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J Reconstr Microsurg 2013; 29(07): 457-460
DOI: 10.1055/s-0033-1343956
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Flap Infection Associated with Medicinal Leeches in Reconstructive Surgery: Two New Drug-Resistant Organisms

Christopher Bibbo
1   Department of Orthopaedics, Marshfield Clinic, Marshfield, Wisconsin
,
Thomas Fritsche
2   Department of Pathology and Microbiology, Marshfield Clinic, Marshfield, Wisconsin
,
Mary Stemper
2   Department of Pathology and Microbiology, Marshfield Clinic, Marshfield, Wisconsin
,
Matthew Hall
3   Department of Infectious Diseases, Marshfield Clinic, Marshfield, Wisconsin
› Author Affiliations
Further Information

Publication History

02 December 2012

31 December 2012

Publication Date:
18 April 2013 (online)

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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.

Keywords

flap - venous congestion - leeches - infection
 

  • References

  • 1 Whitaker IS, Oboumarzouk O, Rozen WM , et al. The efficacy of medicinal leeches in plastic and reconstructive surgery: a systematic review of 277 reported clinical cases. Microsurgery 2012; 32 (3) 240-250
    CrossrefPubMedSearch in Google Scholar
  • 2 Wang EW, Warren DK, Ferris VM, Casabar E, Nussenbaum B. Leech-transmitted ciprofloxacin-resistant Aeromonas hydrophila. Arch Otolaryngol Head Neck Surg 2011; 137 (2) 190-193
    CrossrefPubMedSearch in Google Scholar
  • 3 Bickel KD, Lineaweaver WC, Follansbee S, Feibel R, Jackson R, Buncke HJ. Intestinal flora of the medicinal leech Hirudinaria manillensis. J Reconstr Microsurg 1994; 10 (2) 83-85
    Thieme ConnectPubMedSearch in Google Scholar
  • 4 Kikuchi Y, Graf J. Spatial and temporal population dynamics of a naturally occurring two-species microbial community inside the digestive tract of the medicinal leech. Appl Environ Microbiol 2007; 73 (6) 1984-1991
    CrossrefPubMedSearch in Google Scholar
  • 5 Mackay DR, Manders EK, Saggers GC, Banducci DR, Prinsloo J, Klugman K. Aeromonas species isolated from medicinal leeches. Ann Plast Surg 1999; 42 (3) 275-279
    CrossrefPubMedSearch in Google Scholar