1
|
Aiello F, Gallo Afflitto G, Ceccarelli F, Turco MV, Han Y, Amescua G, Dart JK, Nucci C. Perspectives on the Incidence of Acanthamoeba Keratitis: A Systematic Review and Meta-Analysis. Ophthalmology 2025; 132:206-218. [PMID: 39127408 DOI: 10.1016/j.ophtha.2024.08.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Revised: 07/30/2024] [Accepted: 08/02/2024] [Indexed: 08/12/2024] Open
Abstract
TOPIC To provide an overview on the incidence of Acanthamoeba keratitis (AK). CLINICAL RELEVANCE Although being a sight-threatening cause of infectious keratitis, a comprehensive assessment of the incidence of AK is lacking. METHODS Incidence of AK was computed as the number of eyes with AK per health care center, per year (annualized center incidence [ACI]). Two meta-analytical ratios also were calculated: (1) the ratio of eyes with AK to the count of eyes with nonviral microbial keratitis (MK) and (2) the ratio of eyes with AK to the overall population (i.e., the total number of people in a nation or region, as indicated by the authors in each study). Center was defined as the health care facility where the study took place. Actual and projected estimates of the number of eyes with AK in years were calculated multiplying the ratio of eyes with AK to the total population and the corresponding population estimates, sourced from the United Nations Population Prospects. RESULTS Overall, 105 articles were included, published between 1987 and 2022. The total number of eyes identified was 91 951, with 5660 eyes affected by AK and 86 291 eyes affected by nonviral MK. The median ACI was 1.9 eyes with AK per health care center per year (95% confidence interval [CI], 1.5-2.6 eyes), with no statistically significant differences among continents. The ratio of eyes with AK to the total number of eyes with MK was 1.52% (95% CI, 1.03%-2.22%), whereas the ratio of eyes with AK in relationship to the entire population was estimated at 2.34 eyes per 1 000 000 people (95% CI, 0.98-5.55 per 1 000 000 people). The projected increase in the numbers of eyes with AK indicated an increase of 18.5% (n = 15 355 eyes with AK) in 2053 and 25.5% (n = 16 253 eyes with AK) in 2073, compared with the baseline of 2023 (n = 12 953 eyes with AK). DISCUSSION Acanthamoeba keratitis emerged as a relatively low-incident disorder, and no significant differences in terms of its incidence were found among different continents. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
Collapse
Affiliation(s)
- Francesco Aiello
- Ophthalmology Unit, Department of Experimental Medicine, Università di Roma "Tor Vergata," Rome, Italy
| | - Gabriele Gallo Afflitto
- Ophthalmology Unit, Department of Experimental Medicine, Università di Roma "Tor Vergata," Rome, Italy; Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom.
| | - Francesca Ceccarelli
- Ophthalmology Unit, Department of Experimental Medicine, Università di Roma "Tor Vergata," Rome, Italy
| | - Maria Vittoria Turco
- Ophthalmology Unit, Department of Experimental Medicine, Università di Roma "Tor Vergata," Rome, Italy
| | - Yuyi Han
- Department of Ophthalmology, Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Guillermo Amescua
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
| | - John K Dart
- Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom; National Institute of Health Research (NIHR) Moorfields Biomedical Research Centre, London, United Kingdom
| | - Carlo Nucci
- Ophthalmology Unit, Department of Experimental Medicine, Università di Roma "Tor Vergata," Rome, Italy
| |
Collapse
|
2
|
Akhlaghi E, Shafa S, Akbari Z, Babaei Z, Mohammadi MA, Shamsaddini S, Sharifi A, Harandi MF. Identification and Characterization of Acanthamoeba from Contact Lens Care Solutions and Hospital Environments in the Ophthalmology Wards and Operating Rooms in Southeastern Iran. Acta Parasitol 2025; 70:12. [PMID: 39775293 DOI: 10.1007/s11686-024-00948-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2024] [Accepted: 12/16/2024] [Indexed: 01/11/2025]
Abstract
OBJECTIVE Different Acanthamoeba species are among the most ubiquitous organisms causing serious diseases in humans including central nervous system (CNS) and eye infections. Contact lenses, lens care solutions and the hospital environments particularly the indoor and outdoor environments of ophthalmology wards where people are present with different types of eye diseases, are the potential sources of human infection. The purpose of the present study was the molecular investigation of free-living amoebae in the used contact lenses, lens care solutions and hospital samples from the ophthalmology wards and operating rooms in a referral hospital in southeastern Iran. METHODS Samples were collected from the lens care solutions, used contact lenses, and from indoor and outdoor environments of the ophthalmology ward and operating room of a major referral hospital in Kerman, Southeastern Iran. The samples were cultured on non-nutrient agar (NNA) in 28-30oC and microscopically studied. Molecular study including PCR-sequencing and phylogenetic analysis on partial 18 S rDNA were performed on positive culture samples. RESULT In total 70 samples were collected from the used contact lenses and lens care solutions, as well as the hospital environment of which 11.4% (8 out of 70) were found positive using NNA culture. Two out of 40 samples (5.0%) from the used contact lenses and the care solutions were found positive for the presence of Acanthamoeba T4 genotype. Acanthamoeba cysts were identified in two out of 22 dust samples (9.1%) collected from the ophthalmology ward and operating rooms. Protacanthamoeba bohemica was found in the soil samples from outdoor environment of the ophthalmology ward. CONCLUSION This study identified Acanthamoeba species in contact lenses and in indoor environmental samples from the ophthalmology ward. T4 genotype was found on the contact lenses examined in this study. In the dust sampled from within the ophthalmology ward Acanthamoeba sp. was identified.
Collapse
Affiliation(s)
- Elham Akhlaghi
- Student Research Committee, Kerman University of Medical Sciences, Kerman, Iran
- Research Center for Hydatid Disease in Iran, Institute of Infectious Diseases and Tropical Medicine, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Shahriar Shafa
- Department of Ophthalmology, Afzalipour School of Medicine, Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Zahra Akbari
- Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
- Leishmaniasis Research Center, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Zahra Babaei
- Leishmaniasis Research Center, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Ali Mohammadi
- Research Center for Hydatid Disease in Iran, Institute of Infectious Diseases and Tropical Medicine, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Saeedeh Shamsaddini
- Research Center for Hydatid Disease in Iran, Institute of Infectious Diseases and Tropical Medicine, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Sharifi
- Department of Ophthalmology, Afzalipour School of Medicine, Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Majid Fasihi Harandi
- Research Center for Hydatid Disease in Iran, Institute of Infectious Diseases and Tropical Medicine, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran.
| |
Collapse
|
3
|
Sundararaj BK, Goyal M, Samuelson J. Identification of new targets for the diagnosis of cysts (four) and trophozoites (one) of the eye pathogen Acanthamoeba. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.10.16.618517. [PMID: 39463995 PMCID: PMC11507896 DOI: 10.1101/2024.10.16.618517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/29/2024]
Abstract
Acanthamoebae , which are free-living amoebae, cause corneal inflammation (keratitis) and blindness, if not diagnosed and effectively treated. While trophozoites adhere to and damage the cornea, Acanthamoeba cysts, the walls of which contain cellulose and have two layers connected by conical ostioles, are the diagnostic form by microscopy of the eye or of corneal scrapings. We recently used structural and experimental methods to characterize cellulose-binding domains of Luke and Leo lectins, which are abundant in the inner layer and ostioles. However, no antibodies have been made to these lectins or to a Jonah lectin and a laccase, which are abundant in the outer layer. Here we used confocal microscopy to show that rabbit antibodies to recombinant Luke, Leo, Jonah, and laccase generally support localizations of GFP-tagged proteins in walls of transfected Acanthamoebae. Rabbit antibodies to all four wall proteins efficiently detected calcofluor white-labeled cysts of 10 of 11 Acanthamoeba isolates obtained from the ATCC, including five T4 genotypes that cause most cases of keratitis. Laccase shed into the medium during encystation was detected by an enzyme-linked immunoassay. We also used structural and experimental methods to characterize the mannose-binding domain of an Acanthamoeba mannose-binding protein and showed that rabbit antibodies to the mannose-binding domain efficiently detected trophozoites of all 11 Acanthamoeba isolates. We conclude that four wall proteins are all excellent targets for diagnosing Acanthamoeba cysts in the eye or corneal scrapings, while the mannose-binding domain is an excellent target for identifying trophozoites in cultures of corneal scrapings. Importance Free-living amoeba in the soil or water cause Acanthamoeba keratitis, which is diagnosed by identification of cysts by microscopy of the eye or of corneal scrapings, using calcofluor-white that unfortunately cross-reacts with fungi and plants. Alternatively, Acanthamoeba infections are diagnosed by identification of trophozoites in cultures of scrapings. Here we showed that rabbit antibodies to four abundant cyst wall proteins (Jonah, Luke, Leo, and laccase) each efficiently detect calcofluor-white-labeled cysts of 10 of 11 Acanthamoeba isolates obtained from the ATCC. Further, laccase released into the medium by encysting Acanthamoebae was detected by an enzyme-linked immunoassay. We also showed that rabbit antibodies to the mannose-binding domain of the Acanthamoeba mannose-binding protein, which mediates adherence of trophozoites to keratinocytes, efficiently identifies trophozoites of all 11 ATCC isolates. In summary, four wall proteins and the ManBD appear to be excellent targets for diagnosis of Acanthamoeba cysts and trophozoites, respectively.
Collapse
|
4
|
Kanakapura Sundararaj B, Goyal M, Samuelson J. Cellulose binding and the timing of expression influence protein targeting to the double-layered cyst wall of Acanthamoeba. mSphere 2024; 9:e0046624. [PMID: 39136454 PMCID: PMC11423589 DOI: 10.1128/msphere.00466-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Accepted: 07/22/2024] [Indexed: 09/26/2024] Open
Abstract
The cyst wall of the eye pathogen Acanthamoeba castellanii contains cellulose and has ectocyst and endocyst layers connected by conical ostioles. Cyst walls contain families of lectins that localize to the ectocyst layer (Jonah) or the endocyst layer and ostioles (Luke and Leo). How lectins and an abundant laccase bind cellulose and why proteins go to locations in the wall are not known and are the focus of the studies here. Structural predictions identified β-jelly-roll folds (BJRFs) of Luke and sets of four disulfide knots (4DKs) of Leo, each of which contains linear arrays of aromatic amino acids, also present in carbohydrate-binding modules of bacterial and plant endocellulases. Ala mutations showed that these aromatics are necessary for cellulose binding and proper localization of Luke and Leo in the Acanthamoeba cyst wall. BJRFs of Luke, 4DKs of Leo, a single β-helical fold (BHF) of Jonah, and a copper oxidase domain of the laccase each bind to glycopolymers in both layers of deproteinated cyst walls. Promoter swaps showed that ectocyst localization does not just correlate with but is caused by early encystation-specific expression, while localization in the endocyst layer and ostioles is caused by later expression. Evolutionary studies showed distinct modes of assembly of duplicated domains in Luke, Leo, and Jonah lectins and suggested Jonah BHFs originated from bacteria, Luke BJRFs share common ancestry with slime molds, while 4DKs of Leo are unique to Acanthamoeba.IMPORTANCEAcanthamoebae is the only human parasite with cellulose in its cyst wall and conical ostioles that connect its inner and outer layers. Cyst walls are important virulence factors because they make Acanthamoebae resistant to surface disinfectants, hand sanitizers, contact lens sterilizers, and antibiotics applied to the eye. The goal here was to understand better how proteins are targeted to specific locations in the cyst wall. To this end, we identified three new proteins in the outer layer of the cyst wall, which may be targets for diagnostic antibodies in corneal scrapings. We used structural predictions and mutated proteins to show linear arrays of aromatic amino acids of two unrelated wall proteins are necessary for binding cellulose and proper wall localization. We showed early expression during encystation causes proteins to localize to the outer layer, while later expression causes proteins to localize to the inner layer and the ostioles.
Collapse
Affiliation(s)
- Bharath Kanakapura Sundararaj
- Department of Molecular and Cell Biology, Boston University Goldman School of Dental Medicine, Boston, Massachusetts, USA
| | - Manish Goyal
- Department of Molecular and Cell Biology, Boston University Goldman School of Dental Medicine, Boston, Massachusetts, USA
| | - John Samuelson
- Department of Molecular and Cell Biology, Boston University Goldman School of Dental Medicine, Boston, Massachusetts, USA
| |
Collapse
|
5
|
Musa M, Enaholo E, Aluyi-Osa G, Atuanya GN, Spadea L, Salati C, Zeppieri M. Herpes simplex keratitis: A brief clinical overview. World J Virol 2024; 13:89934. [PMID: 38616855 PMCID: PMC11008405 DOI: 10.5501/wjv.v13.i1.89934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 12/28/2023] [Accepted: 01/22/2024] [Indexed: 03/11/2024] Open
Abstract
The aim of our minireview is to provide a brief overview of the diagnosis, clinical aspects, treatment options, management, and current literature available regarding herpes simplex keratitis (HSK). This type of corneal viral infection is caused by the herpes simplex virus (HSV), which can affect several tissues, including the cornea. One significant aspect of HSK is its potential to cause recurrent episodes of inflammation and damage to the cornea. After the initial infection, the HSV can establish a latent infection in the trigeminal ganglion, a nerve cluster near the eye. The virus may remain dormant for extended periods. Periodic reactivation of the virus can occur, leading to recurrent episodes of HSK. Factors triggering reactivation include stress, illness, immunosuppression, or trauma. Recurrent episodes can manifest in different clinical patterns, ranging from mild epithelial involvement to more severe stromal or endothelial disease. The severity and frequency of recurrences vary among individuals. Severe cases of HSK, especially those involving the stroma and leading to scarring, can result in vision impairment or even blindness in extreme cases. The cornea's clarity is crucial for good vision, and scarring can compromise this, potentially leading to visual impairment. The management of HSK involves not only treating acute episodes but also implementing long-term strategies to prevent recurrences and attempt repairs of corneal nerve endings via neurotization. Antiviral medications, such as oral Acyclovir or topical Ganciclovir, may be prescribed for prophylaxis. The immune response to the virus can contribute to corneal damage. Inflammation, caused by the body's attempt to control the infection, may inadvertently harm the corneal tissues. Clinicians should be informed about triggers and advised on measures to minimize the risk of reactivation. In summary, the recurrent nature of HSK underscores the importance of both acute and long-term management strategies to preserve corneal health and maintain optimal visual function.
Collapse
Affiliation(s)
- Mutali Musa
- Department of Optometry, University of Benin, Benin 300283, Nigeria
- Department of Ophthalmology, Africa Eye Laser Centre, Km 7, Benin 300105, Nigeria
| | - Ehimare Enaholo
- Department of Ophthalmology, Africa Eye Laser Centre, Km 7, Benin 300105, Nigeria
- Department of Ophthalmology, Centre for Sight Africa, Nkpor 434101, Nigeria
| | - Gladness Aluyi-Osa
- Department of Ophthalmology, Africa Eye Laser Centre, Km 7, Benin 300105, Nigeria
| | | | - Leopoldo Spadea
- Eye Clinic, Policlinico Umberto I, "Sapienza" University of Rome, Rome 00142, Italy
| | - Carlo Salati
- Department of Ophthalmology, University Hospital of Udine, Udine 33100, Italy
| | - Marco Zeppieri
- Department of Ophthalmology, University Hospital of Udine, Udine 33100, Italy
| |
Collapse
|
6
|
Dos Santos DL, Chaúque BJM, Matiazo FF, de Miranda Ribeiro L, Rott MB. Agar dehydration: a simple method for long-term storage of Acanthamoeba spp. collection at room temperature. Parasitol Res 2024; 123:153. [PMID: 38446221 DOI: 10.1007/s00436-024-08172-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 02/26/2024] [Indexed: 03/07/2024]
Abstract
This study describes dehydration of agar containing cysts as a novel and inexpensive method for long-term storage of Acanthamoeba spp. collections at room temperature. Five hundred microliters of axenically cultured Acanthamoeba spp. trophozoites (106 cells/mL) in PYG media or 150 µl of amoeba suspension (106 cells or cysts/mL) from monoxenic plate culture was spread onto the surface of non-nutritive agar (NNA, 2-3-mm thick) without or with a layer of heat-inactivated Escherichia coli, respectively. The plates were sealed and incubated at 30 °C. After the encystment, the Parafilm® was removed, and the plates were kept at the same temperature until the NNA was completely dehydrated. The dehydrated cyst-containing NNA was cut in rectangles and stored in airtight tubes at room temperature for up to 3 years. Cyst viability was assessed by inoculating them in fresh NNA with a layer of E. coli and in PYG followed by incubation at 30 °C. One hundred percent of samples from all specimens (19) stored over the 3 years allowed new cultures to be re-established; however, two strains showed reduced viability, at 66.7% and 62.5%, after 2 years of room temperature storage. One hundred percent of the cyst samples produced axenically and maintained in dry NNA allowed the re-establishment of axenic cultures through direct incubation in PYG, with excystment occurring within 24 or 48 h. For the first time, we report the dehydration of cyst-containing agar as an economical and effective method for the long-term storage of Acanthamoeba spp. collections at room temperature. It enables the creation of large collections using reduced space and economical transport of Acanthamoeba strains, in addition to allowing better organization of the collection.
Collapse
Affiliation(s)
- Denise Leal Dos Santos
- Laboratory 520, Protozoology Laboratory, Microbiology Immunology and Parasitology Department, Basic Health Sciences Institute, Federal University of Rio Grande Do Sul, Ramiro Barcelos Street, N 2600, Porto Alegre, Rio Grande Do Sul, 90035-002, Brazil
- Postdoctoral Fellow at Master's Program in Clinical Research (MPPC) at the Hospital de Clínicas de Porto Alegre (HCPA) (CAPES Pilot Program), Rio Grande Do Sul, Brazil
| | - Beni Jequicene Mussengue Chaúque
- Laboratory 520, Protozoology Laboratory, Microbiology Immunology and Parasitology Department, Basic Health Sciences Institute, Federal University of Rio Grande Do Sul, Ramiro Barcelos Street, N 2600, Porto Alegre, Rio Grande Do Sul, 90035-002, Brazil
- Postgraduate Program in Biological Sciences: Pharmacology and Therapeutics, UFRGS, Rio Grande Do Sul, Brazil
- Center of Studies in Science and Technology (NECET), Biology Course, Universidade Rovuma, Niassa Branch, Lichinga, Mozambique
| | - Fernanda Fraga Matiazo
- Laboratory 520, Protozoology Laboratory, Microbiology Immunology and Parasitology Department, Basic Health Sciences Institute, Federal University of Rio Grande Do Sul, Ramiro Barcelos Street, N 2600, Porto Alegre, Rio Grande Do Sul, 90035-002, Brazil
| | - Larissa de Miranda Ribeiro
- Laboratory 520, Protozoology Laboratory, Microbiology Immunology and Parasitology Department, Basic Health Sciences Institute, Federal University of Rio Grande Do Sul, Ramiro Barcelos Street, N 2600, Porto Alegre, Rio Grande Do Sul, 90035-002, Brazil
| | - Marilise Brittes Rott
- Laboratory 520, Protozoology Laboratory, Microbiology Immunology and Parasitology Department, Basic Health Sciences Institute, Federal University of Rio Grande Do Sul, Ramiro Barcelos Street, N 2600, Porto Alegre, Rio Grande Do Sul, 90035-002, Brazil.
| |
Collapse
|
7
|
Ilyas M, Stapleton F, Willcox MDP, Henriquez F, Peguda HK, Rayamajhee B, Zahid T, Petsoglou C, Carnt NA. Epidemiology of and Genetic Factors Associated with Acanthamoeba Keratitis. Pathogens 2024; 13:142. [PMID: 38392880 PMCID: PMC10892102 DOI: 10.3390/pathogens13020142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/14/2024] [Accepted: 01/31/2024] [Indexed: 02/25/2024] Open
Abstract
Acanthamoeba keratitis (AK) is a severe, rare protozoal infection of the cornea. Acanthamoeba can survive in diverse habitats and at extreme temperatures. AK is mostly seen in contact lens wearers whose lenses have become contaminated or who have a history of water exposure, and in those without contact lens wear who have experienced recent eye trauma involving contaminated soil or water. Infection usually results in severe eye pain, photophobia, inflammation, and corneal epithelial defects. The pathophysiology of this infection is multifactorial, including the production of cytotoxic proteases by Acanthamoeba that degrades the corneal epithelial basement membrane and induces the death of ocular surface cells, resulting in degradation of the collagen-rich corneal stroma. AK can be prevented by avoiding risk factors, which includes avoiding water contact, such as swimming or showering in contact lenses, and wearing protective goggles when working on the land. AK is mostly treated with an antimicrobial therapy of biguanides alone or in combination with diaminidines, although the commercial availability of these medicines is variable. Other than anti-amoeba therapies, targeting host immune pathways in Acanthamoeba disease may lead to the development of vaccines or antibody therapeutics which could transform the management of AK.
Collapse
Affiliation(s)
- Muhammad Ilyas
- Primary & Secondary Healthcare Department, Punjab 54000, Pakistan; (M.I.)
| | - Fiona Stapleton
- School of Optometry and Vision Science, University of NSW, Sydney, NSW 2052, Australia (H.K.P.)
| | - Mark D. P. Willcox
- School of Optometry and Vision Science, University of NSW, Sydney, NSW 2052, Australia (H.K.P.)
| | - Fiona Henriquez
- School of Health and Life Sciences, The University of the West of Scotland, Glasgow G72 0LH, UK
| | - Hari Kumar Peguda
- School of Optometry and Vision Science, University of NSW, Sydney, NSW 2052, Australia (H.K.P.)
| | - Binod Rayamajhee
- School of Optometry and Vision Science, University of NSW, Sydney, NSW 2052, Australia (H.K.P.)
| | - Tasbiha Zahid
- Primary & Secondary Healthcare Department, Punjab 54000, Pakistan; (M.I.)
| | | | - Nicole A. Carnt
- School of Optometry and Vision Science, University of NSW, Sydney, NSW 2052, Australia (H.K.P.)
- Centre for Vision Research, Westmead Institute for Medical Research, Sydney, NSW 2145, Australia
| |
Collapse
|
8
|
Curro-Tafili K, Verbraak FD, de Vries R, van Nispen RMA, Ghyczy EAE. Diagnosing and monitoring the characteristics of Acanthamoeba keratitis using slit scanning and laser scanning in vivo confocal microscopy. Ophthalmic Physiol Opt 2024; 44:131-152. [PMID: 37916883 DOI: 10.1111/opo.13238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 09/09/2023] [Accepted: 09/23/2023] [Indexed: 11/03/2023]
Abstract
INTRODUCTION Acanthamoeba keratitis (AK) is a serious and potentially blinding ocular infection caused by the free-living amoeba, Acanthamoeba. In vivo confocal microscopy (IVCM) is a non-invasive device which has been proven of great use to diagnose Acanthamoeba infections immediately. The aim of this review was to establish different patterns and signs of AK that appear on the IVCM both before and after treatment. METHODS A systematic review of the literature from 1974 until September 2021 was performed using Embase and PubMed, following The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. RESULTS Twenty different signs of AK were observed using IVCM. The included studies used vastly different criteria to diagnose infections, ranging from just 1 to 13 of the signs, demonstrating the current lack of a standardised diagnosis of this infection using the IVCM. The appearance of double wall cysts, trophozoites, signet rings, target signs and clusters were shown to be pathognomonic to AK infections. Bright spots located in the corneal epithelium were demonstrated as non-reliable predictors of AK. The presence of cysts in clusters and single file can predict the need for corneal transplantation. The morphological changes in cysts using the IVCM following treatment were described as breaking down to hollow forms and occasionally surrounded by black cavities. Using this information, a visual guideline for identifying AK signs in diagnosis and follow-up using IVCM was created. CONCLUSION Increased awareness of the different signs and patterns of AK that appear on the IVCM is crucial in order to correctly identify an infection and increase the potential of this device. Our guidelines presented here can be used, but further studies are needed in order to determine the relationship and aetiology of these signs and cellular changes on the IVCM both before and after anti-amoeba treatment.
Collapse
Affiliation(s)
- K Curro-Tafili
- Department of Ophthalmology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
| | - F D Verbraak
- Department of Ophthalmology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - R de Vries
- Medical Library, Vrije Universiteit, Amsterdam, the Netherlands
| | - R M A van Nispen
- Department of Ophthalmology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
| | - E A E Ghyczy
- Department of Ophthalmology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| |
Collapse
|
9
|
Chaúque BJM, da Silva TCB, Dos Santos DL, Benitez GB, Chaúque LGH, Benetti AD, Zanette RA, Rott MB. Global prevalence of free-living amoebae in solid matrices - A systematic review with meta-analysis. Acta Trop 2023; 247:107006. [PMID: 37633571 DOI: 10.1016/j.actatropica.2023.107006] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/18/2023] [Accepted: 08/21/2023] [Indexed: 08/28/2023]
Abstract
The ubiquitous free-living amoebae (FLA) are microorganisms of significant medical, sanitary, and ecological importance. However, their characterization within solid matrices such as soil, dust, sediment, mud, sludge, and compost remain to be systematized. In this study, we conducted a systematic review with meta-analysis to explore the global distribution of FLA in solid matrices. From the analysis of 104 out of 4,414 scientific articles retrieved from different databases, it was found that the general global prevalence of FLA in solid matrices was of 55.13% (95% confidence interval (CI) 49.32-60.94). Specifically, FLA prevalence was high in soil (72.40%, 95% CI 69.08-75.73), sediment (57.91%, 95% CI 50.01-65.81), mud (52.90%, 95% CI 24.01-81.78), dust (48.60%, 95% CI 43.00-54.19), and sewage sludge (40.19%, 95% CI 30.68-49.70). In aerosols it was comparatively lower (17.21%, 95% CI 12.76-21.66). Acanthamoeba spp. (52.23%) and Hartmanella/Vermamoeba spp. (36.06%) were found to be more prevalent, whereas Naegleria spp. (34.98%) and Balamuthia spp. (27.32%) were less prevalent. The distribution of the highest global prevalence values for species of Acanthamoeba spp., considering different publication periods of the studies, is as follows: A. hatchetti (51.46%), A. rhysodes (47.49%), A. polyphaga (36.37%), A. culbertsoni (34.31%), A. castellanii (34.21%), and A. lenticulata (32.82%). For other FLA species, the distribution is: Hartmannella/Vermamoeba vermiformis (91.57%), Naegleria fowleri (42.32%), Naegleria gruberi (32.39%), and Balamuthia mandrillaris (25%). The most prevalent Acanthamoeba genotypes were T4 (33.38%) and T3 (23.94%). Overall, the global prevalence of FLA in solid matrices is as high as or greater than that reported in water by previous systematic reviews. Thus, actions aimed at reducing exposure to FLA or exploring their ecological dynamics should consider not only water but also the various solid matrices. The finding outlined here can provide valuable insights for such actions, e.g., informing on the level of exposure to FLA, or on the microbial biodiversity of specific environmental compartments.
Collapse
Affiliation(s)
- Beni Jequicene Mussengue Chaúque
- Graduate Program in Agricultural and Environmental Microbiology, Department of Microbiology, Immunology and Parasitology, Institute of Basic Health Sciences, Universidade Federal do Rio Grande do Sul, Brazil; Postgraduate Program in Biological Sciences: Pharmacology and Therapeutics, UFRGS, Rio Grande do Sul, Brazil; Center of Studies in Science and Technology (NECET), Biology Course, Universidade Rovuma, Niassa Branch, Lichinga, Mozambique
| | - Thaisla Cristiane Borella da Silva
- Graduate Program in Agricultural and Environmental Microbiology, Department of Microbiology, Immunology and Parasitology, Institute of Basic Health Sciences, Universidade Federal do Rio Grande do Sul, Brazil
| | - Denise Leal Dos Santos
- CAPES Clinical Research Pilot Program at Hospital de Clínicas de Porto Alegre, Rio Grande do Sul, Brazil
| | - Guilherme Brittes Benitez
- Industrial and Systems Engineering Graduate Program, Polytechnic School, Pontifical Catholic University of Parana (PUCPR), Brazil
| | | | | | - Régis Adriel Zanette
- Postgraduate Program in Biological Sciences: Pharmacology and Therapeutics, UFRGS, Rio Grande do Sul, Brazil
| | - Marilise Brittes Rott
- Graduate Program in Agricultural and Environmental Microbiology, Department of Microbiology, Immunology and Parasitology, Institute of Basic Health Sciences, Universidade Federal do Rio Grande do Sul, Brazil.
| |
Collapse
|
10
|
Chaúque BJM, Corção G, Benetti AD, Rott MB. A challenge in washing water with the sun: 24h of SODIS fails to inactivate Acanthamoeba castellanii cysts and internalized Pseudomonas aeruginosa under strong real sun conditions. Photochem Photobiol Sci 2023; 22:2179-2188. [PMID: 37296325 DOI: 10.1007/s43630-023-00440-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 05/19/2023] [Indexed: 06/12/2023]
Abstract
Despite access to drinking water being a basic human right, the availability of safe drinking water remains a privilege that many do not have and as a result, many lives are lost each year due to waterborne diseases associated with the consumption of biologically unsafe water. To face this situation, different low-cost household drinking water treatment technologies (HDWT) have been developed, and among them is solar disinfection (SODIS). Despite the effectiveness of SODIS and the epidemiological gains being consistently documented in the literature, there is a lack of evidence of the effectiveness of the batch-SODIS process against protozoan cysts as well as their internalized bacteria under real sun conditions. This work evaluated the effectiveness of the batch-SODIS process on the viability of Acanthamoeba castellanii cysts, and internalized Pseudomonas aeruginosa. Dechlorinated tap water contaminated with 5.6 × 103 cysts/L, contained in PET (polyethylene terephthalate) bottles, was exposed for 8 h a day to strong sunlight (531-1083 W/m2 of maximum insolation) for 3 consecutive days. The maximum water temperature inside the reactors ranged from 37 to 50 °C. Cyst viability was assessed by inducing excystment on non-nutrient agar, or in water with heat-inactivated Escherichia coli. After sun exposure for 0, 8, 16 and 24 h, the cysts remained viable and without any perceptible impairment in their ability to excyst. 3 and 5.5 log CFU/mL of P. aeruginosa were detected in water containing untreated and treated cysts, respectively, after 3 days of incubation at 30 °C. The batch-SODIS process is unable to inactivate A. castellanii cysts as well as its internalized bacteria. Although the use of batch SODIS by communities should continue to be encouraged, SODIS-disinfected water should be consumed within 3 days.
Collapse
Affiliation(s)
- Beni Jequicene Mussengue Chaúque
- Laboratory of Protozoology and Microbiological Analyses, Department of Microbiology, Immunology and Parasitology, Institute of Basic Health Sciences, Universidade Federal do Rio Grande do Sul, Ramiro Barcelos Street, 2600, Porto Alegre/RS, Brazil
- Center of Studies in Science and Technology (NECET), Biology Course, Universidade Rovuma, Niassa Branch, Lichinga, Mozambique
| | - Gertrudes Corção
- Laboratory of Protozoology and Microbiological Analyses, Department of Microbiology, Immunology and Parasitology, Institute of Basic Health Sciences, Universidade Federal do Rio Grande do Sul, Ramiro Barcelos Street, 2600, Porto Alegre/RS, Brazil
| | | | - Marilise Brittes Rott
- Laboratory of Protozoology and Microbiological Analyses, Department of Microbiology, Immunology and Parasitology, Institute of Basic Health Sciences, Universidade Federal do Rio Grande do Sul, Ramiro Barcelos Street, 2600, Porto Alegre/RS, Brazil.
| |
Collapse
|
11
|
Wang Y, Jiang L, Zhao Y, Ju X, Wang L, Jin L, Fine RD, Li M. Biological characteristics and pathogenicity of Acanthamoeba. Front Microbiol 2023; 14:1147077. [PMID: 37089530 PMCID: PMC10113681 DOI: 10.3389/fmicb.2023.1147077] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 03/21/2023] [Indexed: 04/25/2023] Open
Abstract
Acanthamoeba is an opportunistic protozoa, which exists widely in nature and is mainly distributed in soil and water. Acanthamoeba usually exists in two forms, trophozoites and cysts. The trophozoite stage is one of growth and reproduction while the cyst stage is characterized by cellular quiescence, commonly resulting in human infection, and the lack of effective monotherapy after initial infection leads to chronic disease. Acanthamoeba can infect several human body tissues such as the skin, cornea, conjunctiva, respiratory tract, and reproductive tract, especially when the tissue barriers are damaged. Furthermore, serious infections can cause Acanthamoeba keratitis, granulomatous amoebic encephalitis, skin, and lung infections. With an increasing number of Acanthamoeba infections in recent years, the pathogenicity of Acanthamoeba is becoming more relevant to mainstream clinical care. This review article will describe the etiological characteristics of Acanthamoeba infection in detail from the aspects of biological characteristic, classification, disease, and pathogenic mechanism in order to provide scientific basis for the diagnosis, treatment, and prevention of Acanthamoeba infection.
Collapse
Affiliation(s)
- Yuehua Wang
- College of Laboratory Medicine, Jilin Medical University, Jilin City, China
| | - Linzhe Jiang
- General Surgery, Jilin People’s Hospital, Jilin City, China
| | - Yitong Zhao
- College of Laboratory Medicine, Jilin Medical University, Jilin City, China
| | - Xiaohong Ju
- College of Laboratory Medicine, Jilin Medical University, Jilin City, China
| | - Le Wang
- Department of Laboratory Medicine, Jilin Hospital of Integrated Chinese and Western Medicine, Jilin City, China
| | - Liang Jin
- Department of Laboratory Medicine, Jilin Hospital of Integrated Chinese and Western Medicine, Jilin City, China
| | - Ryan D. Fine
- Center for Human Genetics and Genomics, New York University Grossman School of Medicine, New York City, NY, United States
| | - Mingguang Li
- College of Laboratory Medicine, Jilin Medical University, Jilin City, China
- *Correspondence: Mingguang Li,
| |
Collapse
|
12
|
Prevalence of free-living amoebae in swimming pools and recreational waters, a systematic review and meta-analysis. Parasitol Res 2022; 121:3033-3050. [PMID: 36040629 PMCID: PMC9424809 DOI: 10.1007/s00436-022-07631-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 08/16/2022] [Indexed: 11/06/2022]
Abstract
Free-living amoebae (FLA) are cosmopolitan microorganisms known to be pathogenic to humans who often have a history of contact with contaminated water. Swimming pools and recreational waters are among the environments where the greatest human exposure to FLA occurs. This study aimed to determine the prevalence of FLA in swimming pools and recreational waters, through a systematic review and meta-analysis that included studies published between 1977 and 2022. A total of 106 studies were included and an overall prevalence of FLA in swimming pools and recreational waters of 44.34% (95% CI = 38.57–50.18) was found. Considering the studies published up to 2010 (1977–2010), between 2010 and 2015, and those published after 2010 (> 2010–2022), the prevalence was 53.09% (95% CI = 43.33–62.73) and 37.07% (95% CI = 28.87–45.66) and 45.40% (95% CI = 35.48–55.51), respectively. The highest prevalence was found in the American continent (63.99%), in Mexico (98.35%), and in indoor hot swimming pools (52.27%). The prevalence varied with the variation of FLA detection methods, morphology (57.21%), PCR (25.78%), and simultaneously morphology and PCR (43.16%). The global prevalence by genera was Vahlkampfia spp. (54.20%), Acanthamoeba spp. (33.47%), Naegleria spp. (30.95%), Hartmannella spp./Vermamoeba spp. (20.73%), Stenamoeba spp. (12.05%), and Vannella spp. (10.75%). There is considerable risk of FLA infection in swimming pools and recreational waters. Recreational water safety needs to be routinely monitored and, in case of risk, locations need to be identified with warning signs and users need to be educated. Swimming pools and artificial recreational water should be properly disinfected. Photolysis of NaOCl or NaCl in water by UV-C radiation is a promising alternative to disinfect swimming pools and artificial recreational waters.
Collapse
|
13
|
Bellini NK, Thiemann OH, Reyes-Batlle M, Lorenzo-Morales J, Costa AO. A history of over 40 years of potentially pathogenic free-living amoeba studies in Brazil - a systematic review. Mem Inst Oswaldo Cruz 2022; 117:e210373. [PMID: 35792751 PMCID: PMC9252135 DOI: 10.1590/0074-02760210373] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 03/28/2022] [Indexed: 12/17/2022] Open
Abstract
Free-living amoeba (FLA) group includes the potentially pathogenic genera Acanthamoeba, Naegleria, Balamuthia, Sappinia, and Vermamoeba, causative agents of human infections (encephalitis, keratitis, and disseminated diseases). In Brazil, the first report on pathogenic FLA was published in the 70s and showed meningoencephalitis caused by Naegleria spp. FLA studies are emerging, but no literature review is available to investigate this trend in Brazil critically. Thus, the present work aims to integrate and discuss these data. Scopus, PubMed, and Web of Science were searched, retrieving studies from 1974 to 2020. The screening process resulted in 178 papers, which were clustered into core and auxiliary classes and sorted into five categories: wet-bench studies, dry-bench studies, clinical reports, environmental identifications, and literature reviews. The papers dating from the last ten years account for 75% (134/178) of the total publications, indicating the FLA topic has gained Brazilian interest. Moreover, 81% (144/178) address Acanthamoeba-related matter, revealing this genus as the most prevalent in all categories. Brazil’s Southeast, South, and Midwest geographic regions accounted for 96% (171/178) of the publications studied in the present work. To the best of our knowledge, this review is the pioneer in summarising the FLA research history in Brazil.
Collapse
Affiliation(s)
- Natália Karla Bellini
- Universidade Federal de Minas Gerais, Faculdade de Farmácia, Departamento de Análises Clínicas e Toxicológicas, Belo Horizonte, MG, Brasil
| | - Otavio Henrique Thiemann
- Universidade de São Paulo, Instituto de Física de São Carlos, São Carlos, SP, Brasil.,Universidade Federal de São Carlos, Departamento de Genética e Evolução, São Carlos, SP, Brasil
| | - María Reyes-Batlle
- Universidad de La Laguna, Instituto Universitario de Enfermedades Tropicales y Salud Pública de Canarias, Departamento de Obstetricia, Ginecología, Pediatría, Medicina Preventiva y Salud Pública, Toxicología, Medicina Legal y Forense y Parasitología, Red de Investigación Cooperativa en Enfermedades Tropicales, Tenerife, Islas Canarias, Spain
| | - Jacob Lorenzo-Morales
- Universidad de La Laguna, Instituto Universitario de Enfermedades Tropicales y Salud Pública de Canarias, Departamento de Obstetricia, Ginecología, Pediatría, Medicina Preventiva y Salud Pública, Toxicología, Medicina Legal y Forense y Parasitología, Red de Investigación Cooperativa en Enfermedades Tropicales, Tenerife, Islas Canarias, Spain.,Instituto de Salud Carlos III, Consorcio Centro de Investigación Biomédica en Red MP de Enfermedades Infecciosas, Madrid, Spain
| | - Adriana Oliveira Costa
- Universidade Federal de Minas Gerais, Faculdade de Farmácia, Departamento de Análises Clínicas e Toxicológicas, Belo Horizonte, MG, Brasil
| |
Collapse
|
14
|
Dos Santos DL, Virginio VG, Berté FK, Lorenzatto KR, Marinho DR, Kwitko S, Locatelli CI, Freitas EC, Rott MB. Clinical and molecular diagnosis of Acanthamoeba keratitis in contact lens wearers in southern Brazil reveals the presence of an endosymbiont. Parasitol Res 2022; 121:1447-1454. [PMID: 35194678 DOI: 10.1007/s00436-022-07474-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 02/17/2022] [Indexed: 12/17/2022]
Abstract
Acanthamoeba keratitis (AK) is an infection that is mostly observed in contact lens wearers. It is often misdiagnosed causing delays in the administration of the correct treatment. The aim of this study was to report the outcome of clinical and molecular diagnosis of AK cases during the summer of 2019 in the southern region of Brazil. Three suspected cases of AK were discovered after an ophthalmic examination at a public hospital in the city of Porto Alegre. These cases were then confirmed through laboratory diagnosis (cell culture and molecular analysis by PCR and sequencing). In each of the three clinical sample cell cultures of corneal scraping and molecular analysis confirmed the presence of Acanthamoeba spp., all belonging to the morphological group II and to the genotype T4, which is the most common genotype associated with AK. In addition, Acanthamoeba spp. isolated from one of the clinical samples was found to harbor the Candidatus Paracaedibacter acanthamoeba, a bacterial endosymbiont. The presence of Ca. Paracaedibacter acanthamoeba in clinical isolates requires further research to reveal its possible role in the pathogenicity of Acanthamoeba infections.
Collapse
Affiliation(s)
- Denise Leal Dos Santos
- Microbiology, Immunology and Parasitology Department, Basic Health Sciences Institute, Parasitology Sector, Rio Grande Do Sul Federal University, Sarmento Leite Street, N 500, Porto Alegre, Rio Grande Do Sul, 90050-170, Brazil
| | - Veridiana Gomes Virginio
- Microbiology, Immunology and Parasitology Department, Basic Health Sciences Institute, Parasitology Sector, Rio Grande Do Sul Federal University, Sarmento Leite Street, N 500, Porto Alegre, Rio Grande Do Sul, 90050-170, Brazil
| | - Francisco Kercher Berté
- Microbiology, Immunology and Parasitology Department, Basic Health Sciences Institute, Parasitology Sector, Rio Grande Do Sul Federal University, Sarmento Leite Street, N 500, Porto Alegre, Rio Grande Do Sul, 90050-170, Brazil
| | - Karina Rodrigues Lorenzatto
- Microbiology, Immunology and Parasitology Department, Basic Health Sciences Institute, Parasitology Sector, Rio Grande Do Sul Federal University, Sarmento Leite Street, N 500, Porto Alegre, Rio Grande Do Sul, 90050-170, Brazil
| | - Diane Ruschel Marinho
- Cornea Department, Ophthalmology Service, Hospital de Clínicas de Porto Alegre Rio Grande Do Sul, Ramiro Barcelos Street, N 2350, Porto Alegre, Rio Grande Do Sul, 90035-903, Brazil
| | - Sergio Kwitko
- Cornea Department, Ophthalmology Service, Hospital de Clínicas de Porto Alegre Rio Grande Do Sul, Ramiro Barcelos Street, N 2350, Porto Alegre, Rio Grande Do Sul, 90035-903, Brazil
| | - Claudete Inês Locatelli
- Cornea Department, Ophthalmology Service, Hospital de Clínicas de Porto Alegre Rio Grande Do Sul, Ramiro Barcelos Street, N 2350, Porto Alegre, Rio Grande Do Sul, 90035-903, Brazil
| | - Eduarda Correa Freitas
- Cornea Department, Ophthalmology Service, Hospital de Clínicas de Porto Alegre Rio Grande Do Sul, Ramiro Barcelos Street, N 2350, Porto Alegre, Rio Grande Do Sul, 90035-903, Brazil
| | - Marilise Brittes Rott
- Microbiology, Immunology and Parasitology Department, Basic Health Sciences Institute, Parasitology Sector, Rio Grande Do Sul Federal University, Sarmento Leite Street, N 500, Porto Alegre, Rio Grande Do Sul, 90050-170, Brazil.
| |
Collapse
|
15
|
Evaluation of Acanthamoeba keratitis cases in a tertiary medical care centre over 21 years. Sci Rep 2021; 11:1036. [PMID: 33441799 PMCID: PMC7806847 DOI: 10.1038/s41598-020-80222-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 12/17/2020] [Indexed: 01/29/2023] Open
Abstract
To report on Acanthamoeba keratitis cases in a tertiary university eye-hospital in Graz, Austria, over a 21-year period. Retrospective study. Parameters included demographics, diagnostics, clinical courses, medical therapies, surgical interventions, secondary complications, and best spectacle-corrected visual acuity (BSCVA). Patient records for 44 eyes of 42 patients were analysed; 2 bilateral infections. Mean age at presentation was 31 ± 13 (16-65) years; contact lenses were used in 41 of 44 eyes (93.2%). Symptoms at initial presentation were mainly pain (41/43, 95.3%) and photophobia (16/43, 37.2%). Most frequent morphological findings were stromal infiltrates (30/44, 68.2%). Diagnosis was mainly confirmed by smears (40/42, 95.2%) and polymerase chain reaction (8/42, 19%). Antiamoebic treatment comprised biguanides and diamidines. Penetrating keratoplasty was performed in 10/44 (22.7%) eyes. Median time from symptom onset to initial visit was 2 (0-26) weeks; median follow-up was 30 (2-1008) weeks. BSCVA improved in 23/36 (63.9%) eyes, remained unchanged in 6/36 (16.7%) eyes and deteriorated in 7/36 (19.4%) eyes. Acanthamoeba keratitis predominantly occurs in young contact lens wearers. Diagnosis should be considered in patients with pain and stromal infiltrates. In the majority of cases, BSCVA can be improved. Early diagnosis and adequate treatment should be implemented to prevent complications.
Collapse
|
16
|
Lacerda AG, Lira M. Acanthamoeba
keratitis: a review of biology, pathophysiology and epidemiology. Ophthalmic Physiol Opt 2020; 41:116-135. [DOI: 10.1111/opo.12752] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 09/07/2020] [Accepted: 09/09/2020] [Indexed: 01/13/2023]
Affiliation(s)
| | - Madalena Lira
- Centre of Physics University of Minho Braga Portugal
| |
Collapse
|
17
|
Singh K, Bhattacharyya M, Goel A, Arora R, Gotmare N, Aggarwal H. Orthokeratology in Moderate Myopia: A Study of Predictability and Safety. J Ophthalmic Vis Res 2020; 15:210-217. [PMID: 32308956 PMCID: PMC7151515 DOI: 10.18502/jovr.v15i2.6739] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 04/16/2019] [Indexed: 11/29/2022] Open
Abstract
Purpose Literature is relatively silent on safety profile and predictability of orthokeratology lenses in terms of myopia correction and prevention of further progression, especially in semi-tropical countries; this study was designed to fill this gap. Methods This prospective, intervention case series enrolled 30 eyes of 30 patients with myopia up to –5.5 diopters (D). Patients were randomized into two groups of 15 each; the study group was prescribed overnight orthokeratology (OK) lenses, while the control group used daily wear conventional soft contact lenses. Follow-up examinations were performed after 1 h and 6 h, and then at 1, 7, 15, 30 days, and 4 months post lens wear. Uncorrected visual acuity (UCVA), contrast sensitivity, keratometry, central corneal thickness (CCT), and tear film break up time (TBUT) were evaluated at each follow-up examination. Results All patients attained a visual acuity of 0.00 Logarithm of the Minimum Angle of Resolution (logMAR) after one week of lens use, which was maintained throughout the study period. While patients allotted to the study group had a gain of 8.1 Snellen lines (UCVA), those in the control group gained 8.9 lines (BCVA) at the end of follow-up period. In the OK group, cornea showed a flattening of 0.8 D (mean keratometry) after single overnight usage of OK lens and overall flattening of 1.2 D compared to baseline, at the end of four months. The change in contrast sensitivity, corneal endothelial specular count, axial length and tear film status was not significant in either group. Conclusion Orthokeratology is an effective and safe modality to correct moderate myopia in motivated young adults. No side effects were encountered after a short-term follow-up in participants who resided in semi-tropical environments.
Collapse
Affiliation(s)
- Kirti Singh
- Guru Nanak Eye Centre, Maharaja Ranjit Singh Marg, New Delhi, India
| | | | - Abhishek Goel
- Guru Nanak Eye Centre, Maharaja Ranjit Singh Marg, New Delhi, India
| | - Ritu Arora
- Guru Nanak Eye Centre, Maharaja Ranjit Singh Marg, New Delhi, India
| | - Nikhil Gotmare
- Guru Nanak Eye Centre, Maharaja Ranjit Singh Marg, New Delhi, India
| | | |
Collapse
|
18
|
Hewitt MG, Morrison PWJ, Boostrom HM, Morgan SR, Fallon M, Lewis PN, Whitaker D, Brancale A, Varricchio C, Quantock AJ, Burton MJ, Heard CM. In Vitro Topical Delivery of Chlorhexidine to the Cornea: Enhancement Using Drug-Loaded Contact Lenses and β-Cyclodextrin Complexation, and the Importance of Simulating Tear Irrigation. Mol Pharm 2020; 17:1428-1441. [PMID: 32125863 DOI: 10.1021/acs.molpharmaceut.0c00140] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Microbial keratitis is a severe, sight-threatening condition caused by various pathogens. Eyedrops are the standard delivery modality for treating these disorders; however, blinking reflex, elevated tear production, and nasolacrimal drainage eliminate much of the instilled dose within a few seconds. Therefore, eyedrops must be applied repeatedly for prolonged periods. The present study aimed to probe more effective ocular delivery of chlorhexidine based upon drug-loaded hydrogel contact lenses and β-cyclodextrin (β-CD), while also determining the effect of constant irrigation with simulated tear fluid (STF) in in vitro experiments. Chlorhexidine digluconate (as 0.2 and 2% solutions, β-CD inclusion complexes, and loaded hydrogel contact lenses) were applied to enucleated porcine eyes as single or multiple 10 μL doses, or as drug-loaded contact lenses, with and without β-CD. The corneas were then excised and drug-extracted quantified by high-performance liquid chromatography (HPLC). The effect of constant irrigation by STF was evaluated to test the effect of increased tear production on corneal delivery. Potential antimicrobial activity of the delivered drug was also assessed. Results showed that drug-loaded contact lenses delivered the greatest amount of chlorhexidine into the cornea over a 24 h period, while the eyedrop solution comparator delivered the least. The β-CD significantly enhanced chlorhexidine delivery to the cornea from eyedrop solution, although contact lenses loaded with chlorhexidine-β-CD failed to enhance delivery. β-CD within the hydrogel matrix impeded drug release. Constant irrigation with STF significantly reduced the amount of drug delivered to the cornea in all cases. Chlorhexidine retained antimicrobial activity in all delivery methods. Hydrogel contact lenses loaded with chlorhexidine delivered significantly higher levels to the cornea compared to eyedrops, either multiple hourly doses or a single dose. They also offer reduced application, in particular, to a nonulcerated corneal infection. Finally, the importance of fully accounting for tear production in in vitro ocular delivery experiments was highlighted.
Collapse
Affiliation(s)
- Melissa G Hewitt
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Wales, Cardiff CF10 3NB, U.K
| | - Peter W J Morrison
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Wales, Cardiff CF10 3NB, U.K.,School of Optometry and Vision Sciences, Cardiff University, Wales, Cardiff CF24 4HQ, U.K
| | - Hannah M Boostrom
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Wales, Cardiff CF10 3NB, U.K
| | - Siân R Morgan
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Wales, Cardiff CF10 3NB, U.K.,School of Optometry and Vision Sciences, Cardiff University, Wales, Cardiff CF24 4HQ, U.K
| | - Melissa Fallon
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Wales, Cardiff CF10 3NB, U.K.,School of Optometry and Vision Sciences, Cardiff University, Wales, Cardiff CF24 4HQ, U.K
| | - Philip N Lewis
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Wales, Cardiff CF10 3NB, U.K.,School of Optometry and Vision Sciences, Cardiff University, Wales, Cardiff CF24 4HQ, U.K
| | - David Whitaker
- School of Optometry and Vision Sciences, Cardiff University, Wales, Cardiff CF24 4HQ, U.K.,School of Healthcare Sciences, Cardiff University, Wales, Cardiff CF24 4HQ, U.K
| | - Andrea Brancale
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Wales, Cardiff CF10 3NB, U.K
| | - Carmine Varricchio
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Wales, Cardiff CF10 3NB, U.K
| | - Andrew J Quantock
- School of Optometry and Vision Sciences, Cardiff University, Wales, Cardiff CF24 4HQ, U.K
| | - Matthew J Burton
- International Centre for Eye Health, Faculty of Infectious & Tropical Diseases, London School of Hygiene and Tropical Medicine, London WC1E 7HT, U.K.,Moorfields Eye Hospital NHS Foundation Trust, London EC1V 2PD, U.K
| | - Charles M Heard
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Wales, Cardiff CF10 3NB, U.K
| |
Collapse
|
19
|
Peixoto D, Prestes DP. Parasitic Infections of the Stem Cell Transplant Recipient and the Hematologic Malignancy Patient, Including Toxoplasmosis and Strongyloidiasis. Infect Dis Clin North Am 2019; 33:567-591. [PMID: 31005139 DOI: 10.1016/j.idc.2019.02.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Hematopoietic stem cell transplantation (HSCT) recipients may infrequently develop parasitic infections at the time of the procedure via contamination from allograft tissue or blood products, and in the post-transplantation period through the traditional route of infection or as a reactivation caused by immunosuppression related to the transplant. To reduce risk, efforts should be directed at performing a comprehensive history, maintaining a high index of suspicion, and adhering to preventive measures. Additional strategies for the prevention, screening and careful follow-up, identification, and pre-emptive treatment of parasitic infections are required to reduce morbidity and mortality in HSCT patients.
Collapse
Affiliation(s)
- Driele Peixoto
- São Paulo State Cancer Institute (ICESP), Hospital das Clínicas, Av. Dr. Arnaldo, 251, São Paulo CEP: 01246-000, Brazil.
| | - Daniel P Prestes
- A. C. Camargo Cancer Center, Rua Professor Antonio Prudente, 211, Sao Paulo CEP: 01509-010, Brazil; Emilio Ribas Infectious Diseases Institute, Av. Doutor Arnaldo, 165, Sao Paulo CEP: 01246-900, Brazil
| |
Collapse
|
20
|
Li W, Wang Z, Qu J, Zhang Y, Sun X. Acanthamoeba keratitis related to contact lens use in a tertiary hospital in China. BMC Ophthalmol 2019; 19:202. [PMID: 31533675 PMCID: PMC6751601 DOI: 10.1186/s12886-019-1210-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Accepted: 08/30/2019] [Indexed: 12/17/2022] Open
Abstract
Background To report the clinical and microbiological features of Acanthamoeba keratitis (AK) related to contact lens use in a tertiary hospital in China. Methods In this retrospective study, the medical results of 61 cases of AK related to contact lens use from January 2000 to December 2017 were reviewed. The data included patients’ demographics, lens type, history, risk factors, disease stages, corneal scraping and culture reports, and treatments. Moreover, genotypic identification of some of the isolates was carried out with a PCR assay and sequence analysis of the 18S ribosomal DNA gene. Results There were 64 eyes included in the study. A total of 32.8% of the patients wore soft contact lenses, and 67.2% of patients used overnight orthokeratology. In the cases (20 eyes) in the early stage, 65% (13 eyes) had positive results according to Giemsa-stained smears, and 0.9% sodium chloride (NaCl) wet mounts revealed trophozoites in 7 eyes (35%). Six eyes (30%) were diagnosed by confocal microscopy combined with clinical signs. In the orthokeratology patients, 87.8% (36/41) rinsed their lenses and/or cases with tap water; 55% of soft-lens wearers wore their lenses while showering. The genotype of 9 isolates was determined, and all the strains belonged to genotype T4. In the orthokeratology group, the number of patients who required therapeutic penetrating keratoplasty after 2005 was less than that before 2005 (chi-square test, χ2 = 4.209, P = 0.04). Conclusions More than two-thirds of the cases were associated with orthokeratology. Examinations with Giemsa-stained smears, 0.9% NaCl wet mounts and confocal microscopy should be performed for patients who are highly suspected of having early-stage AK to help with early diagnosis. In the orthokeratology group, the rate of therapeutic keratoplasty after 2005 was less than that before 2005. Electronic supplementary material The online version of this article (10.1186/s12886-019-1210-2) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Weiwei Li
- Tianjin Eye Hospital, Tianjin Ophthalmology and Visual Development Key Laboratory, Clinical College of Ophthalmology, Tianjin Medical University, Address: 4, Gansu Road, Heping District, Tianjin, 300020, China
| | - Zhiqun Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Sciences Key Laboratory, Capital Medical University, Address: 17 Hou Gou Lane, Chong Nei Street, Beijing, 100005, China
| | - Jinghao Qu
- Tianjin Eye Hospital, Tianjin Ophthalmology and Visual Development Key Laboratory, Clinical College of Ophthalmology, Tianjin Medical University, Address: 4, Gansu Road, Heping District, Tianjin, 300020, China
| | - Yang Zhang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Sciences Key Laboratory, Capital Medical University, Address: 17 Hou Gou Lane, Chong Nei Street, Beijing, 100005, China
| | - Xuguang Sun
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Sciences Key Laboratory, Capital Medical University, Address: 17 Hou Gou Lane, Chong Nei Street, Beijing, 100005, China.
| |
Collapse
|
21
|
Magistrado-Coxen P, Aqeel Y, Lopez A, Haserick JR, Urbanowicz BR, Costello CE, Samuelson J. The most abundant cyst wall proteins of Acanthamoeba castellanii are lectins that bind cellulose and localize to distinct structures in developing and mature cyst walls. PLoS Negl Trop Dis 2019; 13:e0007352. [PMID: 31095564 PMCID: PMC6541295 DOI: 10.1371/journal.pntd.0007352] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 05/29/2019] [Accepted: 04/01/2019] [Indexed: 12/02/2022] Open
Abstract
Background Acanthamoeba castellanii, which causes keratitis and blindness in under-resourced countries, is an emerging pathogen worldwide, because of its association with contact lens use. The wall makes cysts resistant to sterilizing reagents in lens solutions and to antibiotics applied to the eye. Methodology/Principal findings Transmission electron microscopy and structured illumination microscopy (SIM) showed purified cyst walls of A. castellanii retained an outer ectocyst layer, an inner endocyst layer, and conical ostioles that connect them. Mass spectrometry showed candidate cyst wall proteins were dominated by three families of lectins (named here Jonah, Luke, and Leo), which bound well to cellulose and less well to chitin. An abundant Jonah lectin, which has one choice-of-anchor A (CAA) domain, was made early during encystation and localized to the ectocyst layer of cyst walls. An abundant Luke lectin, which has two carbohydrate-binding modules (CBM49), outlined small, flat ostioles in a single-layered primordial wall and localized to the endocyst layer and ostioles of mature walls. An abundant Leo lectin, which has two unique domains with eight Cys residues each (8-Cys), localized to the endocyst layer and ostioles. The Jonah lectin and glycopolymers, to which it binds, were accessible in the ectocyst layer. In contrast, Luke and Leo lectins and the glycopolymers, to which they bind, were mostly inaccessible in the endocyst layer and ostioles. Conclusions/Significance The most abundant A. castellanii cyst wall proteins are three sets of lectins, which have carbohydrate-binding modules that are conserved (CBM49s of Luke), newly characterized (CAA of Jonah), or unique to Acanthamoebae (8-Cys of Leo). Cyst wall formation is a tightly choreographed event, in which lectins and glycopolymers combine to form a mature wall with a protected endocyst layer. Because of its accessibility in the ectocyst layer, an abundant Jonah lectin is an excellent diagnostic target. A half century ago, investigators identified cellulose in the Acanthamoeba cyst wall, which has two layers and conical ostioles that connect them. Here we showed cyst walls contain three large sets of cellulose-binding lectins, which localize to the ectocyst layer (a Jonah lectin) or to the endocyst layer and ostioles (Luke and Leo lectins). We used the lectins to establish a sequence for cyst wall assembly when trophozoites are starved and encyst. In the first stage, a Jonah lectin and glycopolymers were present in dozens of distinct vesicles. In the second stage, a primordial wall contained small, flat ostioles outlined by a Luke lectin. In the third stage, a Jonah lectin remained in the ectocyst layer, while Luke and Leo lectins moved to the endocyst layer and ostioles. A description of the major events during cyst wall development is a starting point for mechanistic studies of its assembly.
Collapse
Affiliation(s)
- Pamela Magistrado-Coxen
- Department of Molecular and Cell Biology, Boston University Goldman School of Dental Medicine, Boston, Massachusetts, United States of America
| | - Yousuf Aqeel
- Department of Molecular and Cell Biology, Boston University Goldman School of Dental Medicine, Boston, Massachusetts, United States of America
| | - Angelo Lopez
- Department of Molecular and Cell Biology, Boston University Goldman School of Dental Medicine, Boston, Massachusetts, United States of America
- Department of Biochemistry, Boston University School of Medicine, Boston, Massachusetts, United States of America
| | - John R. Haserick
- Department of Molecular and Cell Biology, Boston University Goldman School of Dental Medicine, Boston, Massachusetts, United States of America
- Department of Biochemistry, Boston University School of Medicine, Boston, Massachusetts, United States of America
| | - Breeanna R. Urbanowicz
- Complex Carbohydrate Research Center, University of Georgia, Athens, Georgia, United States of America
| | - Catherine E. Costello
- Department of Biochemistry, Boston University School of Medicine, Boston, Massachusetts, United States of America
| | - John Samuelson
- Department of Molecular and Cell Biology, Boston University Goldman School of Dental Medicine, Boston, Massachusetts, United States of America
- * E-mail:
| |
Collapse
|
22
|
Alves DDSMM, Gonçalves GS, Moraes AS, Alves LM, Carmo Neto JRD, Hecht MM, Nitz N, Gurgel-Gonçalves R, Bernardes G, Castro AMD, Chalita MR, Vinaud MC. The first Acanthamoeba keratitis case in the Midwest region of Brazil: diagnosis, genotyping of the parasite and disease outcome. Rev Soc Bras Med Trop 2018; 51:716-719. [PMID: 30304286 DOI: 10.1590/0037-8682-0010-2018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 07/05/2018] [Indexed: 11/22/2022] Open
Abstract
We report an Acanthamoeba keratitis case associated with the use of contact lens in a 28-year-old female from Brasília, Brazil. Samples from corneal scraping and contact lens case were used for culture establishment, PCR amplification, and partial sequencing (fragments of ~400kb) of small subunit rDNA; both culture and PCR were positive. The sequence analyses of the cornea and of isolates from the contact lens case showed similarity with the T4 genotype. To the best of our knowledge, this is the first report of T4 Acanthamoeba keratitis case from the Midwest region of Brazil.
Collapse
Affiliation(s)
- Daniella de Sousa Mendes Moreira Alves
- Laboratório de Estudos da Relação Parasito-Hospedeiro, Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Goiânia, GO, Brasil
| | - Gustavo Souza Gonçalves
- Departamento de Oftalmologia, Faculdade de Medicina, Universidade de Brasília, Brasília, DF, Brasil
| | - Aline Silva Moraes
- Laboratório Interdisciplinar de Biociências, Faculdade de Medicina, Universidade de Brasília, Brasília, DF, Brasil
| | | | - José Rodrigues do Carmo Neto
- Laboratório de Estudos da Relação Parasito-Hospedeiro, Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Goiânia, GO, Brasil
| | - Mariana Machado Hecht
- Laboratório Interdisciplinar de Biociências, Faculdade de Medicina, Universidade de Brasília, Brasília, DF, Brasil
| | - Nadjar Nitz
- Laboratório Interdisciplinar de Biociências, Faculdade de Medicina, Universidade de Brasília, Brasília, DF, Brasil
| | - Rodrigo Gurgel-Gonçalves
- Laboratório de Parasitologia Médica e Biologia de Vetores, Faculdade de Medicina, Universidade de Brasília, Brasília, DF, Brasil
| | - Geisa Bernardes
- Laboratório de Estudos da Relação Parasito-Hospedeiro, Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Goiânia, GO, Brasil
| | - Ana Maria de Castro
- Laboratório de Estudos da Relação Parasito-Hospedeiro, Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Goiânia, GO, Brasil
| | - Maria Regina Chalita
- Departamento de Oftalmologia, Faculdade de Medicina, Universidade de Brasília, Brasília, DF, Brasil
| | - Marina Clare Vinaud
- Laboratório de Estudos da Relação Parasito-Hospedeiro, Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Goiânia, GO, Brasil
| |
Collapse
|
23
|
|