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Medicinal leech therapy and Aeromonas spp. infection

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European Journal of Clinical Microbiology & Infectious Diseases Aims and scope Submit manuscript

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.

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Authors and Affiliations

  1. Pharmacy Department, Georges Pompidou European Hospital, 20 rue Leblanc, 75015, Paris, France

    B. Verriere, B. Sabatier & P. Prognon

  2. Microbiology Department, Georges Pompidou European Hospital, 20 rue Leblanc, 75015, Paris, France

    E. Carbonnelle & J. l. Mainardi

  3. Reconstructive Surgery and Regenerative Medicine Research Group, Institute of Life Sciences, Swansea University Medical School, Wales, UK

    I. Whitaker

  4. Reconstructive Surgery Department, Georges Pompidou European Hospital, 20 rue Leblanc, 75015, Paris, France

    L. Lantieri & M. Hivelin

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  1. B. Verriere
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Correspondence to B. Verriere.

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This study was self-funded by the pharmacy and microbiology department, and the authors declare that they have no conflict of interest.

Research involving Human Participants and/or Animals

For retrospective studies formal consent is not required. All applicable international, national, and/or institutional guidelines for the care and use of animals were followed. Informed consent is not applicable (retrospective study).

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Verriere, B., Sabatier, B., Carbonnelle, E. et al. Medicinal leech therapy and Aeromonas spp. infection. Eur J Clin Microbiol Infect Dis 35, 1001–1006 (2016). https://doi.org/10.1007/s10096-016-2629-5

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  • DOI: https://doi.org/10.1007/s10096-016-2629-5

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