American Society of Hirudotherapy

Flap infection associated with medicinal leeches in reconstructive surgery: two new drug-resistant organisms

Case report published in Journal of Reconstructive Microsurgery (2013)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Case reportSafety & Infection ControlBibbo C, Fritsche T, Stemper M, Hall M · Journal of reconstructive microsurgery, 2013

Abstract

The use of medicinal leeches in reconstructive surgery has proven value for the salvage of flaps with venous congestion but is associated with a risk of leech-acquired infection. The most common leech-associated organism is Aeromonas hydrophila, which antibiotic prophylaxis is typically directed against. The authors describe two new multidrug-resistant organisms acquired from medicinal leech therapy that resulted in flap infection. The evaluation of suspected leech-borne infection and management protocol for this leech-acquired resistant multi-organism infection is presented.

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

Publication typeCase ReportsJournal ArticleReview
Indexed MeSH termsAeromonasAgedAnimalsAntibiotic ProphylaxisArthropathy, NeurogenicGraft SurvivalGram-Negative Bacterial InfectionsHirudo medicinalisHumansLeechingMaleObesity, Morbid

Summary

Two new multidrug-resistant organisms acquired from medicinal leech therapy resulted in flap infection, with discussion of evaluation and management protocol for leech-acquired resistant multi-organism infections.

Why This Matters for Hirudotherapy

This report describes two new multidrug-resistant organisms acquired from medicinal leech therapy that resulted in flap infection in the context of reconstructive surgery. While Aeromonas hydrophila is noted as the most common leech-associated organism and typical target of antibiotic prophylaxis, these cases involve additional resistant organisms. The authors present their evaluation approach and management protocol for suspected leech-borne resistant multi-organism infection. This finding is relevant to hirudotherapy practice, as it documents microbiological risks associated with medicinal leech use beyond A. hydrophila. However, the specific organisms are not named in the abstract, the report is limited to two cases, and no data on prevalence or systematic evaluation of prophylactic strategies against these organisms are provided.

Citation

Flap infection associated with medicinal leeches in reconstructive surgery: two new drug-resistant organisms.

Bibbo C, Fritsche T, Stemper M, Hall M · Journal of reconstructive microsurgery, 2013

DOI

Added to ASH library: May 26, 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.