American Society of Hirudotherapy

Selection of a multidrug-resistant Aeromonas during medicinal leech therapy

Case report published in New Microbes New Infect (2017)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Research reportSafety & Infection ControlAntimicrobial ResistanceRuppe E et al. · New microbes and new infections, 2017

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

15-year-old boy developed ESBL-producing CTX-M-3 Aeromonas with 13 antibiotic resistance genes after piperacillin/tazobactam and cotrimoxazole prophylaxis during leech therapy.

Why This Matters for Hirudotherapy

The abstract reports the selection of a multidrug-resistant, extended-spectrum β-lactamase-producing Aeromonas salmonicida strain in a 15-year-old boy after medicinal leech therapy; the case required antibiotic prophylaxis based on piperacillin/tazobactam and cotrimoxazole. Whole genome sequencing identified 13 antibiotic resistance genes, including the ESBL CTX-M-3 and the unusual β-lactamase SCO-1. This is directly relevant to ASH's domain as it documents a multidrug-resistant pathogen associated with leech therapy, a notable safety consideration. The limitation is that this describes a single case, and the abstract does not specify the leech indication, clinical outcome, or the temporal relationship between prophylaxis administration and the emergence of resistance.

Citation

Selection of a multidrug-resistant Aeromonas during medicinal leech therapy.

Ruppe E et al. · New microbes and new infections, 2017

DOI

Added to ASH library: May 27, 2026 · Site last updated: June 18, 2026

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.