Medicinal leech therapy and Aeromonas spp. infection
Research article published in European Journal of Clinical Microbiology & Infectious Diseases (2016)
Abstract
While the use of medicinal leech therapy (MLT) in reconstructive and orthopaedic surgery is widely described, post-operative complications related to leeches remain a major concern. Aeromonas spp. strains are involved in the majority of reported cases. As surgical success rate is directly impacted, an adapted antibiotic prophylaxis should be instituted in order to minimize these complications. We assessed pharmaceutical process, microbiological control and related infections in order to provide data and choose the appropriate antibiotherapy for patients requiring MLT. We report a clinical and microbiological study over a 24-month period. Clinical data were collected from patients' database, and microbiological analysis both on leeches' tank water and crushed leeches were performed to characterize isolated strains and their susceptibility to antibiotics. A total of 595 leeches were used to treat 28 patients (12 in plastic surgery and 16 in orthopaedic surgery), and three documented cases of post-operative infections were reported. Aeromonas spp. isolates yielded from 62 % of analyzed batches (75 % of Aeromonas veronii). Eighteen Aeromonas spp. isolates yielded from 23 water samples and three crushed leeches. Isolates were similar in tank and crushed leeches. Strains were susceptible to fluoroquinolones, sulfamethoxazole/trimethoprim, aminosides, and third-generation cephalosporins but resistant to amoxicillin/clavulanic acid and second-generation cephalosporins. According to collected data, routine tank water microbiological analyses are mandatory in order to identify leeches' batches containing resistant strains and to discard them. In this context, the surgeon is able to select an appropriated antibiotic prophylaxis in order to avoid MLT associated serious post-operative complications.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Zusammenfassung
24-month clinical and microbiological study of 595 leeches used in 28 patients across plastic and orthopedic surgery: 62% of analyzed batches yielded Aeromonas spp. isolates; recommends routine tank-water microbiological surveillance.
Warum dies für die Hirudotherapie relevant ist
Über 24 Monate bewertete diese Studie pharmazeutische Prozesse, mikrobiologische Kontrolle (Tankwasser und zerkleinerte Blutegel) und damit verbundene Infektionen bei 595 Blutegeln, die zur Behandlung von 28 plastisch-chirurgischen und orthopädischen Patienten eingesetzt wurden, und berichtete über drei dokumentierte postoperative Infektionen. Aeromonas spp. wurden aus 62 % der Chargen isoliert (75 % Aeromonas veronii); die Isolate waren empfindlich gegenüber Fluorchinolonen, Sulfamethoxazol/Trimethoprim, Aminoglykosiden und Cephalosporinen der dritten Generation, jedoch resistent gegen Amoxicillin/Clavulansäure und Cephalosporine der zweiten Generation. Für die ASH sind dies direkt relevante Daten zur Sicherheit und Prophylaxe der Hirudotherapie, die ein routinemäßiges Tankwasser-Screening empfehlen, um resistente Chargen zu identifizieren und zu verwerfen. Der Abstract bezeichnet das Studiendesign nicht; die Kohorte ist klein (28 Patienten, drei Infektionen), was die Präzision der Inzidenz und die Generalisierbarkeit einschränkt.
Zitation
Medicinal leech therapy and Aeromonas spp. infection.
Verriere B, Sabatier B, Carbonnelle E et al. · European journal of clinical microbiology & infectious diseases, 2016
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