YARALARDA BİYOFİLM İÇEREN BAKTERİLER ÜZERİNE LUCILIA SERICATA LARVALARININ ETKİSİ

The Effect of Lucilia sericata Larvae on Biofilm-Containing Bacteria in Wounds. İstanbul University-Cerrahpasa, Institute of Graduate Studies, Medical Microbiology Department. Thesis of Master. İstanbul.

When wounds do  not  epithelize  for a long time, they become infected with bacteria. As a result, the formation of a structure called biofilm becomes inevitable. Bacteria adhere to a solid surface and they form a layer and increase in number. In addition,  they create resistance  to antimicrobial agents. Wounds containing biofilm are generally chronic and difficult to treat. In this case, it was concluded that when Lucilia sericata larvae are used as a treatment, they have  an immediate effect  on the biofilm layer  as little as two hours.

Swab samples were taken with a swab before and after Larva Debridement Treatment  (LDT) from the wound lesions of  30 patients who applied to the Wound Care Unit of Cerrahpaşa Medical Faculty between December 2019 and March 2021. The samples were evaluated both in terms of bacteriology and biofilm. Traditional and modern techniques have been used to identify microorganisms. The identified bacteria were evaluated in terms of biofilm after incubation at 37 °C for 18-24 hours after inoculation on Congo Red Agar Medium.

In total, 30 patients were studied, of which 23 (76.7%) were male and 7 (23.3%) were female. The mean age of  the patients was 59.4 years and 66.6% of the patients were diabetic in the study group; 33.40 % of the patients was suffering  from other diseases. In some patients, it was observed that the bacterial colony counts gradually decreased in the last sessions of LDT. As a result of this study, it was found that slime was  positive in 21 (70%) patients and  negative in 9 (30%) patients. During the study period, 8 different genus/species of bacteria were isolated from cultivated samples in 19 patients who were examined and had a single type of bacterial growth. It was determined that there was more than one growth in the wound samples of 11 of 30 patients. It has been observed that the most common agents in wound infections are Proteus mirabilis and Gram positive bacillus. After LDT, as a result of each session of the samples taken from the wound lesions of 30 patients, the colony numbers remained the same in 22 patients. While it was determining  that the number of colonies decreases by 50% in the second sessions of LDT in 4 patients and it was determined that the number of colonies  decreases by 50% in the last session of LDT in 4 patients In addition, bacterial species were observed to change in 3rd session of LDT in 13 patients, in 2nd sessions of LDT in 11 patients, in the 4th sessions of LDT in 4 patients. The bacterial species remained as the same in 2 patients after sessions. As a result of this study, it was observed that the active bacteria and the biyofilm layer formed in the wounds were significantly eliminated by LDT.

Keywords: Lucilia sericata, Larval Debridement Treatment, Biofilm, Wound, Microorganism