Hermansdorfer J, Lineaweaver W, Follansbee S, Valauri F A, Buncke H J
Microsurgical Replantation Transplantation Department, Davies Medical Center, San Francisco.
Br J Plast Surg. 1988 Nov;41(6):649-51. doi: 10.1016/0007-1226(88)90176-2.
Increased use of medicinal leeches (Hirudo medicinalis) for the treatment of venous congestion in flaps and replanted parts has coincided with reports of soft tissue infections following leech application. We cultured the gullets of 20 medicinal leeches to re-examine the antibiotic sensitivities of Aeromonas hydrophila, the leech enteric organism associated with reported infections. These isolates reflected reported resistance to penicillin and first generation cephalosporins as well as sensitivity to gentamicin, tetracycline and chloramphenicol. Additionally, the cultures were sensitive to cefamandol, cefoxitin and two third generation cephalosporins (cefoperazone and cefotaxime). These findings suggest that cefamandol, cefoxitin and some third generation cephalosporins may have a role as perioperative antibiotics in replantation and flap surgery. These antibiotics might provide prophylaxis against Aeromonas hydrophila infection when leech use is required.
药用蚂蟥（医蛭）在治疗皮瓣和再植部位静脉淤血方面的使用增加，与此同时，有报道称应用蚂蟥后出现软组织感染。我们对20条药用蚂蟥的食管进行培养，以重新检测嗜水气单胞菌的抗生素敏感性，该菌是与报道的感染相关的蚂蟥肠道菌。这些分离株显示出对青霉素和第一代头孢菌素的耐药性，以及对庆大霉素、四环素和氯霉素的敏感性。此外，培养物对头孢孟多、头孢西丁和两种第三代头孢菌素（头孢哌酮和头孢噻肟）敏感。这些发现表明，头孢孟多、头孢西丁和一些第三代头孢菌素可能在再植和皮瓣手术中作为围手术期抗生素发挥作用。当需要使用蚂蟥时，这些抗生素可能预防嗜水气单胞菌感染。
