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Borges SDL, de Macedo EDS, da Silva FAV, Ataíde BJDA, Mendes NDSF, Passos ADCF, de Moraes SAS, Herculano AM, Oliveira KRHM, Bahia CP, Dolabella SS, Batista EDJO. Experimental Granulomatous Amebic Encephalitis Caused by Acanthamoeba castellanii. Trop Med Infect Dis 2024; 9:145. [PMID: 39058187 PMCID: PMC11281140 DOI: 10.3390/tropicalmed9070145] [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: 05/14/2024] [Revised: 06/12/2024] [Accepted: 06/20/2024] [Indexed: 07/28/2024] Open
Abstract
Acanthamoeba genus can affect humans with diseases such as granulomatous amebic encephalitis (GAE), a highly lethal neuroinfection. Several aspects of the disease still need to be elucidated. Animal models of GAE have advanced our knowledge of the disease. This work tested Wistar rats (Rattus norvegicus albinus) as an animal model of GAE. For this, 32 animals were infected with 1 × 106A. castellanii trophozoites of the T4 genotype. Ameba recovery tests were carried out using agar plates, vascular extravasation assays, behavioral tests, and histopathological technique with H/E staining. Data were subjected to linear regression analysis, one-way ANOVA, and Tukey's test, performed in the GraphPad Prism® 8.0 program, with a significance level of p < 0.05. The results revealed the efficiency of the model. Amebae were recovered from the liver, lungs, and brain of infected animals, and there were significant encephalic vascular extravasations and behavioral changes in these animals, but not in the control animals. However, not all infected animals showed positive histopathology for the analyzed organs. Nervous tissues were the least affected, demonstrating the role of the BBB in the defense of the CNS. Supported by the demonstrated evidence, we confirm the difficulties and the feasibilities of using rats as an animal model of GAE.
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Affiliation(s)
- Samuel da Luz Borges
- Laboratório de Protozoologia, Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém 66055-240, Brazil; (E.d.S.d.M.); (F.A.V.d.S.); (E.d.J.O.B.)
- Laboratório de Biologia, Campus Castanhal, Instituto Federal de Educação, Ciência e Tecnologia do Pará, Castanhal 68740-970, Brazil
| | - Eberson da Silva de Macedo
- Laboratório de Protozoologia, Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém 66055-240, Brazil; (E.d.S.d.M.); (F.A.V.d.S.); (E.d.J.O.B.)
| | - Felipe Alexandre Vinagre da Silva
- Laboratório de Protozoologia, Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém 66055-240, Brazil; (E.d.S.d.M.); (F.A.V.d.S.); (E.d.J.O.B.)
| | - Brenda Jaqueline de Azevedo Ataíde
- Laboratório de Neurofarmacologia Experimental, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075-110, Brazil; (B.J.d.A.A.); (N.d.S.F.M.); (A.d.C.F.P.); (S.A.S.d.M.); (A.M.H.); (K.R.H.M.O.)
| | - Nívia de Souza Franco Mendes
- Laboratório de Neurofarmacologia Experimental, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075-110, Brazil; (B.J.d.A.A.); (N.d.S.F.M.); (A.d.C.F.P.); (S.A.S.d.M.); (A.M.H.); (K.R.H.M.O.)
| | - Adelaide da Conceição Fonseca Passos
- Laboratório de Neurofarmacologia Experimental, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075-110, Brazil; (B.J.d.A.A.); (N.d.S.F.M.); (A.d.C.F.P.); (S.A.S.d.M.); (A.M.H.); (K.R.H.M.O.)
| | - Suellen Alessandra Soares de Moraes
- Laboratório de Neurofarmacologia Experimental, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075-110, Brazil; (B.J.d.A.A.); (N.d.S.F.M.); (A.d.C.F.P.); (S.A.S.d.M.); (A.M.H.); (K.R.H.M.O.)
| | - Anderson Manoel Herculano
- Laboratório de Neurofarmacologia Experimental, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075-110, Brazil; (B.J.d.A.A.); (N.d.S.F.M.); (A.d.C.F.P.); (S.A.S.d.M.); (A.M.H.); (K.R.H.M.O.)
| | - Karen Renata Herculano Matos Oliveira
- Laboratório de Neurofarmacologia Experimental, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075-110, Brazil; (B.J.d.A.A.); (N.d.S.F.M.); (A.d.C.F.P.); (S.A.S.d.M.); (A.M.H.); (K.R.H.M.O.)
| | - Carlomagno Pacheco Bahia
- Laboratório de Neuroplasticidade, Instituto de Ciências da Saúde, Universidade Federal do Pará, Belém 66055-240, Brazil;
| | - Silvio Santana Dolabella
- Laboratório de Entomologia e Parasitologia Tropical, Universidade Federal de Sergipe, Aracajú 49060-108, Brazil;
| | - Evander de Jesus Oliveira Batista
- Laboratório de Protozoologia, Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém 66055-240, Brazil; (E.d.S.d.M.); (F.A.V.d.S.); (E.d.J.O.B.)
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Pezeshki A, Tajic S, Farahmandian P, Haniloo A, Mahmmodzadeh A, Niyyati M, Behniafar H. Phylogenetic analysis of Acanthamoeba isolated from soil samples and nasal cavities of patients with malignancy: a public health concern in the northwest of Iran. Trans R Soc Trop Med Hyg 2024; 118:367-375. [PMID: 38240056 DOI: 10.1093/trstmh/trad100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 10/28/2023] [Accepted: 12/22/2023] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND The genus Acanthamoeba is reported from various environmental sources and can cause multiple complications, including chronic amoebic aeratitis and amoebic granulomatous encephalitis. This study investigated the presence and genotyping of Acanthamoeba in the soil of parks and patients with malignancies referred to health centers in Zanjan city, Iran. METHODS In this cross-sectional study, 200 soil samples were collected from amusement parks in Zanjan city from September 2017 to May 2018. Samples were cultured on 1.5% non-nutrient agar, and the Acanthamoeba genus was identified using the morphological method. PCR was performed on all positive environmental samples, and six microscopically positive clinical samples belonged to our previous study. DNA sequencing of 18S rRNA was performed to analyze the genetic pattern of some PCR-positive isolates. RESULTS Microscopic results showed that 96 (48%) soil samples were positive. PCR confirmed all positive cases of clinical samples and 84 soil samples. Out of the PCR-positive samples, 20 soil samples and five clinical samples were sequenced successfully. All soil isolates belonged to the T4 genotype, and three and two clinical samples belonged to T4 and T5 genotypes, respectively. CONCLUSION : The presence of Acanthamoeba in both the environment and clinical samples of Zanjan city suggests paying greater attention to the infections caused by it.
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Affiliation(s)
- Ali Pezeshki
- Department of Parasitology and Mycology, School of Medicine, Zanjan University of Medical Sciences, 45331 Zanjan, Iran
| | - Shadi Tajic
- Department of Parasitology and Mycology, School of Medicine, Zanjan University of Medical Sciences, 45331 Zanjan, Iran
| | - Parvin Farahmandian
- Department of Parasitology and Mycology, School of Medicine, Zanjan University of Medical Sciences, 45331 Zanjan, Iran
| | - Ali Haniloo
- Department of Parasitology and Mycology, School of Medicine, Zanjan University of Medical Sciences, 45331 Zanjan, Iran
| | - Abbas Mahmmodzadeh
- Department of Parasitology and Mycology, School of Medicine, Zanjan University of Medical Sciences, 45331 Zanjan, Iran
| | - Maryam Niyyati
- Department of Medical Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, 1701706 Tehran, Iran
| | - Hamed Behniafar
- Department of Medical Parasitology, Sarab Faculty of Medical Sciences, 54731 Sarab, East Azerbaijan, Iran
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Alfaro-Sifuentes R, Lares-Jiménez LF, Rojas-Hernández S, Carrasco-Yépez MM, Rojas-Ortega DA, Rodriguez-Anaya LZ, Gonzalez-Galaviz JR, Lares-Villa F. Immunogens in Balamuthia mandrillaris: a proteomic exploration. Parasitol Res 2024; 123:173. [PMID: 38536506 DOI: 10.1007/s00436-024-08193-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 03/20/2024] [Indexed: 04/04/2024]
Abstract
Balamuthia mandrillaris is the causative agent of granulomatous amoebic encephalitis, a rare and often fatal infection affecting the central nervous system. The amoeba is isolated from diverse environmental sources and can cause severe infections in both immunocompromised and immunocompetent individuals. Given the limited understanding of B. mandrillaris, our research aimed to explore its protein profile, identifying potential immunogens crucial for early granulomatous amoebic encephalitis diagnosis. Cultures of B. mandrillaris and other amoebas were grown under axenic conditions, and total amoebic extracts were obtained. Proteomic analyses, including two-dimensional electrophoresis and mass spectrometry, were performed. A 50-kDa band showed a robust recognition of antibodies from immunized BALB/c mice; peptides contained in this band were matched with elongation factor-1 alpha, which emerged as a putative key immunogen. Besides, lectin blotting revealed the presence of glycoproteins in B. mandrillaris, and confocal microscopy demonstrated the focal distribution of the 50-kDa band throughout trophozoites. Cumulatively, these observations suggest the participation of the 50-kDa band in adhesion and recognition mechanisms. Thus, these collective findings demonstrate some protein characteristics of B. mandrillaris, opening avenues for understanding its pathogenicity and developing diagnostic and therapeutic strategies.
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Affiliation(s)
- Rosalía Alfaro-Sifuentes
- Programa de Doctorado en Ciencias Especialidad en Biotecnología, Departamento de Biotecnología y Ciencias Alimentarias, Instituto Tecnológico de Sonora, 85000, Ciudad Obregón, Sonora, México.
| | - Luis Fernando Lares-Jiménez
- Departamento de Ciencias Agronómicas y Veterinarias, Instituto Tecnológico de Sonora, 85000, Ciudad Obregón, Sonora, México
| | - Saul Rojas-Hernández
- Laboratorio de Inmunología Molecular, Instituto Politécnico Nacional, Escuela Superior de Medicina, Salvador Díaz Mirón Esq. Plan de San Luis S/N, Miguel Hidalgo, Casco de Santo Tomas, Ciudad de México, México
| | | | - Diego Alexander Rojas-Ortega
- Centro de Investigación en Ciencias de La Salud (CICSA), FCS, Universidad Anáhuac México, 52786, Huixquilucan, Estado de México, México
| | | | | | - Fernando Lares-Villa
- Departamento de Ciencias Agronómicas y Veterinarias, Instituto Tecnológico de Sonora, 85000, Ciudad Obregón, Sonora, México.
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Fatemi M, Niyyati M, Rouhani S, Karamati SA, Mirjalali H, Karanis P. Contamination of fresh vegetables in municipal stores with pathogenic Acanthamoeba genotypes; a public health concern. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2023; 33:1010-1021. [PMID: 35443833 DOI: 10.1080/09603123.2022.2067328] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 04/12/2022] [Indexed: 05/23/2023]
Abstract
Acanthamoeba spp. cause keratitis and encephalitis, and are a proper carrier of foodborne pathogens. A total of 70 samples including garden cress, chives, mint, parsley, and basil were collected. Samples were cultured onto a 2% non-nutrient agar medium. The cultures were analyzed using morphological and molecular techniques. In total, 18 (25.7%) out of 70 samples were positive including garden cress 10/22 (45.45%), chives 3/12 (25%), mint 2/13 (15.38%), basil 2/13 (15.38%), and parsley 1/10 (10%). The diagnostic fragment 3 was successfully sequenced in 15 samples and represented 11 (73.3%) T4, three (20%) T5, and one T9 genotypes. In addition, three, two, and one strains, belonging to the genotypes T4, T5, and T9 were ranked highly pathogenic. This is the first study reporting contamination of the most commonly consumed fresh vegetables with pathogenic Acanthamoeba genotypes. Our findings signify the public health concerns due the contamination of vegetables in municipal public markets.
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Affiliation(s)
- Marziye Fatemi
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Medical Parasitology and Mycology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Niyyati
- Department of Medical Parasitology and Mycology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soheila Rouhani
- Department of Medical Parasitology and Mycology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Ahmad Karamati
- Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamed Mirjalali
- Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Panagiotis Karanis
- University of Cologne, Medical Faculty and University Hospital, Cologne 50931, Germany
- Department of Basic and Clinical Sciences, Nicosia University Medical School, Nicosia, Cyprus
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Shobhana A, Saha B, Datta A, Trivedi S, Jha S, Bhowmik S, Banerjee K. Something Amiss: Acanthamoeba Meningoencephalitis: Report of Two Cases from Kolkata, India. Ann Indian Acad Neurol 2023; 26:789-792. [PMID: 38022465 PMCID: PMC10666860 DOI: 10.4103/aian.aian_621_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 08/16/2023] [Accepted: 08/18/2023] [Indexed: 12/01/2023] Open
Affiliation(s)
- A Shobhana
- Department Critical Care and Neurology, Tropical Medicine, Stroke Medicine, Institute of Neurosciences, Kolkata, West Bengal, India
| | - Bibhuti Saha
- Department of Infectious Diseases and Advanced Microbiology, Calcutta School of Tropical Medicine, Kolkata, West Bengal, India
| | - Ashis Datta
- Department of Neurology, Institute of Neurosciences, Kolkata, West Bengal, India
| | - Santosh Trivedi
- Department of Neurology, Institute of Neurosciences, Kolkata, West Bengal, India
| | - Shreyashi Jha
- Department of Neurology, Institute of Neurosciences, Kolkata, West Bengal, India
| | - Soumya Bhowmik
- Department of Neurology, Institute of Neurosciences, Kolkata, West Bengal, India
| | - Kokila Banerjee
- Department of Microbiology, Drs. Tribedi and Roy Diagnostic Laboratory, Kolkata, West Bengal, India
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Haston JC, O’Laughlin K, Matteson K, Roy S, Qvarnstrom Y, Ali IKM, Cope JR. The Epidemiology and Clinical Features of Non-Keratitis Acanthamoeba Infections in the United States, 1956-2020. Open Forum Infect Dis 2023; 10:ofac682. [PMID: 36655187 PMCID: PMC9835757 DOI: 10.1093/ofid/ofac682] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Indexed: 01/15/2023] Open
Abstract
Background Acanthamoeba is a free-living ameba that can cause severe disease affecting the central nervous system, skin, sinuses, and other organs, particularly in immunocompromised individuals. These rare but severe infections are often fatal, yet incompletely described. Methods Cases included were either reported to the Centers for Disease Control and Prevention (CDC) Free-Living Ameba program or published in scientific literature. Characteristics of all patients in the United States with laboratory-confirmed non-keratitis Acanthamoeba infections were described using descriptive statistics, and associations with survival were determined using χ2 and Fisher exact tests. Results Of 173 patients identified, 71% were male and the median age was 44 years (range, 0-87 years). Of these, 26 (15%) survived. Most patients (88%) had at least 1 immunocompromising condition, most commonly human immunodeficiency virus (39%), cancer (28%), and solid organ or hematopoietic stem cell transplant (28%). Granulomatous amebic encephalitis (GAE) was the most common disease presentation (71%). Skin (46%), sinuses (29%), lungs (13%), and bone (6%) were also involved. Nearly half of patients (47%) had involvement of >1 organ system. Survival was less frequent among those with GAE (3%, P < .001) compared with cutaneous disease, rhinosinusitis, or multiorgan disease not including GAE. Of 7 who received the currently recommended treatment regimen, 5 (71%) survived. Conclusions Non-keratitis Acanthamoeba infections occur primarily in immunocompromised individuals and are usually fatal. Survival may be associated with disease presentation and treatment. Providers who care for at-risk patients should be aware of the various disease manifestations to improve early recognition and treatment.
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Affiliation(s)
- Julia C Haston
- Correspondence: Julia C. Haston, MD, MSc, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30329, USA ()
| | - Kevin O’Laughlin
- Waterborne Disease Prevention Branch, Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Kelsey Matteson
- Waterborne Disease Prevention Branch, Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA,Epidemiology Elective Program, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Shantanu Roy
- Waterborne Disease Prevention Branch, Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Yvonne Qvarnstrom
- Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Ibne K M Ali
- Waterborne Disease Prevention Branch, Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Insights into genome evolution, pan-genome, and phylogenetic implication through mitochondrial genome sequence of Naegleria fowleri species. Sci Rep 2022; 12:13152. [PMID: 35909191 PMCID: PMC9339544 DOI: 10.1038/s41598-022-17006-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 07/19/2022] [Indexed: 11/09/2022] Open
Abstract
In the current study, we have systematically analysed the mitochondrial DNA (mtDNA) sequence of Naegleria fowleri (N. fowleri) isolate AY27, isolated from Karachi, Pakistan. The N. fowleri isolate AY27 has a circular mtDNA (49,541 bp), which harbours 69 genes (46 protein-coding genes, 21 tRNAs and 2 rRNAs). The pan-genome analysis of N. fowleri species showed a Bpan value of 0.137048, which implies that the pan-genome is open. KEGG classified core, accessory and unique gene clusters for human disease, metabolism, environmental information processing, genetic information processing and organismal system. Similarly, COG characterization of protein showed that core and accessory genes are involved in metabolism, information storages and processing, and cellular processes and signaling. The Naegleria species (n = 6) formed a total of 47 gene clusters; 42 single-copy gene clusters and 5 orthologous gene clusters. It was noted that 100% genes of Naegleria species were present in the orthogroups. We identified 44 single nucleotide polymorphisms (SNP) in the N. fowleri isolate AY27 mtDNA using N. fowleri strain V511 as a reference. Whole mtDNA phylogenetic tree analysis showed that N. fowleri isolates AY27 is closely related to N. fowleri (Accession no. JX174181.1). The ANI (Average Nucleotide Identity) values presented a much clear grouping of the Naegleria species compared to the whole mtDNA based phylogenetic analysis. The current study gives a comprehensive understanding of mtDNA architecture as well as a comparison of Naegleria species (N. fowleri and N. gruberi species) at the mitochondrial genome sequence level.
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Morsli M, Lavigne JP, Drancourt M. Direct Metagenomic Diagnosis of Community-Acquired Meningitis: State of the Art. Front Microbiol 2022; 13:926240. [PMID: 35865915 PMCID: PMC9294516 DOI: 10.3389/fmicb.2022.926240] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 06/06/2022] [Indexed: 11/13/2022] Open
Abstract
Current routine diagnosis of community-acquired meningitis (CAM) by multiplex real-time polymerase chain reaction (RT-PCR) is limited in the number of tested pathogens and their full characterisation, requiring additional in vitro investigations to disclose genotype and antimicrobial susceptibility. We reviewed 51 studies published through December 2021 reporting metagenomic next generation sequencing (mNGS) directly applied to the cerebrospinal fluid (CSF). This approach, potentially circumventing the above-mentioned limitations, indicated 1,248 investigated patients, and 617 patients dually investigated by routine diagnosis and mNGS, in whom 116 microbes were detected, including 50 by mNGS only, nine by routine methods only, and 57 by both routine methods and mNGS. Of 217 discordant CSF findings, 103 CSF samples were documented by mNGS only, 87 CSF samples by routine methods only, and 27 CSF samples in which the pathogen identified by mNGS was different than that found using routine methods. Overall, mNGS allowed for diagnosis and genomic surveillance of CAM causative pathogens in real-time, with a cost which is competitive with current routine multiplex RT-PCR. mNGS could be implemented at point-of-care (POC) laboratories as a part of routine investigations to improve the diagnosis and molecular epidemiology of CAM, particularly in the event of failure of routine assays.
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Affiliation(s)
- Madjid Morsli
- IHU Méditerranée Infection, Marseille, France
- Aix-Marseille Université, IRD, MEPHI, IHU Méditerranée Infection, Marseille, France
| | - Jean Philippe Lavigne
- VBIC, INSERM U1047, Université de Montpellier, Service de Microbiologie et Hygiène Hospitalière, CHU Nîmes, Nîmes, France
| | - Michel Drancourt
- IHU Méditerranée Infection, Marseille, France
- Aix-Marseille Université, IRD, MEPHI, IHU Méditerranée Infection, Marseille, France
- Laboratoire de Microbiologie, Assistance Publique-Hôpitaux de Marseille, IHU Méditerranée Infection, Marseille, France
- *Correspondence: Michel Drancourt,
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Various brain-eating amoebae: the protozoa, the pathogenesis, and the disease. Front Med 2021; 15:842-866. [PMID: 34825341 DOI: 10.1007/s11684-021-0865-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 04/25/2021] [Indexed: 10/19/2022]
Abstract
Among various genera of free-living amoebae prevalent in nature, some members are identified as causative agents of human encephalitis, in which Naegleria fowleri followed by Acanthamoeba spp. and Balamuthia mandrillaris have been successively discovered. As the three dominant genera responsible for infections, Acanthamoeba and Balamuthia work as opportunistic pathogens of granulomatous amoebic encephalitis in immunocompetent and immunocompromised individuals, whereas Naegleria induces primary amoebic meningoencephalitis mostly in healthy children and young adults as a more violent and deadly disease. Due to the lack of typical symptoms and laboratory findings, all these amoebic encephalitic diseases are difficult to diagnose. Considering that subsequent therapies are also affected, all these brain infections cause significant mortality worldwide, with more than 90% of the cases being fatal. Along with global warming and population explosion, expanding areas of human and amoebae activity in some regions lead to increased contact, resulting in more serious infections and drawing increased public attention. In this review, we summarize the present information of these pathogenic free-living amoebae, including their phylogeny, classification, biology, and ecology. The mechanisms of pathogenesis, immunology, pathophysiology, clinical manifestations, epidemiology, diagnosis, and therapies are also discussed.
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Ahmed U, Anwar A, Ong SK, Anwar A, Khan NA. Applications of medicinal chemistry for drug discovery against Acanthamoeba infections. Med Res Rev 2021; 42:462-512. [PMID: 34472107 DOI: 10.1002/med.21851] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 07/13/2021] [Accepted: 08/17/2021] [Indexed: 01/16/2023]
Abstract
Acanthamoeba is a genus of free-living amoebae, pervasively found in the environment. Most of its pathogenic species are the causative agent of sight-threatening Acanthamoeba keratitis and fatal granulomatous amoebic encephalitis. Despite the advancements in the field of chemotherapy, treating Acanthamoeba infections is still challenging due to incomplete knowledge of the complicated pathophysiology. In case of infection, the treatment regimen for the patients is often ineffective due to delayed diagnosis, poor specificity, and side-effects. Besides the resistance of Acanthamoeba cysts to most of the drugs, the recurrence of infection further complicates the recovery. Thus, it is necessary to develop an effective treatment which can eradicate these rare, but serious infections. Based on various computational and in vitro studies, it has been established that the synthetic scaffolds such as heterocyclic compounds may act as potential drug leads for the development of antiamoebic drugs. In this review, we report different classes of synthetic compounds especially heterocyclic compounds which have shown promising results against Acanthamoeba. Moreover, the antiamoebic activities of synthetic compounds with their possible mode of actions against Acanthamoeba, have been summarized and discussed in this review.
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Affiliation(s)
- Usman Ahmed
- Department of Biological Sciences, School of Medical and Life Sciences, Sunway University, Subang Jaya, Selangor, Malaysia
| | - Ayaz Anwar
- Department of Biological Sciences, School of Medical and Life Sciences, Sunway University, Subang Jaya, Selangor, Malaysia
| | - Seng-Kai Ong
- Department of Biological Sciences, School of Medical and Life Sciences, Sunway University, Subang Jaya, Selangor, Malaysia
| | - Areeba Anwar
- Faculty of Defence Science and Technology, National Defence University of Malaysia, Kuala Lampur, Malaysia
| | - Naveed Ahmed Khan
- Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, UAE
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Vishwakarma A, Lal R, Ramya M. Aptamer-based approaches for the detection of waterborne pathogens. Int Microbiol 2021; 24:125-140. [PMID: 33404933 DOI: 10.1007/s10123-020-00154-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 10/13/2020] [Accepted: 12/14/2020] [Indexed: 02/06/2023]
Abstract
Waterborne ailments pose a serious threat to public health and are a huge economic burden. Lack of hygiene in drinking and recreational water is the chief source of microbial pathogens in developing countries. Poor water quality and sanitation account for more than 3.4 million deaths a year worldwide. This has urged authorities and researchers to explore different avenues of pathogen detection. There is a growing demand for rapid and reliable sensor technologies, in particular those that can detect in situ and perform in harsh conditions. Some of the major waterborne pathogens include Vibrio cholerae, Leptospira interrogans, Campylobacter jejuni, Shigella spp., enterotoxigenic Escherichia coli, Clostridium difficile, Cryptosporidium parvum, Entamoeba histolytica, and Hepatitis A virus. While conventional methods of pathogen detection like serodiagnosis and microbiological methods have been superseded by nucleic acid amplification methods, there is still potential for improvement. This review provides an insight into aptamers and their utility in the form of aptasensors. It discusses how aptamer-based approaches have emerged as a novel strategy and its advantages over more resource-intensive and complex biochemical approaches.
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Affiliation(s)
- Archana Vishwakarma
- Molecular Genetics Laboratory, Department of Genetic Engineering, College of Engineering and Technology, SRM Institute of Science and Technology, SRM Nagar, Kattankulathur 603203, Kanchipuram, Chennai, TN, India
| | - Roshni Lal
- Molecular Genetics Laboratory, Department of Genetic Engineering, College of Engineering and Technology, SRM Institute of Science and Technology, SRM Nagar, Kattankulathur 603203, Kanchipuram, Chennai, TN, India
| | - Mohandass Ramya
- Molecular Genetics Laboratory, Department of Genetic Engineering, College of Engineering and Technology, SRM Institute of Science and Technology, SRM Nagar, Kattankulathur 603203, Kanchipuram, Chennai, TN, India.
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12
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In Vitro Amoebicidal Activity of Imidazolium Salts Against Trophozoites. Acta Parasitol 2020; 65:317-326. [PMID: 31939031 DOI: 10.2478/s11686-019-00161-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 12/16/2019] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Several strains of the free-living genus Acanthamoeba can cause granulomatous amoebic encephalitis (GAE), a rare chronic and slowly progressive infection of the central nervous system (CNS), and Acanthamoeba keratitis (AK), a sight-threatening eye infectious disease. AK incidence has increased with the popularization of the contact lens wear and its treatment is currently limited and frequently unsuccessful. As imidazolium salts (IS), cationic imidazole derivatives, have promising antimicrobial potential. MATERIALS AND METHODS The present study evaluated the amoebicidal activity of four IS; 1-n-hexadecyl-3-methylimidazolium methanesulfonate (C16MImMeS), chloride (C16MImCl) and bis (triluoromethylsulfonyl) imide (C16MImNTf2 ), and 1-methyl-3-n-octadecylimidazolium chloride (C18MImCl), against the Acanthamoeba castellanii (ATCC30010) environmental strain and a clinical isolate (genotype T4). RESULTS Three IS showed being lethal to 100% of the Acanthamoeba trophozoites at the minimum inhibitory concentrations of 125 and 62.5 μg/mL (C16MImMeS), 31.25 and 62.5 μg/mL (C16MImCl), and 125 and 125 μg/mL (C18MImCl) for ATCC30010 and isolate T4, respectively. C16MImNTf2 did not demonstrate amoebicidal activity. All active IS caused the hemolysis of erythrocytes. The cytotoxic effect of the IS was tested in RAW macrophages and human brain microvascular endothelial cells, which demonstrated cytotoxicity in all concentrations tested against both cell lines. As a consequence, these IS with amoebicidal activity presented low selectivity index values (SI) (SI < 1.0), demonstrating lack of parasite selectivity. CONCLUSION Thus, C16MImMeS, C16MImCl, and C18MImCl seem to hold greater promise as components for contact lens cleaning and disinfection solutions, instead of direct human application.
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Anwar A, Soomaroo A, Anwar A, Siddiqui R, Khan NA. Metformin-coated silver nanoparticles exhibit anti-acanthamoebic activities against both trophozoite and cyst stages. Exp Parasitol 2020; 215:107915. [PMID: 32461112 DOI: 10.1016/j.exppara.2020.107915] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 05/07/2020] [Accepted: 05/11/2020] [Indexed: 12/20/2022]
Abstract
Acanthamoeba castellanii is an opportunistic protozoan responsible for serious human infections including Acanthamoeba keratitis and granulomatous amoebic encephalitis. Despite advances in antimicrobial therapy and supportive care, infections due to Acanthamoeba are a major public concern. Current methods of treatment are not fully effective against both the trophozoite and cyst forms of A. castellanii and are often associated with severe adverse effects, host cell cytotoxicity and recurrence of infection. Therefore, there is an urgent need to develop new therapeutic approaches for the treatment and management of Acanthamoebic infections. Repurposing of clinically approved drugs is a viable avenue for exploration and is particularly useful for neglected and rare diseases where there is limited interest by pharmaceutical companies. Nanotechnology-based drug delivery systems offer promising approaches in the biomedical field, particularly in diagnosis and drug delivery. Herein, we conjugated an antihyperglycemic drug, metformin with silver nanoparticles and assessed its anti-acanthamoebic properties. Characterization by ultraviolet-visible spectrophotometry and atomic force microscopy showed successful formation of metformin-coated silver nanoparticles. Amoebicidal and amoebistatic assays revealed that metformin-coated silver nanoparticles reduced the viability and inhibited the growth of A. castellanii significantly more than metformin and silver nanoparticles alone at both 5 and 10 μM after 24 h incubation. Metformin-coated silver nanoparticles also blocked encystation and inhibited the excystation in Acanthamoeba after 72 h incubation. Overall, the conjugation of metformin with silver nanoparticles was found to enhance its antiamoebic effects against A. castellanii. Furthermore, the pretreatment of A. castellanii with metformin and metformin-coated silver nanoparticles for 2 h also reduced the amoebae-mediated host cell cytotoxicity after 24 h incubation from 73% to 10% at 10 μM, indicating that the drug-conjugated silver nanoparticles confer protection to human cells. These findings suggest that metformin-coated silver nanoparticles hold promise in the improved treatment and management of Acanthamoeba infections.
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Affiliation(s)
- Ayaz Anwar
- Department of Biological Sciences, School of Science and Technology, Sunway University, Subang Jaya, 47500, Selangor, Malaysia.
| | - Akshinee Soomaroo
- Department of Biological Sciences, School of Science and Technology, Sunway University, Subang Jaya, 47500, Selangor, Malaysia
| | - Areeba Anwar
- Department of Biological Sciences, School of Science and Technology, Sunway University, Subang Jaya, 47500, Selangor, Malaysia
| | - Ruqaiyyah Siddiqui
- Department of Biology, Chemistry and Environmental Sciences, College of Arts and Sciences, American University of Sharjah, Sharjah, 26666, United Arab Emirates
| | - Naveed Ahmed Khan
- Department of Biology, Chemistry and Environmental Sciences, College of Arts and Sciences, American University of Sharjah, Sharjah, 26666, United Arab Emirates
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14
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Carnt NA, Subedi D, Lim AW, Lee R, Mistry P, Badenoch PR, Kilvington S, Dutta D. Prevalence and seasonal variation of Acanthamoeba in domestic tap water in greater Sydney, Australia. Clin Exp Optom 2020; 103:782-786. [PMID: 32227362 DOI: 10.1111/cxo.13065] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 11/17/2019] [Accepted: 02/28/2020] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND This study examined the prevalence of free-living Acanthamoeba in domestic tap water in the greater Sydney region, Australia, and determined any seasonal variation in prevalence. METHODS Fifty-four participants were included in this study following approval from an institutional human research ethics committee. Each participant self-collected two samples (one in summer and another in winter) from the surface of the drain of the bathroom sink using an instructional kit. The samples were cultured by inoculating onto a non-nutrient agar plate seeded with Escherichia coli and incubation at 32°C for two weeks. The plates were microscopically examined for the presence of free-living amoeba. DNA was isolated from 20 samples and a polymerase chain reaction (PCR) assay was performed for amplification of the partial sequence of the 18S ribosomal RNA gene. The PCR amplified products were sequenced using Sanger sequencing and genotyping was performed based on the variation in nucleotide sequences. RESULTS A total of 97 samples were collected over the two collection periods, with 28.6 per cent of samples morphologically classified as Acanthamoeba. The summer period yielded 16 of 54 (29.6 per cent) samples classified as Acanthamoeba, while the winter period yielded 12 of 43 (27.9 per cent) samples classified as Acanthamoeba. There was no statistically significant difference (p = 0.85) between the prevalence of free-living Acanthamoeba in summer compared to winter. Phylogenetic analysis showed that 15 of 20 (75 per cent) isolates belonged to genotype T4, the most frequent genotype isolated in Acanthamoeba keratitis. CONCLUSION The prevalence of free-living Acanthamoeba characterised morphologically in domestic tap water of the greater Sydney region was higher than expected, especially considering the low incidence of Acanthamoeba keratitis in Australia. However, this study did not find variation between seasons. As the T4 genotype was most common, Sydney-based practitioners must always consider Acanthamoeba as a possible causative organism in cases of microbial keratitis, regardless of the season.
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Affiliation(s)
- Nicole A Carnt
- School of Optometry and Vision Science, The University of New South Wales, Sydney, Australia.,Centre for Vision Research, Westmead Institute for Medical Research, The University of Sydney, Sydney, Australia.,Institute of Ophthalmology, University College London, London, UK
| | - Dinesh Subedi
- School of Optometry and Vision Science, The University of New South Wales, Sydney, Australia
| | - Ann W Lim
- School of Optometry and Vision Science, The University of New South Wales, Sydney, Australia
| | - Rebecca Lee
- School of Optometry and Vision Science, The University of New South Wales, Sydney, Australia
| | - Priyal Mistry
- School of Optometry and Vision Science, The University of New South Wales, Sydney, Australia
| | - Paul R Badenoch
- Department of Ophthalmology, Flinders Medical Centre, Adelaide, Australia.,College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Simon Kilvington
- Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK
| | - Debarun Dutta
- School of Optometry and Vision Science, The University of New South Wales, Sydney, Australia.,Optometry and Vision Science, Life and Health Sciences, Aston University, Birmingham, UK
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15
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Identification of T3 and T4 Genotypes of Acanthamoeba sp. in Dust Samples Isolated from Air Conditioning Equipment of Public Hospital of Ituiutaba-MG. Curr Microbiol 2020; 77:890-895. [PMID: 31960093 DOI: 10.1007/s00284-019-01869-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Accepted: 12/30/2019] [Indexed: 12/20/2022]
Abstract
The free-living amoebae are currently considered an emerging parasitic infection. The infection by this protozoan can generate serious infection and even cause death. Due to their amphizoic and opportunistic characters of these microorganisms, one should give more attention, not only in swimming pools but also where there are immunologically susceptible patients such as those found in intensive care units and surgical centers. Due to their difficult diagnosis often postmortem, because they are considered to be an emerging parasitic infection and their diagnosis is difficult, often performed post mortem. This study aimed to evaluate the safety of these protozoa in air conditioners by taking samples of dust from both the surgical center and the intensive therapy unit. We analyzed 48 dust samples that were collected from six air conditioners equipment located in the Intensive Care Unit (ICU) and Surgical Center (SC) of a public hospital. We found 10.4% of the samples collected in the SC, and 75% of the samples collected in the ICU presented free-living amoeba cysts by light microscopy analysis. In total, 35.4% (17/48) of the air conditioning samples of the hospital were positive and, by PCR, were identified to belong to the genus Acanthamoeba spp and Balamuthia mandrillaris species. By DNA sequencing analysis, it was possible to classify the Acanthamoeba samples as belonging to the T3 and T4 genotypes. These genotypes are the main cause of keratitis in humans, and Balamuthia may cause amoebic encephalitis, and together are emerging parasitic infections. Our results show the presence of the two most important amoebas Acanthamoeba (T3 and T4 genotypes) and Balamuthia in the SC and the ICU, and these necessary precautions these sites could be propagating cysts of these amoebas and patients during their stay or discharge could present ocular and NSC alterations without perhaps arriving to the diagnosis of free-living amoeba infection.
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16
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Kalra SK, Sharma P, Shyam K, Tejan N, Ghoshal U. Acanthamoeba and its pathogenic role in granulomatous amebic encephalitis. Exp Parasitol 2019; 208:107788. [PMID: 31647916 DOI: 10.1016/j.exppara.2019.107788] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 10/11/2019] [Accepted: 10/19/2019] [Indexed: 01/13/2023]
Abstract
Acanthamoeba is a free-living amoeba that is widely distributed in the environment. It is an opportunist protist, which is known to cause rare yet fatal infection of the central nervous system (CNS), granulomatous amebic encephalitis (GAE) in humans. GAE cases are increasingly been reported among immunocompromised patients, with few cases in immunocompetent hosts. Diagnosis of GAE primarily includes neuroimaging, microscopy, cerebrospinal fluid (CSF) culture, histopathology, serology and molecular techniques. Early diagnosis is vital for proper management of infected patients. Combination therapeutic approach has been tried in various GAE cases reported worldwide. We tried to present a comprehensive review, which summarizes on the epidemiology of GAE caused by Acanthamoeba along with the associated clinical symptoms, risk factors, diagnosis and treatment of GAE among infected patients.
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Affiliation(s)
- Sonali K Kalra
- Faculty of Applied Sciences and Biotechnology, Shoolini University of Biotechnology and Management Sciences, Bajhol, Distt. Solan, 173229, HP, India.
| | - Palvi Sharma
- Faculty of Applied Sciences and Biotechnology, Shoolini University of Biotechnology and Management Sciences, Bajhol, Distt. Solan, 173229, HP, India
| | - Kirti Shyam
- Faculty of Applied Sciences and Biotechnology, Shoolini University of Biotechnology and Management Sciences, Bajhol, Distt. Solan, 173229, HP, India
| | - Nidhi Tejan
- Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareili Road, Lucknow, 226014, UP, India
| | - Ujjala Ghoshal
- Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareili Road, Lucknow, 226014, UP, India
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Megha K, Sehgal R, Khurana S. Genotyping of Acanthamoeba spp. isolated from patients with granulomatous amoebic encephalitis. Indian J Med Res 2019; 148:456-459. [PMID: 30666010 PMCID: PMC6362713 DOI: 10.4103/ijmr.ijmr_1564_17] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Kirti Megha
- Department of Medical Parasitology, Post Graduate Institute of Medical Education & Research, Chandigarh 160 012, India
| | - Rakesh Sehgal
- Department of Medical Parasitology, Post Graduate Institute of Medical Education & Research, Chandigarh 160 012, India
| | - Sumeeta Khurana
- Department of Medical Parasitology, Post Graduate Institute of Medical Education & Research, Chandigarh 160 012, India
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Chan LL, Mak JW, Ambu S, Chong PY. Identification and ultrastructural characterization of Acanthamoeba bacterial endocytobionts belonging to the Alphaproteobacteria class. PLoS One 2018; 13:e0204732. [PMID: 30356282 PMCID: PMC6200196 DOI: 10.1371/journal.pone.0204732] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 09/13/2018] [Indexed: 12/17/2022] Open
Abstract
The detection and identification of two endocytobiotic bacterial strains, one affiliated to the “Candidatus Caedibacter acanthamoebae”/“Ca. Paracaedimonas acanthamoeba”, and another to the endosymbiont of Acanthamoeba UWC8 and “Ca. Jidaibacter acanthamoeba” are described. For endocytobiont screening, we developed a PCR method with a set of broad-range bacterial 16S rRNA primers to substitute the commonly used but technically demanding fluorescent in situ hybridization technique. Our PCR test alone without sequencing failed to discriminate the endocytobiont-containing and endocytobiont-free Acanthamoeba sp. due to the presence of mismatched primers to host mitochondrial DNA. We highlighted the need to perform bacterial primer checking against the Acanthamoeba genome to avoid false positive detection in PCR. Although the genetic aspect of “Ca. Caedibacter acanthamoebae”/“Ca. Paracaedimonas acanthamoeba” and the endosymbiont of Acanthamoeba UWC8/“Ca. Jidaibacter acanthamoeba” are well studied, knowledge pertaining to their morphologies are quite vague. Hence, we used transmission electron microscopy to examine our endocytobionts which are affiliated to previously described intracellular bacteria of Acanthamoeba sp. We used good-quality TEM images for the localization and the fate of the current endocytobionts inside different life stages of the hosts. Furthermore, to the best of our knowledge, our TEM findings are the first to provide morphological evidence for the clearance of defective Acanthamoeba endocytobionts via an autophagic-like process.
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Affiliation(s)
- Li Li Chan
- Pathology Division, School of Medicine, International Medical University, Kuala Lumpur, Malaysia
- * E-mail:
| | - Joon Wah Mak
- Pathology Division, School of Medicine, International Medical University, Kuala Lumpur, Malaysia
- School of Postgraduate Studies and Research, International Medical University, Kuala Lumpur, Malaysia
| | - Stephen Ambu
- Pathology Division, School of Medicine, International Medical University, Kuala Lumpur, Malaysia
- School of Postgraduate Studies and Research, International Medical University, Kuala Lumpur, Malaysia
| | - Pei Yee Chong
- Medical Sciences, School of Medicine, International Medical University, Kuala Lumpur, Malaysia
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Zhang LL, Wu M, Hu BC, Chen HL, Pan JR, Ruan W, Yao LN. Identification and molecular typing of Naegleria fowleri from a patient with primary amebic meningoencephalitis in China. Int J Infect Dis 2018; 72:28-33. [PMID: 29751112 DOI: 10.1016/j.ijid.2018.05.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 05/02/2018] [Accepted: 05/02/2018] [Indexed: 11/19/2022] Open
Abstract
Naegleria fowleri is the only Naegleria spp. known to cause an acute, fulminant, and rapidly fatal central nervous system infection in humans called primary amebic meningoencephalitis (PAM). In 2016, a patient with suspected PAM was found in Zhejiang Province of China. The pathogen was identified by microscopic examination and PCR. The positive PCR products were sequenced and the sequences were aligned using the NCBI BLAST program. The homologous and phylogenetic analysis was conducted using MEGA 6 program. On microscopy of direct smears, motile cells with pseudopodia were observed, and the motion characteristics of the pseudopodia as well as the cell morphology suggested that the pathogens were amoeba trophozoites. Wright-Giemsa-stained smears showed amoeba trophozoites of various shapes, which measured 10-25μm in size; these were characterized by a prominent, centrally placed nucleolus and a vacuolated cytoplasm. PCR was negative for Entamoeba histolytica and Entamoeba dispar, but positive for Naegleria spp. and N. fowleri. The nucleotide sequences acquired in this study have been submitted to GenBank with accession numbers KX909928 and KX909927, respectively. The BLAST analysis revealed that the sequences of KX909928 and KX909927 had 100% similarity with the sequence of the N. fowleri gene (KT375442.1). Sequence alignment and the phylogenetic tree revealed that the N. fowleri collected in this study was classified as genotype 2 and was most closely related to Naegleria lovaniensis. This study confirmed N. fowleri as the agent responsible for the infection in this patient. PAM normally progresses rapidly and is generally universally fatal within a week. Unfortunately this patient died at 2 weeks after the onset of symptoms.
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Affiliation(s)
- Ling-Ling Zhang
- Department of Communicable Diseases of Control and Prevention, Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, China.
| | - Mao Wu
- Zhejiang Provincial People's Hospital, Hangzhou, China.
| | - Bang-Chuan Hu
- Zhejiang Provincial People's Hospital, Hangzhou, China.
| | - Hua-Liang Chen
- Department of Communicable Diseases of Control and Prevention, Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, China.
| | - Jin-Ren Pan
- Department of Communicable Diseases of Control and Prevention, Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, China.
| | - Wei Ruan
- Department of Communicable Diseases of Control and Prevention, Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, China.
| | - Li-Nong Yao
- Department of Communicable Diseases of Control and Prevention, Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, China.
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