Ciprofloxacin-resistant Aeromonas infection following leech therapy for digit replantation: report of 2 cases.
Medicinal leeches are commonly used after finger replantation to treat surgically unsalvageable venous congestion. Infection from Aeromonas hydrophila is a recognized complication of leech therapy that can be underestimated by the medical community. Ciprofloxacin and trimethoprim-sulfamethoxazole are the most commonly recommended prophylactic antibiotics used to prevent A. hydrophila infections during leech therapy. Here, we report 2 cases of ciprofloxacin-resistant Aeromonas infections, occurring within 4 months of each other. Both cases developed after leech therapy for unsuccessful digital replantation. These infections were successfully treated with ceftriaxone. Ciprofloxacin-resistant Aeromonas should be recognized when determining prophylactic antibiotic protocols for replant centers when leech therapy is used for finger replantation.
Department of Surgery, Division of Plastic & Reconstructive Surgery, Mayo Clinic, Rochester, Minnesota.
Nickolas A
NA
van Alphen
Department of Surgery, Division of Plastic & Reconstructive Surgery, Mayo Clinic, Rochester, Minnesota.
Alexandra
A
Gonzalez
Department of Surgery, Division of Plastic & Reconstructive Surgery, Mayo Clinic, Rochester, Minnesota.
Maureen C
MC
McKenna
Department of Surgery, Division of Plastic & Reconstructive Surgery, Mayo Clinic, Rochester, Minnesota.
Theresa K
TK
McKenna
Department of Surgery, Division of Plastic & Reconstructive Surgery, Mayo Clinic, Rochester, Minnesota.
Brian T
BT
Carlsen
Department of Surgery, Division of Plastic & Reconstructive Surgery, Mayo Clinic, Rochester, Minnesota. Electronic address: moran.steven@mayo.edu.
Steven L
SL
Moran
D000328:Adult; D016980:Aeromonas hydrophila; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002939:Ciprofloxacin / Q000627:therapeutic use*; D024881:Drug Resistance, Bacterial; D005383:Finger Injuries / Q000601:surgery*; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology; D006801:Humans; D024763:Leeching / Q000009:adverse effects*; D008875:Middle Aged; D012092:Replantation / Q000379:methods*
D000900:Anti-Bacterial Agents; D002939:Ciprofloxacin
Aeromonas; Replantation; antibiotic prophylaxis; antibiotic resistance; leeches