Abstract
The present study was conducted to determine the occurrence of potentially pathogenic free-living amoeba in ophthalmology wards in reference hospitals in Iran. Since an increasing number of Acanthamoeba Keratitis cases after eye surgery and eye trauma have been recently observed in this country, it could be possible that the disinfection procedures undertaken in the clinical setting may not have a good hygiene and disinfection procedures, hence the aim of this study. Therefore, 42 dust and biofilm samples were collected from different areas of ophthalmology wards and checked for the presence of FLA using morphological criteria, PCR based analysis and DNA sequencing. Of the 42 samples from dust and biofilm sources, 18(42.86%) isolates were found to contain FLA and 12(92.3%) isolates belonged to Acanthamoeba T4 genotype. Isolation of the pathogenic genotype T4 from medical instruments, including slit lamp in corneal wards, may be a threat for patients undergoing eye surgery in these wards. Other FLA isolated in this study included Acanthamoeba genotype T5, Vahlkampfia sp, Naegleria australiensis, Vermamoeba vermiformis and Echinamoeba exudans. To our knowledge, this is the first report of the presence of potentially pathogenic FLA in ophthalmology wards in Iran. Improved disinfection methods and monitoring of hospitals ward are thus necessary in this area in order to minimize the risk of infection in patients.
References
Cengiz A.M., Harmis N., Stapleton F. 2000. Coincubation of Acanthamoeba castellanii with strains of Pseudomonas aeruginosa alters the survival of amoeba. Clinical Experimental Ophthalmology, 28, 191-193. DOI: 10.1046/j.1442-9071.2000.00291.x 10.1046/j.1442-9071.2000.00291.xSearch in Google Scholar
Chan L.L., Mak J.W., Low Y.T., Koh T.T., Ithoi I., Mohamed S.M. 2011. Isolation and characterization of Acanthamoeba spp. from air conditioners in Kuala Lumpur, Malaysia. Acta Tropica, 117, 23-30. DOI: 10.1016/j.actatropica.2010.09.00410.1016/j.actatropica.2010.09.004Search in Google Scholar
Khan N.A., Jarroll E.L., Paget T.A. 2002. Molecular and Physiological Differentiation Between Pathogenic and Nonpathogenic Acanthamoeba. Current Microbiology, 45, 197-202. DOI: 10.1007/s00284-001-0108-310.1007/s00284-001-0108-3Search in Google Scholar
Khan N.A. 2006. Acanthamoeba: biology and increasing importance in human health. FEMS Microbiology Reviews, 30, 564-595. DOI: 10.1111/j.1574-6976.2006.00023.x 10.1111/j.1574-6976.2006.00023.xSearch in Google Scholar
Kong H.H., Chung D.I. 1996. PCR and RFLP variation of conserved region of small subunit ribosomal DNA among Acanthamoeba isolates assigned to either A. castellanii or A. polyphaga. Korean Journal Of Parasitology, 34, 127-134. DOI: org/10.3347/kjp.1996.34.2.12710.3347/kjp.1996.34.2.127Search in Google Scholar
Kuiper M.W., Valster R.M., Wullings B.A., Boonstra H., Smidt H., der Kooij D.V. 2006. Quantitative Detection of the Free-Living Amoeba Hartmannella vermiformis in Surface Water by Using Real-Time PCR.Applied and Environmental Microbiology, 72, 5750-5756. DOI: 10.1128/AEM.00085-0610.1128/AEM.00085-06Search in Google Scholar
Maghsood A.H., Sissons J., Rezaeian M., Nolder D., Warhurst D., Khan N.A. 2005. Acanthamoeba genotype T4 from the UK and Iran and isolation of the T2 genotype from clinical isolates. Journal of Medical Microbiology, 54, 755-759. DOI: 10.1099/jmm.0.45970-010.1099/jmm.0.45970-0Search in Google Scholar
Lasjerdi Z., Niyyati M., Haghighi A., Shahabi S., Tahvildar-biderouni F., Taghipour N., Eftekhar M., Nazemalhosseini Mojarad E. 2011. Potentially pathogenic free-living amoebae isolated from hospital wards with immunodeficient patients in Tehran, Iran. Parasitology Research, 109, 575-580. DOI: 10.1007/s00 436-011-2288-5Search in Google Scholar
Ledee D.R., Iovieno A., Miller D., Mandal N., Diaz M., Fell J., Fini M.E., Alfonso E.C. 2009. Molecular identification of T4 and T5 genotypes in Acanthamoeba keratitis patients. Journal Of Clinical Microbiology, 47, 1458-1462. DOI: 10.1128/JCM. 02365-08Search in Google Scholar
Lorenzo-Morales J., Ortega-Rivas A., Foronda P., Martiınez E., Valladares B. 2005. Isolation and identification of pathogenic Acanthamoeba strains in Tenerife, Canary Islands, Spain from water sources. Parasitology Research, 95, 273-277. DOI:10.1007/s00436-005-1301-210.1007/s00436-005-1301-2Search in Google Scholar
Lorenzo-Morales J., Ortega-Rivas A., Martiıınez E., Khoubbane M., Artigas P., Periago M.V., Foronda P., Abreu-Acosta N., Valladares B., Mas-Coma S. 2006. Acanthamoeba isolates belonging to T1, T2, T3, T4 and T7 genotypes from environmental freshwater samples in the Nile Delta region, Egypt. Acta Tropica, 100,63-69. DOI: 10.1016/j.actatropica.2006. 09.008Search in Google Scholar
Lorenzo-Morales J., Martinez-Carretero E., Batista N., Alvarez- Marin J., Bahaya Y.,Walochnik J., Valladares B. 2007. Early diagnosis of amoebic keratitis due to a mixed infection with Acanthamoeba and Hartmannella. Parasitology Research, 102, 167-16910.1007/s00436-007-0754-xSearch in Google Scholar
Niyyati M., Lorenzo-Morales J., Rezaie S., Rahimi F., Mohebali M., Maghsood A.H., Motevalli-Haghi A., Martin-Navarro C.M., Farnia S.H., Valladares B., Rezaeian M. 2009a. Genotyping of Acanthamoeba isolates from clinical and environmental specimens in Iran. Experimental Parasitology, 121, 242-245. DOI: 10.1016/j.exppara.2008.11.00310.1016/j.exppara.2008.11.003Search in Google Scholar
Niyyati M., Lorenzo-Morales J., Rezaie S., Rahimi F., Mohebali M., Maghsood A.M. 2009b. Isolation and genotyping of potentially pathogenic Acanthamoeba strains from dust sources in Iran. Transactions Of The Royal Society Of Tropical Medicine and Hygiene, 103, 425-427. DOI: 10.1016/j.trstmh.2008.12.00710.1016/j.trstmh.2008.12.007Search in Google Scholar
Niyyati M., Lorenzo-Morales J., Rezaeian M., Martin-Navarro C.M., Motevalli- Haghi A., Maciver S.K., Valladares B. 2009c. Isolation of Balamuthia mandrillaris from urban dust, free of known infectious involvement. Parasitology Research, 106,279-281.DOI: 10.1007/s00436-009-1592-910.1007/s00436-009-1592-9Search in Google Scholar
Niyyati M., Lorenzo-Morales J., Rezaie S., Rahimi F., Martin- Navarro C.M., Mohebali M., Maghsood A.H., Farnia S., Valladares B.,Rezaeian M. 2010. First report of a mixed infection due to Acanthamoeba genotype T3 and Vahlkampfia in a cosmetic soft contact lens wearer in Iran. Experimental Parasitology, 126,89-90. DOI:10.1016/j.exppara.2009.10.00910.1016/j.exppara.2009.10.009Search in Google Scholar
Page F.C. 1988. A New Key to Freshwater and Soil Gymnamoebae. Freshwater Biological Association, Ambleside, UK. ISBN 1871105021, 9781871105025Search in Google Scholar
Pélandakis M., Pernin P. 2002. Use of Multiplex PCR and PCR Restriction Enzyme Analysis for Detection and Exploration of the Variability in the Free-Living Amoeba Naegleria in the Environment. Applied and Environmental Microbiology, 68, 2061-2065. DOI: 10.1128/AEM.68.4.2061-2065.200210.1128/AEM.68.4.2061-2065.2002Search in Google Scholar
Sambrook J., Fristsch E.F., Maniatis T. 1989. Molecular cloning. A laboratory manual, 2nd ed. Cold Spring Harbour Laboratory Press. DOI: 10.1016/0003-2697(90)90595-Z 10.1016/0003-2697(90)90595-ZSearch in Google Scholar
Schroeder J.M., Booton G.C., Hay J., Niszl I.A., Seal D.V., Markus M.B., Fuerst P.A., Byers T.J. 2001. Use of subgenic 18S ribosomal DNA PCR and sequencing for genus and genotype identification of Acanthamoebae from humans with keratitis and from sewage sludge. Journal Of Clinical Microbiology, 39, 1903-1911. DOI: 10.1128/JCM.39.5.1903-1911.200110.1128/JCM.39.5.1903-1911.2001Search in Google Scholar
Schuster F.L.,Visvesvara G.S. 2004. Free-living amoebae as opportunistic and non-opportunistic pathogens of humans and animals. International Journal Of Parasitology, 34, 1001-1027. DOI: 10.1016/j.ijpara.2004.06.00410.1016/j.ijpara.2004.06.004Search in Google Scholar
Spanakos G., Tzanetou K., Miltsakakis D., Patsoula E., Malamou- Lada E., Vakalis N.C. 2006. Genotyping of pathogenic Acanthamoebae isolated from clinical samples in Greece-report of a clinical isolate presenting T5 genotype. Parasitology International, 55, 147-149. DOI: 10.1016/j.parint.2005.12.00110.1016/j.parint.2005.12.001Search in Google Scholar
Zegans M. E., Becker H.I., Budzik J. and O’Toole G. 2002. The role of bacterial biofilms in ocular infections. DNA and Cell Biology, 21, 415-420. DOI:10.1089/1044549026009970010.1089/10445490260099700Search in Google Scholar
Ziak P., Ondriska F., Mrva M. 2003. Acanthamoeba keratitis after use of soft contact lenses. Case report (in Slovak). Czesk and Slovak Ophthalmology, 59, 352-358Search in Google Scholar
© W. Stefański Institute of Parasitology, PAS