Ciprofloxacin-resistant Aeromonas infection following leech therapy for digit replantation: report of 2 cases
van Alphen NA, Gonzalez A, McKenna MC, McKenna TK, Carlsen BT, Moran SL (2014) · Journal of Hand Surgery · n=2
Perfil del estudio
- Diseño
- two-case report (Mayo Clinic Rochester, cases occurring within 4 months of each other)
- Tamaño de la muestra (n)
- 2
- Intervención
- Leech therapy after unsuccessful digital replantation in patients with subsequent ciprofloxacin-resistant Aeromonas hydrophila infection
- Comparador
- Historical Mayo Clinic protocol with ciprofloxacin or TMP-SMX prophylaxis
- Punto final primario
- Infection characteristics, antibiotic resistance patterns, and treatment outcomes
- Resultado primario
- Both cases successfully treated with ceftriaxone after failure of ciprofloxacin prophylaxis; documents emerging ciprofloxacin-resistant Aeromonas strains in replantation center setting
- Duración del seguimiento
- Infection resolution
- PMID
- 24495623
Hallazgos clave
- Two ciprofloxacin-resistant Aeromonas cases within 4 months
- Ceftriaxone successful as rescue antibiotic
- Documents emerging resistance to first-line prophylaxis
- Replantation centers should monitor local Aeromonas susceptibility
- Antibiogram-guided prophylaxis selection recommended
Limitaciones
- Only 2 cases - cannot quantify resistance prevalence
- Single replantation center experience
- Cannot determine if cases share common Aeromonas source
- Limited microbiologic characterization of resistance mechanism
- Cannot recommend universal protocol changes
Implicaciones clínicas
van Alphen 2014 documents emerging ciprofloxacin-resistant Aeromonas at a major US replantation center, supporting periodic local antibiogram review and consideration of ceftriaxone as backup. For US clinicians under K040187, this Mayo Clinic case series reinforces antimicrobial stewardship principles and the dynamic nature of resistance profiles in leech-treated populations.
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