Infection risk related to the use of medicinal leeches.

Objective: To assess the incidence of postoperative wound infections related to treatment with medicinal leeches at Ghent University Hospital.

Method: A 2-year retrospective analysis of bacteriologic culture results of soft tissue infections in patients treated with medicinal leeches.

Results: Cultures of suspected wound infections were taken and susceptibility testing of isolates was performed on 17 of 47 patients (36.2%). Aeromonas was frequently isolated (18.5%).

Conclusions: A high incidence of infection during and after application of medicinal leeches, despite their external decontamination, necessitates an antibiotic prophylaxis. In particular Aeromonas must be covered, as soft tissue infections with these bacteria can give serious complications. The prophylactic antibiotic should cover the most frequent isolated species taking into account the importance of Aeromonas and the susceptibility pattern. Based on the results, fluoroquinolones seem to be a good choice. The authors believe that practical recommendations to hospital pharmacists on prophylaxis during Hirudo medicinalis treatment, might enhance the safety of it's use by reducing the number of infections.