Institute for Reconstructive Plastic Surgery, New York University Langone Medical Center, New York, New York 10016, USA.
Am J Crit Care. 2010 Sep;19(5):469-71. doi: 10.4037/ajcc2009110. Epub 2009 Nov 25.
Medicinal leeches are used to control venous congestion. Aeromonas in the leech gut are essential for digestion of blood. This case report describes a patient who had Aeromonas bacteremia develop after leeching. He had an injury to his hand that required replantation of his thumb. Following the surgery, leech therapy was started with ampicillin-sulbactam prophylaxis. Sepsis developed. Blood cultures were positive for Aeromonas that were resistant to ampicillin-sulbactam. The antibiotic was changed to ciprofloxacin on the basis of the sensitivity profile of the organisms. Cultures from the leech bathwater confirmed it as the source of the Aeromonas. Clinicians who use leech therapy must be aware that leeches can harbor Aeromonas species resistant to accepted prophylactic antibiotics and that sepsis may occur.
医用水蛭用于控制静脉充血。蛭肠中的气单胞菌对于血液消化至关重要。本病例报告描述了一名患者在接受水蛭治疗后发生气单胞菌菌血症。他的手部受伤需要进行拇指再植。手术后，开始使用氨苄西林-舒巴坦预防措施进行水蛭治疗。发生了脓毒症。血液培养物中分离出气单胞菌，对氨苄西林-舒巴坦耐药。根据生物体的药敏谱，将抗生素更改为环丙沙星。从水蛭浴水中的培养物证实它是气单胞菌的来源。使用水蛭治疗的临床医生必须意识到，水蛭可能携带对抗生素有耐药性的气单胞菌，并且可能会发生脓毒症。
