ABSTRACT
The aim of this study was to examine the burden of fungal disease in Norway, contributing to a worldwide effort to improve awareness of the needs for better diagnosis and treatment of such infections. We used national registers and actual data from the Departments of Microbiology from 2015 and estimated the incidence and/or prevalence of superficial, allergic and invasive fungal disease using published reports on specific populations at risk. One in 6 Norwegians suffered from fungal disease: Superficial skin infections (14.3%: 745,600) and recurrent vulvovaginal candidiasis in fertile women (6%: 43,123) were estimated to be the most frequent infections. Allergic fungal lung disease was estimated in 17,755 patients (341/100,000). Pneumocystis jirovecii was diagnosed in 262 patients (5/100,000), invasive candidiasis in 400 patients (7.7/100,000), invasive aspergillosis in 278 patients (5.3/100,000) and mucormycosis in 7 patients (0.1/100,000). Particular fungal infections from certain geographic areas were not observed. Overall, 1.79% of the population was estimated to be affected by serious fungal infections in Norway in 2015. Even though estimates for invasive infections are small, the gravity of such infections combined with expected demographic changes in the future emphasizes the need for better epidemiological data.
ABSTRACT
BACKGROUND: Maggots' ability to prevent infections and promote wound healing has been known since the 19th century. Increasing problems with treatment-resistant wounds and antibiotic-resistant bacteria has aroused interest in maggot therapy. MATERIAL AND METHODS: Literature on maggot therapy - identified through a non-systematic search of Pubmed - was reviewed. RESULTS: Maggot therapy is the medical use of disinfected fly larvae (usually the larvae of Lucilia sericata) in treatment of wounds resistant to conventional treatment. The maggots work through three mechanisms of action; they debride wounds by dissolving necrotic tissue, clean wounds by killing bacteria and promote wound healing. The larvae have a broad antibacterial action against Gram-negative and Gram-positive bacteria, including MRSA. Maggot therapy is used to debride a number of complicated skin and soft tissue wounds - e.g.. pressure ulcers, venous stasis ulcers, neurovascular ulcers, traumatic wounds and burns - but also as a treatment for osteomyelitis. Large controlled clinical trials have not been performed. Maggot therapy has not been associated with serious side effects. INTERPRETATION: Maggot therapy seems to be an effective and environmentally friendly treatment of complicated necrotic wounds that are resistant to conventional treatment. Maggot therapy should also be considered in earlier stages of treatment.
