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Antibiotic-resistant infections appeared after surgery. Were they transmitted by leeches?

An outbreak of antibiotic-resistant infections that appeared in Iowa has been traced to medical leeches from France, highlighting how accidental contamination can resurface over 4,000 miles away.

The enigma emerged in the form of some greenish-white pus, swabbed from the wound of a patient not long after surgery. On Dec. 13th, 2012, surgeons at the University of Iowa Hospitals and Clinics had excised a tumor from his face, patching over the wound with a Post-it note of flesh from his thigh. But that flap had died, and a week later he was under the knife again, to have his wound re-mended with a strip of skin from his back.

When doctors saw blood pooling in the new graft, threatening to kill this one, too, they had the perfect treatment. Down in a hospital lab was a tank rippling with leeches. They fished some out and placed them on the man’s face.

Things got better for Christmas. For New Year’s, they got worse. The wound had started oozing pus, which smelled like a sewer and baffled the physicians. Leech guts, like ours, are crawling with bacteria, so the team had pumped the patient full of ciprofloxacin before allowing his blood to be sucked. That should have stopped any infections before they started. Then lab tests confirmed their suspicions: These bugs, called Aeromonas, were cipro-resistant.

When they searched the hospital’s records, they found another, similar case of antibiotic resistance, from July 2012, when plastic surgeons had used leeches after repairing a foot that had been crushed by a crane. There were reports from hospitals elsewhere, too: California, Missouri, even France.

Where was the resistance coming from? Five years later, a team

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