Maggot Debridement Therapy as an Alternate Treatment for MRSA Skin Infections

Wound care is challenging in today’s era of antibiotic-resistant bacterial infections, but healthcare practitioners treating infectious wounds have some tiny allies. A new study in BMC Biotechnology describes new advances in maggot debridement therapy (MDT), a cost-effective approach in wound management.

While the idea of intentionally interacting with the little larvae may make some individuals squirm, their role in medical applications goes back centuries. According to the study, when applied to wounds, maggots speed up healing by releasing an enzyme that helps them consume and digest dead tissue while leaving behind healthy tissue, a process known as debridement. Maggot secretions also have antimicrobial properties that help fight against a wide range of pathogenic bacteria, including many of those with antibiotic resistance.

In 2004 the Food and Drug Administration approved MDT as a medical device for the purpose of treating wounds such as chronic ulcers, non-healing necrotic wounds and soft tissue wounds, and non-healing traumatic or post-surgical wounds that become infected. When compared to conventional treatment approaches, MDT can offer significantly faster improvement in non-healing wounds with debridement occurring within the first week of maggot application.

The new study in BMC Biotechnology takes a look at how the next generation of maggots could be used to fight infected wounds. The authors of the study outline how the green bottle fly Lucilia sericata, often used in MDT, can be genetically engineered to promote would healing.

Through genetic engineering, insects can emit secretions packed with human growth factors and other proteins. One such human platelet derived growth factor-BB (PDGF-BB) is a secreted dimeric peptide growth factor that binds the PDGF receptor. PDGF-BB stimulates cell proliferation and survival, promotes wound healing and has been investigated as a possible topical treatment for non-healing wounds. In their paper, the authors conclude that their system could potentially be used to deliver a variety of growth factors and antimicrobial peptides to the wound environment with the aim of enhancing wound healing, thereby improving patient outcome in a cost-effective manner.

The promise of such a method of wound management is particularly of interest for the treatment of skin wounds infected with antibiotic-resistant bacteria such as methicillin-resistant Staphylococcus aureus (MRSA). According to the Centers for Disease Control and Prevention, there are more than 80,000 severe MRSA infections in the United States every year, and more than 11,000 of those result in death. The bacteria are a leading cause of healthcare-associated infections. A MRSA skin infection may first appear as a bump or infected area on the skin with symptoms such as:

• Redness
• Swelling
• Pain
• Feeling warm to the touch
• Pus or other drainage
• Accompanied by a fever

Earlier research indicates that maggot therapy is an effective weapon against hard-to-treat wounds infected with MRSA, making it a promising treatment option for preventing and healing necrotic and gangrenous wounds.

MDT popularity has grown in the decade since receiving FDA approval. All licensed physicians in the United States can prescribe maggot therapy for use in wound treatment and there are more than 50,000 MDT treatments applied every year.