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Das AV, Bagga B, Joseph J. Clinical Profile and Demographic Distribution of Acanthamoeba Keratitis: An Electronic Medical Record-Driven Data Analytics from an Eye Care Network in India. Ocul Immunol Inflamm 2024; 32:722-726. [PMID: 37084281 DOI: 10.1080/09273948.2023.2199331] [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: 08/23/2022] [Accepted: 03/31/2023] [Indexed: 04/23/2023]
Abstract
OBJECTIVE To describe the clinical profile of patients presented with Acanthamoeba keratitis (AK) to a multi-tier ophthalmology hospital network in India. METHODS This cross-sectional hospital-based study included 1945339 new patients registering between September 2016 and May 2022. Patients with clinically confirmed diagnosis of AK in one or both eyes were included in the study. All the relevant data were documented using an electronic medical record (EMR) system. RESULTS A total of 245 (0.013%) patients were diagnosed with AK and majority were male (62.86%) with unilateral (99.59%) affliction. The most common age group was during the fourth decade of life, 65 (26.53%) patients and predominantly were adults (95.51%). The prevalence of the infection was higher in patients from a lower socioeconomic status (43.27%) from rural geography (52.24%) and in agriculture-related work (28.16%). The most common inciting factor was injury with vegetative matter (8.98%), dust (7.76%) and contact lens wear (4.49%). The majority of the eyes had blindness (20/400 to 20/1200) in 116 (47.15%) eyes with a presenting visual acuity (logMAR) of 2.14 ± 1.04. Among the surgical interventions, therapeutic keratoplasty was performed in 41 (16.67%) eyes, penetrating keratoplasty in 22 (8.94%) eyes, and evisceration in 2 (0.81%) eyes. CONCLUSION AK more commonly affects males presenting during the fourth decade of life from lower socio-economic status and is predominantly unilateral. A fourth of the affected eyes underwent keratoplasty and the majority had significant visual impairment at presentation.
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Affiliation(s)
- Anthony Vipin Das
- Department of eyeSmart EMR & AEye, L V Prasad Eye Institute, Hyderabad, India
- Indian Health Outcomes, Public Health and Economics Research Centre, Hyderabad, India
| | - Bhupesh Bagga
- The Cornea Institute, L V Prasad Eye Institute, Hyderabad, India
- The Ramoji Foundation Centre for Ocular Infections, L V Prasad Eye Institute, Hyderabad, India
| | - Joveeta Joseph
- The Ramoji Foundation Centre for Ocular Infections, L V Prasad Eye Institute, Hyderabad, India
- Jhaveri Microbiology Center, L V Prasad Eye Institute, Hyderabad, India
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2
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Ngarmsom R, Horatanaruang O. Epidemiology of Microbial Keratitis at a Tertiary Care Hospital in Southern Thailand. Clin Ophthalmol 2024; 18:1267-1275. [PMID: 38737595 PMCID: PMC11088849 DOI: 10.2147/opth.s464935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 04/28/2024] [Indexed: 05/14/2024] Open
Abstract
Purpose This study aimed to ascertain the microbial profiles and predisposing risk factors for microbial keratitis and to analyze the trend of mixed microbial infection cases over 8 years. Patients and Methods In this retrospective analysis, we reviewed the electronic medical records of inpatients diagnosed with microbial keratitis between January 2012 and December 2019. Data on demographics, risk factors, and causative pathogens were analyzed. Multivariate logistic regression models were utilized to identify risk factors associated with pathogens. Results This study included 640 eyes of 638 patients. Trauma was the most common predisposing risk factor (57.2%), followed by a combination of factors (14.4%). Among diagnostic test results, bacteria, fungi, and mixed pathogens were identified in 46.72%, 46.56%, and 21.41% of cases, respectively. Positive culture results were obtained in 324 eyes (53.6%), with Pseudomonas aeruginosa (25.1%) and Fusarium spp. (17.4%) being the most prevalent pathogens. In the multivariate logistic regression model, contact lens use, presence of diabetes mellitus, and HIV infection were statistically significant risk factors for Pseudomonas aeruginosa infection (p = 0.001, p = 0.046, and p = 0.04, respectively). Trauma was associated with Fusarium spp. infection (p = 0.001). An increase in the percentage of mixed microbial infection cases was observed when comparing the periods of 2016-2019 with 2012-2015 (p = 0.023). Conclusion Bacteria and fungi are equally common causes of microbial keratitis, with Pseudomonas aeruginosa and Fusarium spp. being the predominant pathogens causing bacterial and fungal infections. Trauma is the primary predisposing risk factor for microbial keratitis. There was a notable increase in mixed infection cases over the study period.
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Affiliation(s)
- Ratchapol Ngarmsom
- Department of Ophthalmology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Orasa Horatanaruang
- Department of Ophthalmology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
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3
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Cheng Y, An N, Ishaq HM, Xu J. Ocular microbial dysbiosis and its linkage with infectious keratitis patients in Northwest China: A cross-sectional study. Microb Pathog 2023; 184:106371. [PMID: 37741304 DOI: 10.1016/j.micpath.2023.106371] [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: 06/25/2023] [Revised: 09/19/2023] [Accepted: 09/20/2023] [Indexed: 09/25/2023]
Abstract
OBJECTIVES To evaluate the alteration of ocular surface microbiome of patients with infectious keratitis in northwest of China. METHODS The corneal scrapings, eyelid margin and conjunctiva samples were collected from 57 participants, who were divided into bacterial keratitis, fungal keratitis, viral keratitis and control group. The V3-V4 region of bacterial 16S rDNA in each sample was amplified and sequenced on the Illumina HiSeq 2500 sequencing platform, and the differences among different groups were compared bioinformatically. RESULTS Significant alterations of the microbiome were observed in alpha-diversity and beta-diversity analysis between the keratitis groups and the control group (p < 0.05). There was no significant differences between eyelid margin and conjunctiva samples in Alpha-Diversity analysis, but a significant difference between eyelid margin and corneal scraping samples in the keratitis group (p < 0.05, independent t-test). The abundances of Bacillus, Megamonas, Acinetobacter, and Rhodococcu were significantly elevated, while the abundance of Staphylococcus was decreased in the keratitis group compared to the control group. CONCLUSIONS The abundance of the ocular microbiome in patients with bacterial keratitis, fungal keratitis, or viral keratitis was significantly higher than those in the control group. Keratitis patients may have ecological disorder on ocular surface microbiome compared with controls. We believe that the conjunctiva and eyelid margin microbiome combined analysis can more comprehensively reflect the composition and abundance of ocular surface microbiome.
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Affiliation(s)
- Yan Cheng
- Department of Microbiology and Immunology, Key Laboratory of Environment and Genes Related to Diseases of Chinese Ministry of Education, School of Medicine, Xi'an Jiaotong University, Xi'an, China
| | - Na An
- The Fist Affiliated Hospital of Northwestern University, Department of Ophthalmology, The Xi'an Fist Hospital, Shaanxi Institute of Ophthalmology, China
| | - Hafiz Muhammad Ishaq
- Faculty of Veterinary and Animal Sciences, Muhammad Nawaz Shareef University of Agriculture Multan, Pakistan
| | - Jiru Xu
- Department of Microbiology and Immunology, Key Laboratory of Environment and Genes Related to Diseases of Chinese Ministry of Education, School of Medicine, Xi'an Jiaotong University, Xi'an, China.
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Motro Y, Wajnsztajn D, Michael-Gayego A, Mathur S, Marano RB, Salah I, Rosenbluh C, Temper V, Strahilevitz J, Moran-Gilad J. Metagenomic sequencing for investigation of a national keratoconjunctivitis outbreak, Israel, 2022. Euro Surveill 2023; 28:2300010. [PMID: 37535472 PMCID: PMC10401915 DOI: 10.2807/1560-7917.es.2023.28.31.2300010] [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: 01/03/2023] [Accepted: 06/20/2023] [Indexed: 08/05/2023] Open
Abstract
BackgroundEpidemics of keratoconjunctivitis may involve various aetiological agents. Microsporidia are an uncommon difficult-to-diagnose cause of such outbreaks.AimDuring the third quarter of 2022, a keratoconjunctivitis outbreak was reported across Israel, related to common water exposure to the Sea of Galilee. We report a comprehensive diagnostic approach that identified Vittaforma corneae as the aetiology, serving as proof of concept for using real-time metagenomics for outbreak investigation.MethodsCorneal scraping samples from a clinical case were subjected to standard microbiological testing. Samples were tested by calcofluor white staining and metagenomic short-read sequencing. We analysed the metagenome for taxonomical assignment and isolation of metagenome-assembled genome (MAG). Targets for a novel PCR were identified, and the assay was applied to clinical and environmental samples and confirmed by long-read metagenomic sequencing.ResultsFluorescent microscopy was suggestive of microsporidiosis. The most abundant species (96.5%) on metagenomics analysis was V. corneae. Annotation of the MAG confirmed the species assignment. A unique PCR target in the microsporidian rRNA gene was identified and validated against the clinical sample. The assay and metagenomic sequencing confirmed V. corneae in an environmental sludge sample collected at the exposure site.ConclusionsThe real-time utilisation of metagenomics allowed species detection and development of diagnostic tools, which aided in outbreak source tracking and can be applied for future cases. Metagenomics allows a fully culture-independent investigation and is an important modality for public health microbiology.
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Affiliation(s)
- Yair Motro
- Department of Health Policy and Management, School of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
- These authors contributed equally to the manuscript and share first authorship
| | - Denise Wajnsztajn
- Department of Ophthalmology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
- These authors contributed equally to the manuscript and share first authorship
| | - Ayelet Michael-Gayego
- Clinical Microbiology Laboratory, Department of Clinical Microbiology and Infectious Diseases, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Shubham Mathur
- Department of Health Policy and Management, School of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Roberto Bm Marano
- Department of Health Policy and Management, School of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Ikram Salah
- Department of Health Policy and Management, School of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Chaggai Rosenbluh
- Department of Genetics, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Violeta Temper
- Clinical Microbiology Laboratory, Department of Clinical Microbiology and Infectious Diseases, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Jacob Strahilevitz
- Clinical Microbiology Laboratory, Department of Clinical Microbiology and Infectious Diseases, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Jacob Moran-Gilad
- Department of Health Policy and Management, School of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
- Clinical Microbiology Laboratory, Department of Clinical Microbiology and Infectious Diseases, Hadassah Hebrew University Medical Center, Jerusalem, Israel
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Chomicz L, Szaflik JP, Szostakowska B, Izdebska J, Baltaza W, Łazicka-Gałecka M, Kuligowska A, Machalińska A, Zawadzki PJ, Szaflik J. Successive Acanthamoeba Corneal Isolates Identified in Poland Monitored in Terms of In Vitro Dynamics. Microorganisms 2023; 11:1174. [PMID: 37317148 DOI: 10.3390/microorganisms11051174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 04/24/2023] [Accepted: 04/27/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Amoebae of the genus Acanthamoeba cause a sight-threatening infection called Acanthamoeba keratitis. It is considered a rare disease in humans but poses an increasing threat to public health worldwide, including in Poland. We present successive isolates from serious keratitis preliminary examined in terms of the identification and monitoring of, among others, the in vitro dynamics of the detected strains. METHODS Clinical and combined laboratory methods were applied; causative agents of the keratitis were identified at the cellular and molecular levels; isolates were cultivated in an axenic liquid medium and regularly monitored. RESULTS In a phase-contrast microscope, Acanthamoeba sp. cysts and live trophozoites from corneal samples and in vitro cultures were assessed on the cellular level. Some isolates that were tested at the molecular level were found to correspond to A. mauritanensis, A. culbertsoni, A. castellanii, genotype T4. There was variability in the amoebic strain dynamics; high viability was expressed as trofozoites' long duration ability to intense multiply. CONCLUSIONS Some strains from keratitis under diagnosis verification and dynamics assessment showed enough adaptive capability to grow in an axenic medium, allowing them to exhibit significant thermal tolerance. In vitro monitoring that was suitable for verifying in vivo examinations, in particular, was useful to detect the strong viability and pathogenic potential of successive Acanthamoeba strains with a long duration of high dynamics.
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Affiliation(s)
- Lidia Chomicz
- Department of Medical Biology, Medical University of Warsaw, 00-575 Warsaw, Poland
| | - Jacek P Szaflik
- Department of Ophthalmology, Independent Public Clinical Ophthalmology Hospital, Medical University of Warsaw, 00-576 Warsaw, Poland
| | - Beata Szostakowska
- Department of Tropical Parasitology, Faculty of Health Sciences, Medical University of Gdansk, 80-210 Gdańsk, Poland
| | - Justyna Izdebska
- Department of Ophthalmology, Independent Public Clinical Ophthalmology Hospital, Medical University of Warsaw, 00-576 Warsaw, Poland
| | - Wanda Baltaza
- Department of Public Health, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Monika Łazicka-Gałecka
- Department of Ophthalmology, Independent Public Clinical Ophthalmology Hospital, Medical University of Warsaw, 00-576 Warsaw, Poland
| | - Agnieszka Kuligowska
- First Department of Ophthalmology, Pomeranian Medical University, 70-111 Szczecin, Poland
| | - Anna Machalińska
- First Department of Ophthalmology, Pomeranian Medical University, 70-111 Szczecin, Poland
| | - Paweł J Zawadzki
- Clinic of Cranio-Maxillo-Facial and Oral Surgery and Implantology, Medical University of Warsaw, 02-005 Warsaw, Poland
| | - Jerzy Szaflik
- Laser Eye Microsurgery Centre Clinic of Prof. Jerzy Szaflik, Brand Med Medical Research Centre, 00-215 Warsaw, Poland
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Zhang Y, Xu X, Wei Z, Cao K, Zhang Z, Liang Q. The global epidemiology and clinical diagnosis of Acanthamoeba keratitis. J Infect Public Health 2023; 16:841-852. [PMID: 37030037 DOI: 10.1016/j.jiph.2023.03.020] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 03/05/2023] [Accepted: 03/20/2023] [Indexed: 04/10/2023] Open
Abstract
Acanthamoeba keratitis is a rare parasitic infection of the cornea that can lead to permanent blindness if not diagnosed and treated promptly. We collected data on the incidences of Acanthamoeba keratitis from 20 countries and calculated an annual incidence of 23,561 cases, with the lowest rates in Tunisia and Belgium, and the highest in India. We analyzed 3755 Acanthamoeba sequences from the GenBank database across Asia, Europe, North America, South America, and Oceania and genotyped them into T1, T2, T3, T4, T5, T10, T11, T12, and T15. Many genotypes possess different characteristics, yet T4 is the most prevalent genotype. As efficient treatment against Acanthamoeba remains lacking, prevention from early diagnosis via staining, PCR, or in vivo confocal microscopy (IVCM) becomes significant for the condition's prognosis. IVCM is the most recommended approach for the early detection of Acanthamoeba. If IVCM is unavailable, PCR should be used as an alternative.
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Affiliation(s)
- Yuheng Zhang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing 100005, China
| | - Xizhan Xu
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing 100005, China
| | - Zhenyu Wei
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing 100005, China
| | - Kai Cao
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing 100005, China
| | - Zijun Zhang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing 100005, China
| | - Qingfeng Liang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing 100005, China.
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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: 15] [Impact Index Per Article: 15.0] [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.
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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,
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Pastrana C, Guerreiro JRL, Elumalai M, Carpena-Torres C, Crooke A, Carracedo G, Prado M, Huete-Toral F. Dual-Mode Gold Nanoparticle-Based Method for Early Detection of Acanthamoeba. Int J Mol Sci 2022; 23:ijms232314877. [PMID: 36499204 PMCID: PMC9740238 DOI: 10.3390/ijms232314877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/23/2022] [Accepted: 11/25/2022] [Indexed: 11/29/2022] Open
Abstract
Acanthamoeba keratitis is an aggressive and rapidly progressing ocular pathology whose main risk factor is the use of contact lenses. An early and differential diagnosis is considered the main factor to prevent the progression and improve the prognosis of the pathology. However, current diagnosis techniques require time, complex and costly materials making an early diagnosis challenging. Thus, there is a need for fast, accessible, and accurate methods for Acanthamoeba detection by practitioners for timely and suitable treatment and even for contact lens user as preventive diagnosis. Here, we developed a dual-mode colorimetric-based method for fast, visual, and accurate detection of Acanthamoeba using gold nanoparticles (AuNPs). For this strategy, AuNPs were functionalized with thiolated probes and the presence of target Acanthamoeba genomic sequences, produce a colorimetric change from red to purple. This approach allows the detection of 0.02 and 0.009 μM of the unamplified Acanthamoeba genome by the naked eye in less than 20 min and by color analysis using a smartphone. Additionally, real samples were successfully analyzed showing the potential of the technology considering the lack of point-of-care tools that are mostly needed.
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Affiliation(s)
- Cristina Pastrana
- Ocupharm Research Group, Department of Optometry and Vision, Faculty of Optics and Optometry, Complutense University of Madrid, C/Arcos de Jalón 118, 28037 Madrid, Spain
- Correspondence: (C.P.); (J.R.L.G.)
| | - J. Rafaela L. Guerreiro
- Food Quality and Safety Group, International Iberian Nanotechnology Laboratory (INL), Av. Mestre José Veiga, 4715-330 Braga, Portugal
- BioMark@ISEP, School of Engineering of the Polytechnic Institute of Porto, Rua Dr. António Bernardino de Almeida 431, 4249-015 Porto, Portugal
- CEB/LABBELS, Center of Biological Engineering, Minho University, Campus de Gualtar, Rua da Universidade, 4710-057 Braga, Portugal
- Correspondence: (C.P.); (J.R.L.G.)
| | - Monisha Elumalai
- Food Quality and Safety Group, International Iberian Nanotechnology Laboratory (INL), Av. Mestre José Veiga, 4715-330 Braga, Portugal
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN 47907, USA
| | - Carlos Carpena-Torres
- Ocupharm Research Group, Department of Optometry and Vision, Faculty of Optics and Optometry, Complutense University of Madrid, C/Arcos de Jalón 118, 28037 Madrid, Spain
| | - Almudena Crooke
- Department of Biochemistry and Molecular Biology, Faculty of Optics and Optometry, Complutense University of Madrid, C/Arcos de Jalón 118, 28037 Madrid, Spain
| | - Gonzalo Carracedo
- Ocupharm Research Group, Department of Optometry and Vision, Faculty of Optics and Optometry, Complutense University of Madrid, C/Arcos de Jalón 118, 28037 Madrid, Spain
| | - Marta Prado
- Food Quality and Safety Group, International Iberian Nanotechnology Laboratory (INL), Av. Mestre José Veiga, 4715-330 Braga, Portugal
| | - Fernando Huete-Toral
- Ocupharm Research Group, Department of Optometry and Vision, Faculty of Optics and Optometry, Complutense University of Madrid, C/Arcos de Jalón 118, 28037 Madrid, Spain
- Department of Biochemistry and Molecular Biology, Faculty of Optics and Optometry, Complutense University of Madrid, C/Arcos de Jalón 118, 28037 Madrid, Spain
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Sepulveda-Beltran PA, Levine H, Altamirano DS, Martinez JD, Durkee H, Mintz K, Leblanc R, Tóthová JD, Miller D, Parel JM, Amescua G. Rose Bengal Photodynamic Antimicrobial Therapy: A review of the intermediate term clinical and surgical outcomes. Am J Ophthalmol 2022; 243:125-134. [PMID: 35952754 DOI: 10.1016/j.ajo.2022.08.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 07/29/2022] [Accepted: 08/03/2022] [Indexed: 11/01/2022]
Abstract
PURPOSE To evaluate the intermediate term clinical outcomes of Rose Bengal Photodynamic Antimicrobial Therapy (RB-PDAT) for infectious keratitis. Secondarily, to evaluate the surgical outcomes of individuals that underwent optical keratoplasty after RB-PDAT. DESIGN Retrospective cohort study. METHODS Retrospective chart review of 31 eyes from 30 consecutive individuals with infectious keratitis refractory to standard medical therapy who underwent RB-PDAT at the Bascom Palmer Eye Institute between January 2016 and July 2020. Data collected included demographics, risk factors for infectious keratitis, microbiological diagnosis, Best Spectacle-Corrected Visual Acuity (BCVA), clinical outcomes after RB-PDAT and complication rates post-keratoplasty. RB-PDAT was performed as described in previous studies. Graft survival was evaluated using Kaplan Meier curves with log-ranks in individuals that underwent keratoplasty after RB-PDAT. RESULTS Mean age of the study population was 53±18.0 years. 70% were female; 53.3% self-identified as non-Hispanic White; 43.3% as Hispanic. Mean follow-up time was 28.0±14.4 months. Risk factors included contact lens use (80.6%), history of infectious keratitis (19.3%), and ocular surface disease (16.1%). Cultures were positive for Acanthamoeba (51.6%), Fusarium (12.9%), and Pseudomonas (6.5%). 22.5% of individuals with Acanthamoeba infection were treated with concomitant Miltefosine. Clinical resolution was achieved in 77.4% of individuals on average 2.72±1.85 months after RB-PDAT with 22.5% requiring therapeutic penetrating keratoplasties and 54.8% subsequently requiring optical penetrating keratoplasties. At 2 years, the overall probability of graft survival was 78.7% and the graft failure rate was 21.3%. CONCLUSION RB-PDAT is a potential adjunct therapy for infectious keratitis that may reduce the need for a therapeutic penetrating keratoplasty. Cases that undergo keratoplasty after RB-PDAT may have a higher probability of graft survival at one year postoperatively.
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Affiliation(s)
- Paula A Sepulveda-Beltran
- Anne Bates Leach Eye Center, Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL, USA; Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Harry Levine
- Anne Bates Leach Eye Center, Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Diego S Altamirano
- Anne Bates Leach Eye Center, Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jaime D Martinez
- Anne Bates Leach Eye Center, Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Heather Durkee
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Keenan Mintz
- Department of Chemistry, University of Miami, Coral Gables, FL, USA
| | - Roger Leblanc
- Department of Chemistry, University of Miami, Coral Gables, FL, USA
| | - Jana D'Amato Tóthová
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Darlene Miller
- Ocular Microbiology Laboratory, Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jean-Marie Parel
- Anne Bates Leach Eye Center, Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL, USA; Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Guillermo Amescua
- Anne Bates Leach Eye Center, Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL, USA; Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL, USA.
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10
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Wang X, Jacobs DS. An Update on the Initial Treatment of Acanthamoeba Keratitis. Int Ophthalmol Clin 2022; 62:101-110. [PMID: 35325913 DOI: 10.1097/iio.0000000000000408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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11
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Eftekhari-Kenzerki R, Solhjoo K, Babaei Z, Rezanezhad H, Abolghazi A, Taghipour A. High occurrence of Acanthamoeba spp. in the water samples of public swimming pools from Kerman Province, Iran. JOURNAL OF WATER AND HEALTH 2021; 19:864-871. [PMID: 34665778 DOI: 10.2166/wh.2021.162] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Acanthamoeba spp. is a free-living amoeba that can cause major infections in humans, including keratitis and granulomatous encephalitis. Thus, water resources play an important role in transmitting Acanthamoeba spp. infection to humans. The purpose of this study was to investigate the presence of Acanthamoeba spp. in public swimming pools from three cities of Kerman Province, southeastern Iran. Eighty water samples of 20 public indoor swimming pools were taken from Kerman, Jiroft, and Kahnauj cities. Water temperature (°C), pH, and free chlorine concentration (ppm) were measured. Filtration and cultivation were applied on non-nutrient agar medium. The polymerase chain reaction was applied by using the genus-specific primers (JDP1 and JDP2) on positive samples; these primers can amplify the 423-551 bp fragment. Eighteen of the 20 swimming pools (including 32/80; 40% samples) were contaminated with Acanthamoeba spp. All swimming pools of Jiroft and Kahnauj and 88.2% of swimming pools in Kerman were contaminated. As such, all 32 Acanthamoeba isolates were amplified using the JDP primer pairs. Two genotypes, T3 and T4, were also identified. The present research is the first to report Acanthamoeba spp. in public swimming pools from Kerman Province. Due to high occurrence of this protozoan, it is recommended to use warning signs around swimming pools to create awareness of this infection.
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Affiliation(s)
- Raheleh Eftekhari-Kenzerki
- Department of Medical Parasitology and Mycology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran E-mail:
| | - Kavous Solhjoo
- Department of Medical Parasitology and Mycology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran E-mail: ; Zoonoses Research Center, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Zahra Babaei
- Leishmaniasis Research Center, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Hassan Rezanezhad
- Department of Medical Parasitology and Mycology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran E-mail: ; Zoonoses Research Center, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Ahmad Abolghazi
- Department of Medical Parasitology and Mycology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran E-mail:
| | - Ali Taghipour
- Zoonoses Research Center, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
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The role of Acanthamoeba spp. in biofilm communities: a systematic review. Parasitol Res 2021; 120:2717-2729. [PMID: 34292376 DOI: 10.1007/s00436-021-07240-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 07/01/2021] [Indexed: 12/16/2022]
Abstract
Acanthamoeba spp. have always caused disease in immunosuppressed patients, but since 1986, they have become a worldwide public health issue by causing infection in healthy contact lens wearers. Amoebae of the Acanthamoeba genus are broadly distributed in nature, living either freely or as parasites, and are frequently associated with biofilms throughout the environment. These biofilms provide the parasite with protection against external aggression, thus favoring its increased pathogeny. This review aims to assess observational studies on the association between Acanthamoeba spp. and biofilms, opening potential lines of research on this severe ocular infection. A systematic literature search was conducted in May 2020 in the following databases: PubMed Central®/Medline, LILACS, The Cochrane Library, and EMBASE®. The studies were selected following the inclusion and exclusion criteria specifically defined for this review. Electronic research recovered 353 publications in the literature. However, none of the studies met the inclusion criterion of biofilm-producing Acanthamoeba spp., inferring that the parasite does not produce biofilms. Nonetheless, 78 studies were classified as potentially included regarding any association of Acanthamoeba spp. and biofilms. These studies were allocated across six different locations (hospital, aquatic, ophthalmic and dental environments, biofilms produced by bacteria, and other places). Acanthamoeba species use biofilms produced by other microorganisms for their benefit, in addition to them providing protection to and facilitating the dissemination of pathogens residing in them.
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13
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Acanthamoeba Keratitis, Pathology, Diagnosis and Treatment. Pathogens 2021; 10:pathogens10030323. [PMID: 33801905 PMCID: PMC7998329 DOI: 10.3390/pathogens10030323] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/03/2021] [Accepted: 03/04/2021] [Indexed: 11/06/2022] Open
Abstract
Acanthamoeba keratitis is an unusual corneal infection that is recently increasing in frequency and is often contracted by contact lens wearers, someone who experienced recent eye trauma, or someone exposed to contaminated waters. Acanthamoeba survive in air, soil, dust, and water. Therefore, eye trauma and poor contact lens hygiene practices lead to the entrapment of debris and thus infection. Acanthamoeba keratitis results in severe eye pain, inflammation, and defects of the epithelium and stroma that can potentially result in vision loss if not diagnosed early and treated promptly. The disease can be diagnosed using corneal scrape/biopsy, polymerase chain reactions, impression cytology, or in vivo confocal microscopy. Once diagnosed, it is usually treated with an antimicrobial combination therapy of biguanide and aromatic diadine eye drops for several months. Advanced stages of the disease result in vision loss and the need for corneal transplants. Avoiding the risk factors and diagnosing the disease early are the most effective ways to combat Acanthamoeba keratitis.
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Yee A, Walsh K, Schulze M, Jones L. The impact of patient behaviour and care system compliance on reusable soft contact lens complications. Cont Lens Anterior Eye 2021; 44:101432. [PMID: 33678542 DOI: 10.1016/j.clae.2021.02.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 01/07/2021] [Accepted: 02/23/2021] [Indexed: 11/19/2022]
Abstract
Reusable soft daily wear contact lenses (CLs) remain popular and were fit to just over half of all wearers in the most recent international CL prescribing survey. Unlike daily disposable CLs, reusables require cleaning and disinfecting after every use, along with storage in a CL case. These additional requirements add a number of steps to the daily wear and care routine, increasing the opportunities for CL wearers to exhibit non-compliant behaviour. The impact of non-compliance ranges from poor lens comfort through to potentially sight-threatening infective keratitis. The coronavirus pandemic has refocused the profession on the importance of hand hygiene in particular, and the need for promoting safe CL wear in general. This review summarises typical non-compliant behaviour related to reusable CLs, and examines strategies and opportunities to better support wearers. Patient education has a central role in encouraging compliant behaviour, although patient recall of information is low, and personal belief systems may result in continuation of non-compliant behaviour despite awareness of the risks. CL care solutions are required for the daily disinfection of lenses, however misuse of multipurpose solutions (MPS) and hydrogen peroxide (H2O2)-based care systems can challenge their ability to be fully efficacious. Standard efficacy testing is reviewed, with consideration of how well current protocols model real-world use of CL solutions. Although some recommendations are in place for the inclusion of additional variables such as lens cases, CL materials, organic soil and efficacy against Acanthamoeba, opportunity still exists to reevaluate global standards to ensure consistency of testing in all markets. Finally, potential future innovations are discussed which may further support increased safety in reusable lens wear through novel antimicrobial additions to both CL materials and cases.
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Affiliation(s)
- Alan Yee
- Centre for Ocular Research & Education (CORE), School of Optometry and Vision Science, University of Waterloo, Canada.
| | - Karen Walsh
- Centre for Ocular Research & Education (CORE), School of Optometry and Vision Science, University of Waterloo, Canada.
| | - Marc Schulze
- Centre for Ocular Research & Education (CORE), School of Optometry and Vision Science, University of Waterloo, Canada.
| | - Lyndon Jones
- Centre for Ocular Research & Education (CORE), School of Optometry and Vision Science, University of Waterloo, Canada.
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Szczotka-Flynn LB, Shovlin JP, Schnider CM, Caffery BE, Alfonso EC, Carnt NA, Chalmers RL, Collier S, Jacobs DS, Joslin CE, Kroken AR, Lakkis C, Pearlman E, Schein OD, Stapleton F, Tu E, Willcox MDP. American Academy of Optometry Microbial Keratitis Think Tank. Optom Vis Sci 2021; 98:182-198. [PMID: 33771951 PMCID: PMC8075116 DOI: 10.1097/opx.0000000000001664] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
SIGNIFICANCE Think Tank 2019 affirmed that the rate of infection associated with contact lenses has not changed in several decades. Also, there is a trend toward more serious infections associated with Acanthamoeba and fungi. The growing use of contact lenses in children demands our attention with surveillance and case-control studies. PURPOSE The American Academy of Optometry (AAO) gathered researchers and key opinion leaders from around the world to discuss contact lens-associated microbial keratitis at the 2019 AAO Annual Meeting. METHODS Experts presented within four sessions. Session 1 covered the epidemiology of microbial keratitis, pathogenesis of Pseudomonas aeruginosa, and the role of lens care systems and storage cases in corneal disease. Session 2 covered nonbacterial forms of keratitis in contact lens wearers. Session 3 covered future needs, challenges, and research questions in relation to microbial keratitis in youth and myopia control, microbiome, antimicrobial surfaces, and genetic susceptibility. Session 4 covered compliance and communication imperatives. RESULTS The absolute rate of microbial keratitis has remained very consistent for three decades despite new technologies, and extended wear significantly increases the risk. Improved oxygen delivery afforded by silicone hydrogel lenses has not impacted the rates, and although the introduction of daily disposable lenses has minimized the risk of severe disease, there is no consistent evidence that they have altered the overall rate of microbial keratitis. Overnight orthokeratology lenses may increase the risk of microbial keratitis, especially secondary to Acanthamoeba, in children. Compliance remains a concern and a significant risk factor for disease. New insights into host microbiome and genetic susceptibility may uncover new theories. More studies such as case-control designs suited for rare diseases and registries are needed. CONCLUSIONS The first annual AAO Think Tank acknowledged that the risk of microbial keratitis has not decreased over decades, despite innovation. Important questions and research directions remain.
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Affiliation(s)
| | | | | | | | - Eduardo C Alfonso
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
| | - Nicole A Carnt
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | | | - Sarah Collier
- U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Deborah S Jacobs
- Massachusetts Eye and Ear, Cornea Service, Harvard Medical School, Boston, Massachusetts
| | - Charlotte E Joslin
- Department of Ophthalmology and Visual Science, College of Medicine, Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, Illinois
| | - Abby R Kroken
- School of Optometry, University of California, Berkeley, Berkeley, California
| | | | - Eric Pearlman
- Departments of Ophthalmology, and Physiology and Biophysics, University of California, Irvine, Irvine, California
| | - Oliver D Schein
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Fiona Stapleton
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Elmer Tu
- University of Illinois Eye and Ear Infirmary, Chicago, Illinois
| | - Mark D P Willcox
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
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16
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Chabbar I, Serghini L, Berraho A. [Acanthamoeba keratitis in infant: An atypical case presentation]. J Fr Ophtalmol 2021; 44:e227-e229. [PMID: 33423811 DOI: 10.1016/j.jfo.2020.06.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Revised: 05/29/2020] [Accepted: 06/30/2020] [Indexed: 10/22/2022]
Affiliation(s)
- I Chabbar
- Service d'ophtalmologie B, hôpital des spécialités, CHU Ibn Sina, Quartier-Souissi, 6220 Rabat, Maroc.
| | - L Serghini
- Service d'ophtalmologie B, hôpital des spécialités, CHU Ibn Sina, Quartier-Souissi, 6220 Rabat, Maroc
| | - A Berraho
- Service d'ophtalmologie B, hôpital des spécialités, CHU Ibn Sina, Quartier-Souissi, 6220 Rabat, Maroc
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17
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Effectiveness and Safety of Topical Chlorhexidine and Vitamin E TPGS in the Treatment of Acanthamoeba Keratitis: A Survey on 29 Cases. J Clin Med 2020; 9:jcm9113775. [PMID: 33238434 PMCID: PMC7700543 DOI: 10.3390/jcm9113775] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 11/16/2020] [Accepted: 11/20/2020] [Indexed: 12/13/2022] Open
Abstract
This study aimed to test the effectiveness of a solution of chlorhexidine (CHX) and D-α-tocopheryl polyethylene glycol succinate (Vitamin E TPGS or TPGS) in the treatment of Acanthamoeba keratitis (AK) via a prospective, interventional case series study. Twenty-nine consecutive patients with AK were enrolled. At baseline, best-corrected visual acuity (BCVA), slit lamp examination, confocal microscopy, and polymerase chain reaction (PCR) were performed. Topical therapy with CHX 0.02% and VE-TPGS 0.2% was administered hourly/24 h for the first day, hourly in the daytime for the next three days, and finally, every two hours in the daytime up to one month. BCVA and ocular inflammation were recorded after two weeks, four weeks, and three months from baseline. Mean logMAR BCVA significantly improved at two weeks (0.78) compared to baseline (1.76), remaining stable over time (0.80 at four weeks, 0.77 at three months). Ocular inflammation improved in 14 eyes at 2 weeks, with further slow improvements in all cases. At three months, no patient had signs of corneal inflammation. The presence of corneal scars was first recorded at the two-week follow-up, with an enlargement at the four-week follow-up. At the three-month follow-up, 19 eyes still showed corneal opacities. In conclusion, the tested solution was shown to be effective for the treatment of AK. Furthermore, it might represent a good first-line treatment.
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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: 6.8] [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
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19
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Carnt NA, Subedi D, Connor S, Kilvington S. The relationship between environmental sources and the susceptibility of Acanthamoeba keratitis in the United Kingdom. PLoS One 2020; 15:e0229681. [PMID: 32160218 PMCID: PMC7065798 DOI: 10.1371/journal.pone.0229681] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 02/11/2020] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To determine whether Acanthamoeba keratitis (AK) patients have higher rates of Acanthamoeba and free-living amoeba (FLA) colonising domestic sinks than control contact lens (CL) wearers, and whether these isolates are genetically similar to the corneal isolates from their CL associated AK. METHODS 129 AK patients from Moorefield Eye Hospital, London and 64 control CL wearers from the Institute of Optometry were included in this study. The participants self-collected home kitchen and bathroom samples from tap-spouts, overflows and drains using an instructional kit. The samples were cultured by inoculating onto a non-nutrient agar plate seeded with Escherichia coli, incubated at 32°C and examined for amoebae by microscopy for up to 2 weeks. Partial sequences of mitochondrial cytochrome oxidase genes (coxA) of Acanthamoeba isolates from four AK patients were compared to Acanthamoeba isolated from the patient's home. The association between sampling sites was analysed with the chi-square test. RESULTS A total of 513 samples from AK patients and 189 from CL controls were collected. The yield of FLA was significantly greater in patients' bathrooms (72.1%) than CL controls' bathrooms (53.4%) (p<0.05). Spouts (kitchen 6.7%, bathroom 11%) had the lowest rate of Acanthamoeba isolation compared to drains (kitchen 18.2%, bathroom 27.9%) and overflow (kitchen 39.1%, bathroom 25.9%) either in kitchens or bathrooms (p<0.05). There was no statistically significant difference between the average prevalence of Acanthamoeba in all three sample sites in kitchens (16.9%) compared to all three sample sites in bathrooms (21.5%) and no association for Acanthamoeba prevalence between AK patients and CL controls. All four corneal isolates had the same coxA sequence as at least one domestic water isolate from the patients' sink of the kitchen and the bathroom. CONCLUSION The prevalence of Acanthamoeba and FLA was high in UK homes. FLA colonisation was higher in AK patients compared to controls but the prevalence of Acanthamoeba between AK patients and CL controls domestic sinks was similar. This study confirms that domestic water isolates are probably the source of AK infection. Advice about avoiding water contact when using CL's should be mandatory.
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Affiliation(s)
- Nicole A Carnt
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia.,Westmead Institute for Medical Research, University of Sydney, Sydney, Australia.,University College London Institute of Ophthalmology, London, England, United Kingdom
| | - Dinesh Subedi
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia.,School of Biological Sciences, Monash University, Clayton, Australia
| | - Sophie Connor
- Research Organisation (KC) Ltd, London, England, United Kingdom
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Tananuvat N, Techajongjintana N, Somboon P, Wannasan A. The First Acanthamoeba keratitis Case of Non-Contact Lens Wearer with HIV Infection in Thailand. THE KOREAN JOURNAL OF PARASITOLOGY 2019; 57:505-511. [PMID: 31715691 PMCID: PMC6851254 DOI: 10.3347/kjp.2019.57.5.505] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 09/24/2019] [Indexed: 11/23/2022]
Abstract
Acanthamoeba keratitis (AK) is a rare sight-threatening corneal infection, often reporting from contact lens wearers. An asymptomatic human immunodeficiency virus (HIV)-infected Thai male without history of contact lens use complained foreign body sensation at his left eye during motorbike riding. He had neither specific keratitis symptoms nor common drugs responding, which contributed to delayed diagnosis. By corneal re-scraping, Acanthamoeba-like cysts were detected by calcofluor white staining and agar culture. The etiological agent obtained from the culture was molecularly confirmed by Acanthamoeba spp.-specific PCR, followed by DNA sequencing. The results from BLAST and phylogenetic analysis based on the DNA sequences, revealed that the pathogen was Acanthamoeba T4, the major genotype most frequently reported from clinical isolates. The infection was successfully treated with polyhexamethylene biguanide resulting in corneal scar. This appears the first reported AK case from a non-contact lens wearer with HIV infection in Thailand. Although AK is sporadic in developing countries, a role of free-living Acanthamoeba as an opportunistic pathogen should not be neglected. The report would increase awareness of AK, especially in the case presenting unspecific keratitis symptoms without clinical response to empirical antimicrobial therapy.
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Affiliation(s)
- Napaporn Tananuvat
- Department of Opththalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Natnaree Techajongjintana
- Department of Opththalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Pradya Somboon
- Department of Parasitology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Anchalee Wannasan
- Department of Parasitology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
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Bunsuwansakul C, Mahboob T, Hounkong K, Laohaprapanon S, Chitapornpan S, Jawjit S, Yasiri A, Barusrux S, Bunluepuech K, Sawangjaroen N, Salibay CC, Kaewjai C, de Lourdes Pereira M, Nissapatorn V. Acanthamoeba in Southeast Asia - Overview and Challenges. THE KOREAN JOURNAL OF PARASITOLOGY 2019; 57:341-357. [PMID: 31533401 PMCID: PMC6753290 DOI: 10.3347/kjp.2019.57.4.341] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Revised: 07/18/2019] [Accepted: 07/18/2019] [Indexed: 12/21/2022]
Abstract
Acanthamoeba, one of free-living amoebae (FLA), remains a high risk of direct contact with this protozoan parasite which is ubiquitous in nature and man-made environment. This pathogenic FLA can cause sight-threatening amoebic keratitis (AK) and fatal granulomatous amoebic encephalitis (GAE) though these cases may not commonly be reported in our clinical settings. Acanthamoeba has been detected from different environmental sources namely; soil, water, hot-spring, swimming pool, air-conditioner, or contact lens storage cases. The identification of Acanthamoeba is based on morphological appearance and molecular techniques using PCR and DNA sequencing for clinico-epidemiological purposes. Recent treatments have long been ineffective against Acanthamoeba cyst, novel anti-Acanthamoeba agents have therefore been extensively investigated. There are efforts to utilize synthetic chemicals, lead compounds from medicinal plant extracts, and animal products to combat Acanthamoeba infection. Applied nanotechnology, an advanced technology, has shown to enhance the anti-Acanthamoeba activity in the encapsulated nanoparticles leading to new therapeutic options. This review attempts to provide an overview of the available data and studies on the occurrence of pathogenic Acanthamoeba among the Association of Southeast Asian Nations (ASEAN) members with the aim of identifying some potential contributing factors such as distribution, demographic profile of the patients, possible source of the parasite, mode of transmission and treatment. Further, this review attempts to provide future direction for prevention and control of the Acanthamoeba infection.
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Affiliation(s)
- Chooseel Bunsuwansakul
- School of Allied Health, Southeast Asia Water Team (SEA Water Team) and World Union for Herbal Drug Discovery (WUHeDD), Walailak University, Nakhon Si Thammarat, Thailand
| | - Tooba Mahboob
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Kruawan Hounkong
- Department of Microbiology, Princess of Naradhiwas University, Narathiwat, Thailand
| | | | | | - Siriuma Jawjit
- School of Public Health, Walailak University, Nakhon Si Thammarat, Thailand
| | - Atipat Yasiri
- Chulabhorn International College of Medicine, Thammasat University, Pathum Thani, Thailand
| | - Sahapat Barusrux
- School of Allied Health, Southeast Asia Water Team (SEA Water Team) and World Union for Herbal Drug Discovery (WUHeDD), Walailak University, Nakhon Si Thammarat, Thailand
| | - Kingkan Bunluepuech
- School of Allied Health, Southeast Asia Water Team (SEA Water Team) and World Union for Herbal Drug Discovery (WUHeDD), Walailak University, Nakhon Si Thammarat, Thailand
| | | | - Cristina C. Salibay
- College of Science and Computer Studies, De La Salle University-Dasmarinas, Dasmarinas City, Cavite, Philippines
| | - Chalermpon Kaewjai
- Faculty of Medical Technology, Rangsit University, Pathum Thani, Thailand
| | - Maria de Lourdes Pereira
- Department of Medical Sciences & CICECO-Aveiro Institute of Materials, University of Aveiro, Aveiro, Portugal
| | - Veeranoot Nissapatorn
- School of Allied Health, Southeast Asia Water Team (SEA Water Team) and World Union for Herbal Drug Discovery (WUHeDD), Walailak University, Nakhon Si Thammarat, Thailand
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22
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Habibpour H, Haddad MF, Shokri A, Nejadi SH. A review of Acanthamoeba keratitis in the middle East and Iran. JOURNAL OF ACUTE DISEASE 2019. [DOI: 10.4103/2221-6189.263705] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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23
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Kusrini E, Hashim F, Gunawan C, Mann R, Azmi WNNWN, Amin NM. Anti-amoebic activity of acyclic and cyclic-samarium complexes on Acanthamoeba. Parasitol Res 2018. [DOI: 10.1007/s00436-018-5814-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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24
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Zhong J, Li X, Deng Y, Chen L, Zhou S, Huang W, Lin S, Yuan J. Associated factors, diagnosis and management of Acanthamoeba keratitis in a referral Center in Southern China. BMC Ophthalmol 2017; 17:175. [PMID: 28969610 PMCID: PMC5625641 DOI: 10.1186/s12886-017-0571-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 09/21/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To analyse the associated factors, diagnosis, clinical manifestations and therapeutic effects of Acanthamoeba keratitis at a tertiary ophthalmic centre in Southern China. METHODS A retrospective clinical study was performed in fifteen patients who were admitted to Zhongshan Ophthalmic Centre (ZOC) from January 2004 to December 2014. The patients' pathogenesis-associated factors were analysed, and preoperative diagnoses were determined using corneal scraping cultures and/or confocal microscopy followed. All diagnoses were confirmed by postoperative pathological examinations. At follow-up, best-corrected visual acuity (BCVA), the recurrence rate and graft transparency were evaluated to assess therapeutic effects. RESULTS The main pathogenic factors observed in the fifteen patients were a history of injury or a foreign body entering the eyes (12 cases). In all, Acanthamoeba keratitis was preoperatively diagnosed in 5 cases using corneal scraping cultures or confocal microscopy. Ocular symptoms included redness, photophobia, tearing, and blurred vision. Penetrating keratoplasty was performed in thirteen patients, and postoperative pathological examinations were performed to confirm these diagnoses. The logarithm of the minimum angle of resolution (logMAR) of visual acuity was significantly improved after keratoplasty (p < 0.01). No recurrence was observed, and approximately 90% of the corneal grafts were found to be transparent during the follow-up period. CONCLUSIONS Corneal trauma may be the main pathogenic factor that causes Acanthamoeba keratitis in southern China. Corneal scraping combined with confocal microscopy was helpful for achieving a correct diagnosis. Early keratoplasty combined with amoebicidal therapy is an effective treatment strategy in Acanthamoeba keratitis.
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Affiliation(s)
- Jing Zhong
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Sun Yat-Sen University, Guangzhou, 510064 China
| | - Xingyi Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Sun Yat-Sen University, Guangzhou, 510064 China
| | - Yuqing Deng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Sun Yat-Sen University, Guangzhou, 510064 China
| | - Ling Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Sun Yat-Sen University, Guangzhou, 510064 China
| | - Shiyou Zhou
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Sun Yat-Sen University, Guangzhou, 510064 China
| | - Weilan Huang
- Department of Ophthalmology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630 China
| | - Shiqi Lin
- Department of Ophthalmology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630 China
| | - Jin Yuan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Sun Yat-Sen University, Guangzhou, 510064 China
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Casero RD, Mongi F, Laconte L, Rivero F, Sastre D, Teherán A, Herrera G, Ramírez JD. Molecular and morphological characterization of Acanthamoeba isolated from corneal scrapes and contact lens wearers in Argentina. INFECTION GENETICS AND EVOLUTION 2017; 54:170-175. [DOI: 10.1016/j.meegid.2017.06.031] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 06/20/2017] [Accepted: 06/30/2017] [Indexed: 11/29/2022]
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Lass A, Guerrero M, Li X, Karanis G, Ma L, Karanis P. Detection of Acanthamoeba spp. in water samples collected from natural water reservoirs, sewages, and pharmaceutical factory drains using LAMP and PCR in China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2017; 584-585:489-494. [PMID: 28131444 DOI: 10.1016/j.scitotenv.2017.01.046] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 01/05/2017] [Accepted: 01/07/2017] [Indexed: 06/06/2023]
Abstract
Various species of amoebas belonging to the genus Acanthamoeba are widely distributed in many parts of the world. Some strains of these protozoans may exist as parasites and pose risks to human health as causative agents of serious human diseases. Currently in China there is a lack of information about the distribution of Acanthamoeba strains in the environment. Accordingly, 261 environmental water samples taken from rivers, sewage, and pharmaceutical factory drains were collected in Qinghai Province, China. The material was filtered and then analysed with both LAMP and PCR assays. Of the samples examined, Acanthamoeba DNA was found in 32 (14.68%) samples with the use of LAMP; in 13 of these samples, DNA from this amoeba was also detected using PCR. Sequencing of selected positive samples confirmed that the PCR products were fragments of the Acanthamoeba 18S rRNA gene and that isolates represent the T4 genotype, known as the most common strain related to AK cases. The results indicate that surface water, as well as water taken from sewage and pharmaceutical drains, may be a source of acanthamoebic strains potentially pathogenic for humans in China. It has been also demonstrated that LAMP assays is more sensitive than PCR and can be regarded as useful tool for screening the environment for Acanthamoeba spp.
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Affiliation(s)
- Anna Lass
- State Key Laboratory of Plateau Ecology and Agriculture, Center for Biomedicine and Infectious Disease, Qinghai Academy of Animal Sciences and Veterinary Medicine, Medical School of Qinghai University Xining, 1#Wei'er Road, Qinghai, Biological Scientific Estate Garden, Xining 810016, PR China; Department of Tropical Parasitology, Institute of Maritime and Tropical Medicine in Gdynia, Medical University of Gdansk, 9b Powstania Styczniowego Str, 81-519 Gdynia, Poland
| | - Milena Guerrero
- State Key Laboratory of Plateau Ecology and Agriculture, Center for Biomedicine and Infectious Disease, Qinghai Academy of Animal Sciences and Veterinary Medicine, Medical School of Qinghai University Xining, 1#Wei'er Road, Qinghai, Biological Scientific Estate Garden, Xining 810016, PR China; Research Group of Functional Materials and Catalysis, GIMFC, Universidad de Nariño, Calle 18 Cra. 50, Campus Torobajo, Pasto-Colombia. Doctorate in Biotechnology, Universidad Nacional de Colombia, Bogotá D.C., Colombia
| | - Xiuping Li
- State Key Laboratory of Plateau Ecology and Agriculture, Center for Biomedicine and Infectious Disease, Qinghai Academy of Animal Sciences and Veterinary Medicine, Medical School of Qinghai University Xining, 1#Wei'er Road, Qinghai, Biological Scientific Estate Garden, Xining 810016, PR China
| | - Gabriele Karanis
- State Key Laboratory of Plateau Ecology and Agriculture, Center for Biomedicine and Infectious Disease, Qinghai Academy of Animal Sciences and Veterinary Medicine, Medical School of Qinghai University Xining, 1#Wei'er Road, Qinghai, Biological Scientific Estate Garden, Xining 810016, PR China; Qinghai University Affiliated Hospital, Xining City 810016, Qinghai Province, PR China
| | - Liqing Ma
- State Key Laboratory of Plateau Ecology and Agriculture, Center for Biomedicine and Infectious Disease, Qinghai Academy of Animal Sciences and Veterinary Medicine, Medical School of Qinghai University Xining, 1#Wei'er Road, Qinghai, Biological Scientific Estate Garden, Xining 810016, PR China
| | - Panagiotis Karanis
- State Key Laboratory of Plateau Ecology and Agriculture, Center for Biomedicine and Infectious Disease, Qinghai Academy of Animal Sciences and Veterinary Medicine, Medical School of Qinghai University Xining, 1#Wei'er Road, Qinghai, Biological Scientific Estate Garden, Xining 810016, PR China.
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Daas L, Szentmáry N, Eppig T, Langenbucher A, Hasenfus A, Roth M, Saeger M, Nölle B, Lippmann B, Böhringer D, Reinhard T, Kelbsch C, Messmer E, Pleyer U, Roters S, Zhivov A, Engelmann K, Schrecker J, Zumhagen L, Thieme H, Darawsha R, Meyer-Ter-Vehn T, Dick B, Görsch I, Hermel M, Kohlhaas M, Seitz B. [The German Acanthamoeba keratitis register: Initial results of a multicenter study]. Ophthalmologe 2016; 112:752-63. [PMID: 25833754 DOI: 10.1007/s00347-014-3225-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND AND PURPOSE In September 2011 the cornea section of the German Ophthalmological Society (DOG) established the first German Acanthamoeba keratitis registry. The data of this multicenter survey are being collected, compiled and evaluated at the Department of Ophthalmology at the Saarland University. The aim of this article is to present an intermediate report. PATIENTS AND METHODS Data from 172 eyes with Acanthamoeba keratitis were collected during the last 10 years. For this interim report we actually evaluated 121 eyes (60.2 % female patients, average age 41.3 years) and collected the following data: date of onset of symptoms, date and method of diagnosis, initial diagnosis, anamnestic data, clinical symptoms and signs at diagnosis and during follow-up, conservative and surgical therapy. Criteria for inclusion in the Acanthamoeba registry was the established diagnosis of an Acanthamoeba keratitis with at least one of the methods described in this article. RESULTS Acanthamoeba keratitis could be histologically proven in 55.3 % of the cases, via PCR in 25.6 %, with confocal microscopy in 20.4 % and using in vitro cultivation in 15.5 %. Clinical symptoms and signs in Acanthamoeba keratitis were pain in 67.0 %, ring infiltrates in 53.4 %, pseudodendritiform epitheliopathy in 11.7 % and keratoneuritis in 5.8 %. In 47.6 % of the cases the initial diagnosis was herpes simplex virus keratitis followed by bacterial keratitis in 25.2 % and fungal keratitis in 3.9 %. Acanthamoeba keratitis was the correct initial diagnosis in only 23.2 % of cases. The average time period between first symptoms and diagnosis was 2.8 ± 4.0 months (range 0-23 months). A triple therapy with Brolene® Lavasept® and antibiotic eye drops at least 5 ×/day was used in 54.5 % of eyes (n = 66). Penetrating keratoplasty was performed in 40.4 %, in 18 cases in combination with cryotherapy of the cornea. The mean graft diameter was 7.9 ± 1.1 mm (range 3.5-11.0 mm). The final visual acuity (Snellen visual acuity chart at 5 m) was comparable in the two groups of eyes with (5/40 ± 5/25) and without (5/32 ± 5/25) keratoplasty. CONCLUSION Acanthamoeba keratitis is a rare and often very late diagnosed disease and two thirds of the cases were initially misdiagnosed. The early recognition of the typical symptoms is crucial for the prognosis of the disease. All ophthalmological departments in Germany are invited to submit further data of all confirmed cases (berthold.seitz@uks.eu), whether retrospectively or prospectively in order to generate an adequate standardized diagnostic and therapeutic approach for this potentially devastating disease.
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Affiliation(s)
- L Daas
- Klinik für Augenheilkunde, Universitätsklinikum des Saarlandes UKS, Kirrbergerstr. 100, 66424, Homburg/Saar, Deutschland.
| | - N Szentmáry
- Klinik für Augenheilkunde, Universitätsklinikum des Saarlandes UKS, Kirrbergerstr. 100, 66424, Homburg/Saar, Deutschland
| | - T Eppig
- Experimentelle Ophthalmologie, Universität des Saarlandes, Homburg/Saar, Deutschland
| | - A Langenbucher
- Experimentelle Ophthalmologie, Universität des Saarlandes, Homburg/Saar, Deutschland
| | - A Hasenfus
- Institut für Allgemeine und spezielle Pathologie, Universität des Saarlandes, Homburg/Saar, Deutschland
| | - M Roth
- Universitätsaugenklinik, Düsseldorf, Deutschland
| | - M Saeger
- Klinik für Ophthalmologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Deutschland
| | - B Nölle
- Klinik für Ophthalmologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Deutschland
| | - B Lippmann
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - D Böhringer
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - T Reinhard
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - C Kelbsch
- Universitätsaugenklinik, Tübingen, Deutschland
| | - E Messmer
- Augenklinik der LMU, München, Deutschland
| | - U Pleyer
- Universitätsaugenklinik, Berlin Charité, Berlin, Deutschland
| | - S Roters
- Universitätsaugenklinik, Köln, Deutschland
| | - A Zhivov
- Universitätsaugenklinik, Rostock, Deutschland
| | | | | | - L Zumhagen
- Universitätsaugenklinik, Münster, Deutschland
| | - H Thieme
- Universitätsaugenklinik, Magdeburg, Deutschland
| | - R Darawsha
- Universitätsaugenklinik, Essen, Deutschland
| | | | - B Dick
- Universitätsaugenklinik, Bochum, Deutschland
| | - I Görsch
- Universitätsaugenklinik, Hamburg-Eppendorf, Deutschland
| | - M Hermel
- Universitätsaugenklinik, Aachen, Deutschland
| | - M Kohlhaas
- Augenklinik Dortmund, Dortmund, Deutschland
| | - B Seitz
- Klinik für Augenheilkunde, Universitätsklinikum des Saarlandes UKS, Kirrbergerstr. 100, 66424, Homburg/Saar, Deutschland
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Ocular parasitoses: A comprehensive review. Surv Ophthalmol 2016; 62:161-189. [PMID: 27720858 DOI: 10.1016/j.survophthal.2016.09.005] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2016] [Revised: 09/27/2016] [Accepted: 09/29/2016] [Indexed: 12/14/2022]
Abstract
Parasitic infections of the eyes are a major cause of ocular diseases across the globe. The causative agents range from simple organisms such as unicellular protozoans to complex metazoan helminths. The disease spectrum varies depending on the geographic location, prevailing hygiene, living and eating habits of the inhabitants, and the type of animals that surround them. They cause enormous ocular morbidity and mortality not because they are untreatable, but largely due to late or misdiagnosis, often from unfamiliarity with the diseases produced. We provide an up-to-date comprehensive overview of the ophthalmic parasitoses. Each section describes the causative agent, mode of transmission, geographic distribution, ocular pathologies, and their management for common parasites with brief mention of the ones that are rare.
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Ong HS, Corbett MC. Corneal infections in the 21st century. Postgrad Med J 2015; 91:565-71. [PMID: 26354125 DOI: 10.1136/postgradmedj-2015-133323] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 08/14/2015] [Indexed: 11/04/2022]
Abstract
Ninety years ago, the first issue of the Postgraduate Medical Journal published a review of an article written by Mr Robert Lindsay-Rea, a consultant ophthalmic surgeon in the Western Ophthalmic Hospital and an oculist in the West End Hospital for Nervous Diseases, entitled "A preliminary report on the treatment of keratitis". Today, microbial keratitis remains an important cause of avoidable visual impairment in the world. The aetiology of microbial keratitis has changed greatly over the past century due to the discovery of antibiotics, improvement in sanitation and education, the rising trend of contact lens wear and increased air travel. Significant advances have also been made in our understanding and management of this important disorder. This article highlights some of these changes and discusses the current management and research.
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Affiliation(s)
- Hon Shing Ong
- Department of Corneal and Ocular Surface Disease, The Western Eye Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Melanie C Corbett
- Department of Corneal and Ocular Surface Disease, The Western Eye Hospital, Imperial College Healthcare NHS Trust, London, UK
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Honda JR, Bernhard JN, Chan ED. Natural disasters and nontuberculous mycobacteria: a recipe for increased disease? Chest 2015; 147:304-308. [PMID: 25644904 DOI: 10.1378/chest.14-0974] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Infectious diseases acquired by survivors of large-scale natural disasters complicate the recovery process. During events such as tsunamis, hurricanes, earthquakes, and tornados and well into the recovery period, victims often are exposed to water-soil mixtures that have relocated with indigenous microbes. Because nontuberculous mycobacteria (NTM) are ubiquitous in water and soil, there is potential for increased exposure to these organisms during natural disasters. In this hypothesis-driven commentary, we discuss the rise in NTM lung disease and natural disasters and examine the geographic overlap of NTM infections and disaster frequencies in the United States. Moreover, we show an increased number of positive NTM cultures from Louisiana residents in the years following three of the relatively recent epic hurricanes and posit that such natural disasters may help to drive the increased number of NTM infections. Finally, we advocate for increased environmental studies and surveillance of NTM infections before and after natural disasters.
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Affiliation(s)
- Jennifer R Honda
- Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Anschutz Medical Campus, Aurora; National Jewish Health, Denver Veterans Affairs Medical Center, Denver, CO.
| | - Jon N Bernhard
- Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Anschutz Medical Campus, Aurora
| | - Edward D Chan
- Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Anschutz Medical Campus, Aurora; National Jewish Health, Denver Veterans Affairs Medical Center, Denver, CO
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Acanthamoeba keratitis: 10-Year study at a tertiary eye care center in Hong Kong. Cont Lens Anterior Eye 2015; 38:99-103. [DOI: 10.1016/j.clae.2014.11.146] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2014] [Revised: 10/27/2014] [Accepted: 11/16/2014] [Indexed: 11/23/2022]
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Abstract
BACKGROUND Acanthamoeba are microscopic, free-living, single-celled organisms which can infect the eye and lead to Acanthamoeba keratitis (AK). AK can result in loss of vision in the infected eye or loss of eye itself; however, there are no formal guidelines or standards of care for the treatment of AK. OBJECTIVES To evaluate the relative effectiveness and safety of medical therapy for the treatment of AK. SEARCH METHODS We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (2015, Issue 1), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to January 2015), EMBASE (January 1980 to January 2015), PubMed (1948 to January 2015), Latin American and Caribbean Health Sciences Literature Database (LILACS) (1982 to January 2015), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic search for trials. We last searched the electronic databases on 9 January 2015. SELECTION CRITERIA We included randomized controlled trials (RCTs) of medical therapy for AK, regardless of the participants' age, sex, or etiology of disease. We included studies that compared either anti-amoeba therapy (drugs used alone or in combination with other medical therapies) with no anti-amoeba therapy or one anti-amoeba therapy with another anti-amoeba therapy. DATA COLLECTION AND ANALYSIS Two authors independently screened search results and full-text reports, assessed risk of bias, and abstracted data. We used standard methodological procedures as set forth by the Cochrane Collaboration. MAIN RESULTS We included one RCT (56 eyes of 55 participants) in this review. The study compared two types of topical biguanides for the treatment of AK: chlorhexidine 0.02% and polyhexamethylene biguanide (PHMB) 0.02%. All participants were contact lens wearers with a median age of 31 years. Treatment duration ranged from 51 to 145 days. The study, conducted in the UK, was well-designed and had low risk of bias overall.Outcome data were available for 51 (91%) of 56 eyes. Follow-up times for outcome measurements in the study were not reported. Resolution of infection, defined as control of ocular inflammation, relief of pain and photosensitivity, and recovery of vision, was 86% in the chlorhexidine group compared with 78% in the PHMB group (relative risk (RR) 1.10, 95% confidence intervals (CI) 0.84 to 1.42). In the chlorhexidine group, 20 of 28 eyes (71%) had better visual acuity compared with 13 of 23 eyes (57%) in the PHMB group at final follow-up (RR 1.26, 95% CI 0.82 to 1.94). Five participants required therapeutic keratoplasty: 2 in the chlorhexidine group compared with 3 in the PHMB group (RR 0.55, 95% CI 0.10 to 3.00). No serious adverse event related to drug toxicity was observed in the study. AUTHORS' CONCLUSIONS There is insufficient evidence to evaluate the relative effectiveness and safety of medical therapy for the treatment of AK. Results from the one included study yielded no difference with respect to outcomes reported between chlorhexidine and PHMB. However, the sample size was inadequate to detect clinically meaningful differences between the two groups as indicated by the wide confidence intervals of effect estimates.
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Affiliation(s)
- Majed Alkharashi
- Department of Ophthalmology, King Saud University, Riyadh, Saudi Arabia.
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Monitoring of in vitro dynamics of Acanthamoeba strains isolated from infected eyes as a useful tool in keratitis management. Exp Parasitol 2014; 145 Suppl:S73-7. [DOI: 10.1016/j.exppara.2014.06.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Revised: 05/31/2014] [Accepted: 06/24/2014] [Indexed: 11/21/2022]
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Tripathi T, Alizadeh H. Role of protease-activated receptors 2 (PAR2) in ocular infections and inflammation. ACTA ACUST UNITED AC 2014; 1. [PMID: 26078987 DOI: 10.14800/rci.291] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Protease-activated receptors (PARs) belong to a unique family of G protein-coupled receptors (GPCRs) that are cleaved at an activation site within the N-terminal exodomain by a variety of proteinases, essentially of the serine (Ser) proteinase family. After cleavage, the new N-terminal sequence functions as a tethered ligand, which binds intramolecularly to activate the receptor and initiate signaling. Cell signals induced through the activation of PARs appear to play a significant role in innate and adoptive immune responses of the cornea, which is constantly exposed to proteinases under physiological or pathophysiological conditions. Activation of PARs interferes with all aspects of the corneal physiology such as barrier function, transports, innate and adoptive immune responses, and functions of corneal nerves. It is not known whether the proteinase released from the microorganism can activate PARs and triggers the inflammatory responses. The role of PAR2 expressed by the corneal epithelial cells and activation by serine protease released from microorganism is discussed here. Recent evidences suggest that activation of PAR2, by the serine proteinases, play an important role in innate and inflammatory responses of the corneal infection.
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Affiliation(s)
- Trivendra Tripathi
- Department of Cell Biology and Immunology, University of North Texas Health Science Center, and North Texas Eye Research Institute, Fort Worth, Texas, 76107, USA
| | - Hassan Alizadeh
- Department of Cell Biology and Immunology, University of North Texas Health Science Center, and North Texas Eye Research Institute, Fort Worth, Texas, 76107, USA
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Bouheraoua N, Labbé A, Chaumeil C, Liang Q, Laroche L, Borderie V. [Acanthamoeba keratitis]. J Fr Ophtalmol 2014; 37:640-52. [PMID: 25169145 DOI: 10.1016/j.jfo.2014.05.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Revised: 05/25/2014] [Accepted: 05/26/2014] [Indexed: 11/24/2022]
Abstract
Early diagnosis and appropriate therapy are key elements for a good prognosis in Acanthamoeba keratitis (AK). AK should be considered in any case of corneal trauma complicated by exposure to soil or contaminated water, and in all contact lens (CL) wearers. A presumptive diagnosis of AK can be made clinically and with in vivo confocal microscopy, although a definitive diagnosis requires identification of Acanthamoeba on direct scraping, histology, or identification of Acanthamoeba DNA by polymerase chain reaction (PCR). We use cysticidal drugs for treating AK because encysted forms are more resistant than trophozoites to treatment. The treatment protocol used a biguanide (PHMB 0.02% or chlorhexidine 0.02%) and a diamidine (propamidine 0.1% or hexamidine 0.1%). New diagnostic modalities and more specific topical anti-amoebic treatments would substantially benefit patients with AK.
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Affiliation(s)
- N Bouheraoua
- Service d'ophtalmologie 5, Centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France; Inserm, U968, UPMC Paris VI, UMR S 968, CNRS, UMR 7210, institut de la vision, 17, rue Moreau, 75012 Paris, France.
| | - A Labbé
- Inserm, U968, UPMC Paris VI, UMR S 968, CNRS, UMR 7210, institut de la vision, 17, rue Moreau, 75012 Paris, France; Service d'ophtalmologie 3, Centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France; Service d'ophtalmologie, hôpital Ambroise-Paré, AP-HP, DHU View maintain, 9, avenue Charles-de-Gaulle, 92100 Boulogne-Billancourt, France
| | - C Chaumeil
- Service de biologie médicale, Centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France
| | - Q Liang
- Beijing Institute of Ophthalmology, Beijing TongRen Eye Center, Beijing TongRen Hospital, Capital Medical University, Beijing, Chine
| | - L Laroche
- Service d'ophtalmologie 5, Centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France; Inserm, U968, UPMC Paris VI, UMR S 968, CNRS, UMR 7210, institut de la vision, 17, rue Moreau, 75012 Paris, France
| | - V Borderie
- Service d'ophtalmologie 5, Centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France; Inserm, U968, UPMC Paris VI, UMR S 968, CNRS, UMR 7210, institut de la vision, 17, rue Moreau, 75012 Paris, France
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Abstract
PURPOSE The aim was to describe a geographically and clinically diverse sample of cases of Acanthamoeba keratitis (AK) and establish the risk factors for poor outcomes among patients with this disease. METHODS We conducted a retrospective, population-based case series of 116 patients with AK identified through a national surveillance network. Data were collected via a medical record review by diagnosing ophthalmologists and by phone interviews with patients. Exact logistic regression modeling was used to determine risk factors for poor visual outcomes. RESULTS Among patients with data available on contact lens use, it was found that 93.3% wore contact lenses. The median time from symptom onset to care seeking was 2 days, whereas the median time from symptom onset to diagnosis was 27 days. Keratoplasty was performed in 27 of 81 patients with available outcome data and was more likely in patients >40 years old [odds ratio (OR) 5.25, 95% confidence interval (CI) 1.49-21.92]. When adjusted for age, the risk factors for keratoplasty included the presence of a ring infiltrate (OR 40.00, 95% CI 3.58-447.0) or any sign of stromal invasion (OR 10.48, 95% CI 2.56-55.09). One-third of patients with available data on best-corrected visual acuity had a best-corrected visual acuity <20/200, with the presence of a ring infiltrate as the only significant predictor of this outcome when adjusted for age (aOR 3.45, 95% CI 1.01-12.31). CONCLUSIONS AK remains challenging to diagnose. Consequently, patients with advanced disease are more likely to have poor outcomes, particularly if they are older. The increasing awareness of AK among general eye care providers may shorten referral times and potentially improve outcomes.
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Padzik M, Chomicz L, Szaflik JP, Chruścikowska A, Perkowski K, Szaflik J. In vitro effects of selected contact lens care solutions on Acanthamoeba castellanii strains in Poland. Exp Parasitol 2014; 145 Suppl:S98-S101. [PMID: 24967738 DOI: 10.1016/j.exppara.2014.06.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Revised: 06/02/2014] [Accepted: 06/12/2014] [Indexed: 11/27/2022]
Abstract
Free-living, cosmopolitan amoebae of the Acanthamoeba genus may be the causative agents of Acanthamoeba keratitis (AK) - a progressive, vision-threatening infection of the human cornea described particularly among contact lens wearers. Use of contact lens care solutions, effective against these organisms, is important in preventing AK infections. 3 different strains of Acanthamoeba castellanii of the T4 genotype (Neff strain and two others, isolated from patients with AK) were exposed to 4 selected multipurpose contact lens care solutions available in Poland: Ciba Vision AoSept Plus, Bausch & Lomb ReNu MultiPlus, Alcon Opti-Free, Ciba Vision Solo Care Aqua. No amoebicidal effect was observed. The strongest amoebostatic effect was visible after 24h of exposition to Opti-Free and ReNu solution and associated with percentage increase of rounded, motionless forms. This is significantly longer than minimum disinfection time recommended by manufacturers of all tested multipurpose solutions. Surprisingly, no clear induction of the encystation process was observed.
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Affiliation(s)
- Marcin Padzik
- Department of Medical Biology, Medical University of Warsaw, 73 Nowogrodzka Str., 02-018 Warsaw, Poland.
| | - Lidia Chomicz
- Department of Medical Biology, Medical University of Warsaw, 73 Nowogrodzka Str., 02-018 Warsaw, Poland
| | - Jacek P Szaflik
- Department of Ophthalmology, SPKSO Ophthalmic Hospital, Medical University of Warsaw, 13 Sierakowskiego Str., 03-709 Warsaw, Poland
| | - Agnieszka Chruścikowska
- Department of Medical Biology, Medical University of Warsaw, 73 Nowogrodzka Str., 02-018 Warsaw, Poland
| | - Konrad Perkowski
- Department of Orthodontics, Medical University of Warsaw, 59 Nowogrodzka Str., 02-005 Warsaw, Poland
| | - Jerzy Szaflik
- Department of Ophthalmology, SPKSO Ophthalmic Hospital, Medical University of Warsaw, 13 Sierakowskiego Str., 03-709 Warsaw, Poland
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The first genotype determination of Acanthamoeba potential threat to human health, isolated from natural water reservoirs in Poland. Parasitol Res 2014; 113:2693-9. [PMID: 24770720 PMCID: PMC4058056 DOI: 10.1007/s00436-014-3925-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Accepted: 04/16/2014] [Indexed: 11/20/2022]
Abstract
Different species of amoebae belonging to the genus Acanthamoeba are widely distributed in many parts of the world and known as free-living organisms. Some strains of the protozoans may exist as parasites and cause risk to human health as causative agents of serious human diseases. Currently, in Poland, there is no sufficient information about the distribution of Acanthamoeba strains and their genotypes in the environment. Therefore, 20 environmental surface water samples were collected from different sites located at five water reservoirs in Gdynia, Sopot, and Gdańsk (northern Poland). The material was cultured to obtain Acanthamoeba isolates that were then specifically analyzed with both PCR and real-time PCR assays. Of the 20 samples examined, Acanthamoeba DNA was found in 13 samples tested with the use of real-time PCR; in 10 of them, DNA of the amoeba was also detected using PCR technique. The comparison with sequences available in the GenBank confirmed that the PCR products are fragments of Acanthamoeba 18S rRNA gene and that isolates represent T4 genotype, known as the most common strains related to AK cases. This is the first investigation in Poland describing Acanthamoeba detection in environmental water samples with molecular techniques and genotyping. The results indicate that surface water in Poland may be a source of acanthamoebic strains potentially pathogenic for humans.
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Non-contact lens use-related Acanthamoeba keratitis in southern Turkey: evaluation of risk factors and clinical features. Eur J Ophthalmol 2013; 24:164-72. [PMID: 24030538 DOI: 10.5301/ejo.5000357] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2013] [Indexed: 11/20/2022]
Abstract
PURPOSE To assess the diagnostic methods, risk factors, and clinical features of Acanthamoeba keratitis cases in patients who do not wear contact lenses. METHODS Medical records of 26 consecutive patients with non-contact lens-related Acanthamoeba keratitis, who were followed up at the tertiary eye care center between May 2010 and May 2012, were analyzed. Laboratory, demographic, and clinical findings were evaluated pertaining to the patients. RESULTS Twenty-six non-contact lens-related Acanthamoeba keratitis cases were included in the study. The main risk factors were trauma (group 1, n = 13 patients) and ocular surface disease (group 2, n = 12 patients). One patient had both of the risk factors mentioned above. Overall test results showed that Acanthamoeba positivity rates were 15.3% for direct microscopy, 46.1% for culture, 92.3% for conventional polymerase chain reaction (PCR), and 100% for real-time PCR. The rates of full-thickness corneal involvement and ring-shaped infiltrations were higher in group 2, whereas superficial keratitis and radial keratoneuritis were higher in group 1. The final visual acuities were significantly better in group 1 than group 2 (p<0.025). CONCLUSIONS This study is the first regional report from Turkey about Acanthamoeba keratitis in non-contact lens users. A majority of cases admitted to a tertiary eye care center were related to trauma or ocular surface disease. Physician suspicion is critically important for the timely diagnosis of these cases. At this point, molecular diagnostic tests (PCR or real-time PCR) seem to support the clinical diagnosis of Acanthamoeba keratitis with the help of fast and reliable results.
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Pacella E, La Torre G, De Giusti M, Brillante C, Lombardi AM, Smaldone G, Lenzi T, Pacella F. Results of case-control studies support the association between contact lens use and Acanthamoeba keratitis. Clin Ophthalmol 2013; 7:991-4. [PMID: 23761962 PMCID: PMC3673962 DOI: 10.2147/opth.s43471] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Acanthamoeba keratitis (AK) is ever more frequently reported in industrialized countries. The loss of the corneal surface integrity consequent to secondary microtrauma produced by the use of contact lens (CL) favors the penetration of the parasite into the corneal tissue. OBJECTIVES A scientific review was performed to investigate the association of CL wear as an Acanthamoeba keratitis (AK) risk factor. METHODS A computerized screening of 7834 Medline articles (4623 from PubMed; 3211 from Scopus) used a strict selection criteria of case-control studies involving CL wear and/or trauma. RESULTS The search yielded five case-control studies published from 1995 to 2012. All studies included showed a statistically significant positive association between AK and CL use, with a combined odds ratio (OR) of 10.21 (95%, confidence intervals [CI]; 3.57-27.64). STATISTICAL ANALYSIS All studies included showed a statistically significant positive association between AK and CL use, though with differing OR values. CONCLUSION Though rare, AK should be held in higher consideration when ophthalmologists are faced with CL users exhibiting simplex-like lesions associated with circular stromal infiltrates and disproportionate ocular pain in respect to the objective clinical picture.
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Affiliation(s)
- Elena Pacella
- Department of Sense Organs, Faculty of Medicine and Dentistry, Sapienza University of Rome, Italy
| | - Giuseppe La Torre
- Department of Public Health and Infectious Diseases, Faculty of Pharmacy and Medicine, Sapienza University of Rome, Italy
| | - Maria De Giusti
- Department of Public Health and Infectious Diseases, Faculty of Pharmacy and Medicine, Sapienza University of Rome, Italy
| | - Chiara Brillante
- Department of Sense Organs, Faculty of Medicine and Dentistry, Sapienza University of Rome, Italy
| | - Anna Maria Lombardi
- Department of Public Health and Infectious Diseases, Faculty of Pharmacy and Medicine, Sapienza University of Rome, Italy
| | - Gianpaolo Smaldone
- Department of Sense Organs, Faculty of Medicine and Dentistry, Sapienza University of Rome, Italy
| | - Tommaso Lenzi
- Department of Sense Organs, Faculty of Medicine and Dentistry, Sapienza University of Rome, Italy
| | - Fernanda Pacella
- Department of Sense Organs, Faculty of Medicine and Dentistry, Sapienza University of Rome, Italy
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Yoon JH, Jung JW, Moon HS, Moon HS, Shyn KH, Kim KH. Antibiotics Susceptibility in Bacterial Keratitis and Proper Initial Treatment. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2013. [DOI: 10.3341/jkos.2013.54.1.38] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Je Hwan Yoon
- Department of Ophthalmology, Gachon University Gil Medical Center, Incheon, Korea
| | | | | | - Ho Seok Moon
- Department of Ophthalmology, Gachon University Gil Medical Center, Incheon, Korea
| | | | - Kyun Hyung Kim
- Department of Ophthalmology, Gachon University Gil Medical Center, Incheon, Korea
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Dendana F, Sellami H, Trabelsi H, Neji S, Cheikhrouhou F, Makni F, Ayadi A. Acanthamoeba T4 genotype associated with keratitis infections in Tunisia. Parasitol Res 2012; 112:401-5. [PMID: 23052779 DOI: 10.1007/s00436-012-3149-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2012] [Accepted: 09/26/2012] [Indexed: 11/27/2022]
Abstract
Acanthamoeba keratitis (AK) is a sight-threatening infection. We report five cases of AK diagnosed from 2005 to 2009 in the Laboratory of Parasitology-Mycology at Habib Bourguiba Sfax Hospital, Tunisia. All were associated with improper care of contact lenses (rinsing of contact lenses with tap water and inappropriate cleaning) and lens storage. The patients displayed different clinical presentations: corneal inflammation, corneal ulceration, and corneal abscess. The diagnosis was made after direct examination, culture, and polymerase chain reaction amplification with specific primers. The genotype classification was based on the highly variable DF3 region in the 18S rRNA gene. This is the first study characterizing Acanthamoeba genotype in Tunisia and North Africa. All Acanthamoeba isolates were associated to the T4 genotype. Three different DF3 sequence types were related to AK infections T4/10, T4/15, and T4/16.
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Affiliation(s)
- F Dendana
- Laboratory of Fungal and Parasitic Molecular Biology, School of Medicine Sfax, Sfax University, Sfax, Tunisia
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Fraser MN, Wong Q, Shah L, Holland SP, Morshed M, Isaac-Renton J, Chong M, Kibsey P, Patrick DM. Characteristics of an Acanthamoeba Keratitis Outbreak in British Columbia between 2003 and 2007. Ophthalmology 2012; 119:1120-5. [DOI: 10.1016/j.ophtha.2011.12.041] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2011] [Revised: 12/21/2011] [Accepted: 12/21/2011] [Indexed: 11/28/2022] Open
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Revisiting the Acanthamoeba species that form star-shaped cysts (genotypes T7, T8, T9, and T17): characterization of seven new Brazilian environmental isolates and phylogenetic inferences. Parasitology 2011; 139:45-52. [PMID: 21943405 DOI: 10.1017/s0031182011001648] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Free-living amoebae of the genus Acanthamoeba are the agents of both opportunistic and non-opportunistic infections and are frequently isolated from the environment. Of the 17 genotypes (T1-T17) identified thus far, 4 (T7, T8, T9, and T17) accommodate the rarely investigated species of morphological group I, those that form large, star-shaped cysts. We report the isolation and characterization of 7 new Brazilian environmental Acanthamoeba isolates, all assigned to group I. Phylogenetic analyses based on partial (~1200 bp) SSU rRNA gene sequences placed the new isolates in the robustly supported clade composed of the species of morphological group I. One of the Brazilian isolates is closely related to A. comandoni (genotype T9), while the other 6, together with 2 isolates recently assigned to genotype T17, form a homogeneous, well-supported group (2·0% sequence divergence) that likely represents a new Acanthamoeba species. Thermotolerance, osmotolerance, and cytophatic effects, features often associated with pathogenic potential, were also examined. The results indicated that all 7 Brazilian isolates grow at temperatures up to 40°C, and resist under hyperosmotic conditions. Additionally, media conditioned by each of the new Acanthamoeba isolates induced the disruption of SIRC and HeLa cell monolayers.
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Patel DV, Rayner S, McGhee CNJ. Resurgence of Acanthamoeba keratitis in Auckland, New Zealand: a 7-year review of presentation and outcomes. Clin Exp Ophthalmol 2010; 38:15-20; quiz 87. [PMID: 20447096 DOI: 10.1111/j.1442-9071.2009.02182.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE To investigate the presentation, clinical characteristics and outcomes of Acanthamoeba keratitis (AK) in Auckland, New Zealand over a 7-year period. METHODS Retrospective analysis of all cases of AK treated by the tertiary corneal service at Auckland City Hospital/ University of Auckland Department of Ophthalmology (August 2001 to May 2008). Data were collected regarding age, gender, contact lens history, presenting signs and symptoms, diagnosis at first presentation, time to final diagnosis, identifiable risk factors, presenting and final visual acuity, results of microbiological testing, medical treatment, surgical interventions, recurrence of disease and length of follow up. All photographs and in vivo confocal microscopy images were reviewed. RESULTS Twenty-five eyes of 25 patients were identified with a diagnosis of AK (mean age 40 +/- 13 years). Ninety-six per cent were contact lens wearers. Mean time to diagnosis was 41 +/- 49 days (range 0-181 days, median 21 days). Fourteen patients (56%) had been treated with topical corticosteroids prior to the diagnosis. Early diagnosis of AK (<21 days) was associated with significantly better final visual acuity and did not require any surgical intervention compared with those diagnosed at a later stage. Six patients, all in the late diagnosis group, required surgical intervention. CONCLUSIONS AK has become significantly more common in New Zealand in the current decade. This study highlights the fundamental importance of early diagnosis and appropriate management in ensuring favourable outcomes. Practitioners should maintain a clinical suspicion of AK, especially as 96% of the subjects in this study were contact lens wearers.
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Affiliation(s)
- Dipika V Patel
- Department of Ophthalmology, New Zealand National Eye Centre, University of Auckland, New Zealand
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Chomicz L, Padzik M, Graczyk Z, Starosciak B, Graczyk TK, Naprawska A, Oledzka G, Szostakowska B. Acanthamoeba castellanii: in vitro effects of selected biological, physical and chemical factors. Exp Parasitol 2010; 126:103-5. [PMID: 20138870 DOI: 10.1016/j.exppara.2010.01.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2009] [Revised: 01/23/2010] [Accepted: 01/27/2010] [Indexed: 10/19/2022]
Abstract
Trophozoites and cysts of free-living Acanthamoeba castellanii present a serious risk to human health as causative agents of human diseases such as fatal granulomatous amoebic encephalitis and Acanthamoeba keratitis that is reported from various part of the world, also in Poland, with increasing frequency, particularly in the contact lens wearers. The amphizoic amoebae are generally extremely resistant to different chemical agents, however, several strains/isolates within A. castellanii may differ in virulence. Among the features considered as associated with the amoeba pathogenicity, temperature tolerance and resistance to different environmental conditions are reported. In the present study, A. castellanii strain cultured in 26 degrees C after several year passages were tested for sensibility/tolerance to instant temperature changes as well as exposition to deuterium oxide, D2O. Significant decrease of number of viable amoebae during in vitro exposition to D2O occurred, but no changes in trophozoites/cysts ratio. The ability of the strain examined to develop in higher temperature may indicate a wide adaptation reserve and its pathogenic potential.
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Affiliation(s)
- Lidia Chomicz
- Department of Medical Biology, Medical University of Warsaw, 73 Nowogrodzka Str., 02-018 Warsaw, Poland.
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Magliano AC, da Silva FM, Teixeira MM, Alfieri SC. Genotyping, physiological features and proteolytic activities of a potentially pathogenic Acanthamoeba sp. isolated from tap water in Brazil. Exp Parasitol 2009; 123:231-5. [DOI: 10.1016/j.exppara.2009.07.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2009] [Revised: 06/23/2009] [Accepted: 07/21/2009] [Indexed: 11/26/2022]
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