蛆虫疗法对糖尿病足溃疡中金黄色葡萄球菌和铜绿假单胞菌的疗效：一项随机对照试验
Efficacy of Maggot Therapy on Staphylococcus aureus and Pseudomonas aeruginosa in Diabetic Foot Ulcers: A Randomized Controlled Trial.
作者信息
Malekian Azam, Esmaeeli Djavid Gholamreza, Akbarzadeh Kamran, Soltandallal Mehdi, Rassi Yavar, Rafinejad Javad, Rahimi Foroushani Abbas, Farhoud Amirreza, Bakhtiary Ronak, Totonchi Mehrangiz
机构信息
Azam Malekiam, MSc, Maggot Debridement Therapy Clinic, Iranian Center for Wound Healing, Academic Center for Education, Culture and Research (ACECR), Tehran, Iran; and Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Gholamreza Esmaeeli Djavid, MD, Maggot Debridement Therapy Clinic, Iranian Center for Wound Healing, ACECR, Tehran, Iran; and Medical Laser Research Center, ACECR, Tehran, Iran. Kamran Akbarzadeh, PhD, Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Mehdi Soltandallal, PhD, Department of Medical Pathology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Yavar Rassi, PhD, Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Javad Rafinejad, PhD, Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Abbas Rahimi Forooshani, PhD, Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Amirreza Farhoud, Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Ronak Bakhtiary, Department of Medical Pathology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
出版信息
J Wound Ostomy Continence Nurs. 2019 Jan/Feb;46(1):25-29. doi: 10.1097/WON.0000000000000496.
PURPOSE
This study was conducted to evaluate the antimicrobial effects of medicinal maggots of Lucilia sericata on Staphylococcus aureus and Pseudomonas aeruginosa on diabetic foot ulcers (DFUs).
DESIGN
Randomized controlled trial.
SUBJECTS AND SETTING
The sample comprised 50 adult patients from the clinic of the Academic Center for Education, Culture and Research of Tehran University of Medical Sciences, Iran. All participants who had at least 1 DFU present for at least 12 weeks, an arterial brachial index value of more than 0.6, and a hemoglobin A1c value of less than 8% were included in this study.
METHODS
Subjects were randomly selected for the maggot-treated (treatment) or conventional treatment (control) group. Conventional treatments such as antibiotic therapy, debridement, and offloading were done for both groups, but maggot therapy (MT) was added to the protocol of the treatment group. Bacterial burden was monitored and compared for both groups using cultures collected using swab technique. Wound secretions were measured and compared in both groups.
RESULTS
The number of infected cases with S aureus in the treatment group was significantly reduced after 48 hours in comparison with the control group (P = .047). The number of infected cases with P aeruginosa was significantly reduced after 96 hours (P = .002). We also found that wound secretions in the treatment group were significantly higher than in the control group (P < .00).
CONCLUSIONS
Our findings indicate that MT is a safe and efficacious treatment of DFUs.
目的
本研究旨在评估丝光绿蝇药用蛆虫对糖尿病足溃疡（DFU）患者金黄色葡萄球菌和铜绿假单胞菌的抗菌作用。
设计
随机对照试验。
研究对象与地点
样本包括来自伊朗德黑兰医科大学教育、文化与研究学术中心诊所的50名成年患者。所有至少有1个DFU存在至少12周、肱动脉指数值大于0.6且糖化血红蛋白值小于8%的参与者均纳入本研究。
方法
将受试者随机分为蛆虫治疗组（治疗组）或传统治疗组（对照组）。两组均进行抗生素治疗、清创和减负等传统治疗，但治疗组的方案中增加了蛆虫疗法（MT）。使用拭子技术收集培养物，监测并比较两组的细菌负荷。测量并比较两组的伤口分泌物。
结果
与对照组相比，治疗组金黄色葡萄球菌感染病例数在48小时后显著减少（P = 0.047）。铜绿假单胞菌感染病例数在96小时后显著减少（P = 0.002）。我们还发现治疗组的伤口分泌物明显高于对照组（P < 0.00）。
结论
我们的研究结果表明，蛆虫疗法是一种安全有效的糖尿病足溃疡治疗方法。
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