooled samples of C .…”

A Comprehensive Review of Medicinal Leeches in Plastic and Reconstructive Surgery

“…13,[38][39][40][41] Third-generation cephalosporins, fluoroquinolones, aminoglycosides, tetracycline, and trimethoprim-sulfamethoxazole are the most effective antibiotics against Aeromonas species and are first line for infection prophylaxis. 6,42,43 Due to emergence of resistant organisms, hospitals should conduct regular sampling, culture, and susceptibility indices of leech tank water, which should be used to determine institution-specific chemoprophylaxis measures. 6 Studies by Litwinowicz and Blaszkowska also suggest prefeeding leeches with appropriate antibiotics as a method by which chemoprophylaxis in patients can be eliminated while still reducing infectious risk to an acceptable level.…”

“…6 Studies by Litwinowicz and Blaszkowska also suggest prefeeding leeches with appropriate antibiotics as a method by which chemoprophylaxis in patients can be eliminated while still reducing infectious risk to an acceptable level. 42…”

Overview of Zoonotic Diseases in Turkey: The One Health Concept and Future Threats

“…These pathogens lead to pneumonia, sepsis, or gastroenteritis besides some tissue infections on skin and in some soft tissues. In addition, some leech species can play a vector role for some fungal, viral, and bacterial pathogens, such as Serratia marcescens, Pseudomonas spp, Vibrio fluvialis, Streptococcus spp, Clostridium tetani, classical swine fever virus, bovine parvovirus, feline calicivirus, equine arteritis virus, equine herpes virus type 1, Rickettsia spp, and Bartonella spp (380)(381)(382). Leeches can also transmit several Trypanosoma spp to fish (382).…”