title: Flap infection associated with medicinal leeches in reconstructive surgery: two new drug-resistant organisms.
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.
authors.affiliation: Department of Orthopaedics, Marshfield Clinic, Marshfield, Wisconsin 54449, USA. cbibbo@charter.net
authors.forename: Christopher
authors.initials: C
authors.lastname: Bibbo
authors.forename: Thomas
authors.initials: T
authors.lastname: Fritsche
authors.forename: Mary
authors.initials: M
authors.lastname: Stemper
authors.forename: Matthew
authors.initials: M
authors.lastname: Hall
mesh_terms: D000333:Aeromonas / Q000472:pathogenicity; D000368:Aged; D000818:Animals; D019072:Antibiotic Prophylaxis / Q000379:methods; D001177:Arthropathy, Neurogenic / Q000150:complications / Q000382:microbiology* / Q000628:therapy; D006085:Graft Survival; D016905:Gram-Negative Bacterial Infections / Q000209:etiology / Q000382:microbiology* / Q000628:therapy; D047709:Hirudo medicinalis / Q000382:microbiology; D006801:Humans; D024763:Leeching / Q000009:adverse effects*; D008297:Male; D009767:Obesity, Morbid / Q000150:complications / Q000382:microbiology* / Q000628:therapy; D019651:Plastic Surgery Procedures / Q000009:adverse effects; D016038:Skin Transplantation / Q000009:adverse effects*; D016896:Treatment Outcome; D014946:Wound Infection / Q000382:microbiology* / Q000628:therapy