Use of maggot therapy for treating a diabetic foot ulcer colonized by multidrug resistant bacteria in Brazil

Marilia A R Q Pinheiro, Julianny B Ferraz, Miguel A A Junior, Andrew D Moura, Maria E S M da Costa, Fagner J M D Costa, Valter F A Neto, Renato M Neto, Renata A Gama, Marilia A R Q Pinheiro, Julianny B Ferraz, Miguel A A Junior, Andrew D Moura, Maria E S M da Costa, Fagner J M D Costa, Valter F A Neto, Renato M Neto, Renata A Gama

Abstract

This study reports the efficacy of maggot therapy in the treatment of diabetic foot ulcer infected with multidrug resistant microorganisms. A 74 year old female patient with diabetes for over 30 years, was treated with maggot therapy using larvae of Chrysomya megacephala. The microbiological samples were collected to evaluate aetiology of the infection. The therapy done for 43 days resulted in a reduction of necrosis and the ulcer's retraction of 0.7 cm [2] in area. Analysis of the bacteriological swabs revealed the presence of Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa. Further studies need to be done to confirm the role of maggot therapy in wound healing using a large sample and a proper study design.

Figures

Fig. 1
Fig. 1
Patient's foot ulcer before and after the maggot therapy. (A). Measurement of the extent of necrosis and application of treatment (day 1). Asterisks represent areas of tissue necrosis. (B). Patient's foot ulcer image during treatment with maggot therapy (day 14). The asterisks represent areas of tissue necrosis and the arrows indicate the larvae of Chrysomya megacephala. (C). Patient's foot ulcer image after treatment with maggot therapy (day 43).

References

    1. Martini RK, Sherman RA. Maggot debridement therapy. J Bras Med. 2003;85:82–5.
    1. Sherman RA, Hall MJR, Thomas S. Medicinal Maggots: an ancient remedy for some contemporary afflictions. Annu Rev Entomol. 2000;45:55–81.
    1. Marcondes CB. 1st ed. Florianópolis: Editora da UFSC; 2006. Use of maggot therapy for treating a diabetic foot ulcer colonized by multidrug resistant bacteria in Brazil.
    1. Murray PR, Baron EJ, Pfaller MA, Tenover FC, Yolken RH. 7th ed. Washington DC: ASM Press; 1999. Manual of clinical microbiology.
    1. Wayne, PA, USA: CLSI; 2013. Clinical and Laboratory Standards Institute (CLSI). Performance standards for antimicrobial susceptibility testing; 23rd informational supplement.
    1. de Oliveira CF, Salla A, Lara VM, Rieger A, Horta JA, Alves SH. Prevalence of extended spectrum beta-lactamases producing microorganisms in noscomial patients and molecular characterization of the shv type isolates. Braj J Microbiol. 2010;41:278–82.
    1. Tanyuksel M, Araz E, Dundar K, Uzun G, Gumus T, Alten B, et al. Maggot debridement therapy in the treatment of chronic wounds in a military hospital setup in Turkey. Dermatology. 2005;210:115–8.
    1. Chambers L, Woodrow S, Brown AP, Harris PD, Philips D, Hall M, et al. Degradation extracellular matrix components by defined proteinases from the green bottle larva Lucillia sericata used for the clinical debridement of non-healing wounds. Br J Dermatol. 2003;148:14–23.
    1. Mclnnes W, Ruzehaji N, Wright N, Cowin AJ, Fitridge R. Venous ulceration contaminated by multi-resistant organisms: larval therapy & debridement. J Wound Care. 2013;22(Suppl 10):s27–30.
    1. Bexfield A, Nigam Y, Thomas S, Ratcliffe NA. Detection and partial characterization of two antibacterial factors from the excretions/secretions of the medicinal maggot Lucilia sericata and their activity against methicillin-resistant Staphylococcus aureus (MRSA) Microbes Infect. 2004;6:1297–304.
    1. Hubernan L, Gollop N, Mumcuoglu KY, Block C, Galun R. Antibacterial properties of whole body extracts and haemolymph of Lucilia sericata maggots. J Wound Care. 2007;16:123–7.

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