American Society of Hirudotherapy

In vivo selection of a multidrug-resistant Aeromonas salmonicida during medicinal leech therapy

Case report published in New Microbes and New Infections (2017)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Research reportSafety & Infection ControlRuppé E, Cherkaoui A, Wagner N et al. · New microbes and new infections, 2018

Abstract

We report the selection in a 15-year-old boy of a multidrug-resistant, extended-spectrum β-lactamase (ESBL)-producing Aeromonas salmonicida after medicinal leech therapy that required an antibiotic prophylaxis based on piperacillin/tazobactam and cotrimoxazole. Whole genome sequencing of the strain indeed revealed 13 antibiotic resistance genes, including the ESBL CTX-M-3 and the unusual β-lactamase SCO-1.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeJournal Article

Summary

A 15-year-old boy receiving medicinal leech therapy under piperacillin/tazobactam and cotrimoxazole prophylaxis had selection of a multidrug-resistant, extended-spectrum β-lactamase-producing Aeromonas salmonicida, with whole genome sequencing revealing 13 antibiotic resistance genes, including CTX-M-3 and SCO-1.

Why This Matters for Hirudotherapy

This report documents selection of a multidrug-resistant, extended-spectrum β-lactamase (ESBL)-producing Aeromonas salmonicida in a 15-year-old boy during medicinal leech therapy requiring piperacillin/tazobactam and cotrimoxazole prophylaxis. Whole genome sequencing revealed 13 antibiotic resistance genes, including CTX-M-3 and the unusual β-lactamase SCO-1. The case describes a safety concern in hirudotherapy: the potential for leech-associated Aeromonas to harbor or acquire clinically important resistance mechanisms, complicating prophylaxis. This is a single case report involving one patient and one strain; it cannot establish incidence or general risk, and it provides no efficacy or comparative outcome data.

Citation

Reference (Vancouver style)

Ruppé E, Cherkaoui A, Wagner N, La Scala GC, Beaulieu JY, Girard M, et al. In vivo selection of a multidrug-resistant Aeromonas salmonicida during medicinal leech therapy. New Microbes New Infect. 2018;21:23-27. doi:10.1016/j.nmni.2017.10.005. PMID: 29204282

Bibliographic details (authors, volume, pages, DOI) are taken from the PubMed record.

DOIPubMed

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This website provides educational information and does not constitute medical advice, diagnosis, or treatment recommendations. Medicinal leech therapy carries clinically meaningful risks and should be performed only by qualified clinicians under institutionally approved protocols. FDA 510(k) clearance for medicinal leeches is limited to specific indications; investigational and off-label discussions are labeled accordingly. For patient-specific guidance, consult a qualified healthcare provider.