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Aiello F, Afflitto GG, Ceccarelli F, Turco MV, Han Y, Amescua G, Dart JK, Nucci C. Perspectives on the incidence of Acanthamoeba Keratitis: A Systematic Review and Meta-Analysis. Ophthalmology 2024:S0161-6420(24)00462-7. [PMID: 39127408 DOI: 10.1016/j.ophtha.2024.08.003] [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: 04/14/2024] [Revised: 07/30/2024] [Accepted: 08/02/2024] [Indexed: 08/12/2024] Open
Abstract
TOPIC To provide an overview on the incidence of Acanthamoeba Keratitis (AK). CLINICAL RELEVANCE Although being a major and sight-threatening cause of infectious keratitis in the population, a comprehensive assessment of the incidence of this condition is lacking. METHODS Incidence of AK was computed as the number of AK eyes, per healthcare center, per year (annualized-center-incidence, or ACI). Two meta-analytical ratios were also calculated: a) the ratio of AK eyes to the count of non-viral microbial keratitis (MK) eyes; b) the ratio of AK eyes to the overall population (i.e., the total number of subjects of a nation or region, as indicated by the authors in each study). Center was defined as the healthcare facility (e.g., Hospital, Private Practice, Clinic) where the study took place. Actual and projected estimates of the number of AK eyes in years were calculated multiplying the ratio of AK to the total population and the corresponding present and projected population estimates (age range: 15 to 70), sourced from the United Nations (UN) Population Prospects. RESULTS Overall, 105 articles were included, published between 1987 and 2022. The total number of eyes identified was 91,951, with 5,660 affected by AK and 86,291 by non-viral MK. The median ACI was 1.9 new AK eyes per healthcare center per year (95%CI of the median: 1.5 to 2.6), with no statistically significant differences observed among continents. The ratio of AK eyes to the total number of MK eyes was 1.52% (95%CI: 1.02% to 2.24%), while the ratio of AK in relation to the entire population was estimated at 0.0002% (95%CI: 0.0001 to 0.0006), or 2.34 eyes per 1,000,000 subjects (95%CI: 0.98 to 5.55 per 1.000.000 subjects). The projected increase in the numbers of AK eyes indicates a rise of +18.5% (15,356 AK eyes) in 2053 and +25.5% (16,253 AK eyes) in 2073, compared to the baseline of 2023 (12,954 AK eyes) CONCLUSION: AK emerged as a relatively low-incident disorder, and no significant differences in terms of its incidence were found among different continents.
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Affiliation(s)
- Francesco Aiello
- Ophthalmology Unit, Dpt. of Experimental Medicine, Università di Roma "Tor Vergata
| | - Gabriele Gallo Afflitto
- Ophthalmology Unit, Dpt. of Experimental Medicine, Università di Roma "Tor Vergata; Moorfields Eye Hospital NHS Foundation Trust, 162 City Road, London, EC1V 2PD, UK.
| | - Francesca Ceccarelli
- Ophthalmology Unit, Dpt. of Experimental Medicine, Università di Roma "Tor Vergata
| | - Maria Vittoria Turco
- Ophthalmology Unit, Dpt. of Experimental Medicine, Università di Roma "Tor Vergata
| | - Yuyi Han
- Ophthalmology Department, Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Guillermo Amescua
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami FL
| | - John K Dart
- Moorfields Eye Hospital NHS Foundation Trust, 162 City Road, London, EC1V 2PD, UK; National Institute of Health Research (NIHR) Moorfields Biomedical Research Centre, London, UK
| | - Carlo Nucci
- Ophthalmology Unit, Dpt. of Experimental Medicine, Università di Roma "Tor Vergata
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Erdem E, Köktaş Z, İnan Harbiyeli I, Atalay E, Kibar F, Durmaz G, Arslan YK, Seydaoğlu G, Yıldırım N, Yağmur M. The effect of climatic and seasonal factors on the microbial keratitis profile. J Fr Ophtalmol 2024; 47:104018. [PMID: 37932171 DOI: 10.1016/j.jfo.2023.07.019] [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: 06/29/2023] [Accepted: 07/31/2023] [Indexed: 11/08/2023]
Abstract
PURPOSE To compare retrospective data on microbial keratitis (MK) from two different climatic regions in Turkey over 11 years. STUDY DESIGN Retrospective cohort. METHODS This retrospective cohort study included patients diagnosed with presumed MK at two referral centers. Center A was located in the subtropical region of Turkey, whereas Center B was located in a continental temperate climate zone. Clinical and laboratory data were also recorded. The results were evaluated for seasonal variations. RESULTS This study included data from 665 patients with presumed MK (351 and 314 patients from centers A and B, respectively). The most common predisposing factors were ocular trauma in Center A, prior ocular surgery, and systemic disease in Center B. Severe keratitis was related to prior ocular surgery, presence of systemic disease, and fungal infection at presentation. The culture positivity rate was higher in spring and lower in summer at both centers. Gram-positive bacteria were the most commonly isolated bacteria in both centers in all seasons. The fungal and mixed keratitis ratios were higher in Center A than in Center B. In Center A, filamentous fungi were common pathogens that were found year-round, and peaks were observed in July and October. CONCLUSION The results of this study show that climatic and seasonal factors may affect the microbial profile of keratitis. Fungal keratitis appears to be a climatic disease. Understanding the regional profile of MK can aid clinicians in their disease management.
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Affiliation(s)
- E Erdem
- Ophthalmology Department, Faculty of Medicine, Cukurova University, Balcalı Hospital, 1380 Sarıcam, Adana, Turkey.
| | - Z Köktaş
- Ophthalmology Department, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey
| | - I İnan Harbiyeli
- Ophthalmology Department, Faculty of Medicine, Cukurova University, Balcalı Hospital, 1380 Sarıcam, Adana, Turkey
| | - E Atalay
- Ophthalmology Department, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey
| | - F Kibar
- Microbiology Department, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - G Durmaz
- Microbiology Department of Eskişehir Osmangazi, University Faculty of Medicine, Eskişehir, Turkey
| | - Y K Arslan
- Statistic Department of Cukurova University, Faculty of Medicine, Adana, Turkey
| | - G Seydaoğlu
- Statistic Department of Cukurova University, Faculty of Medicine, Adana, Turkey
| | - N Yıldırım
- Ophthalmology Department, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey
| | - M Yağmur
- Ophthalmology Department, Faculty of Medicine, Cukurova University, Balcalı Hospital, 1380 Sarıcam, Adana, Turkey
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Petrillo F, Tortori A, Vallino V, Galdiero M, Fea AM, De Sanctis U, Reibaldi M. Understanding Acanthamoeba Keratitis: An In-Depth Review of a Sight-Threatening Eye Infection. Microorganisms 2024; 12:758. [PMID: 38674702 PMCID: PMC11052265 DOI: 10.3390/microorganisms12040758] [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: 03/13/2024] [Revised: 04/02/2024] [Accepted: 04/04/2024] [Indexed: 04/28/2024] Open
Abstract
Acanthamoeba keratitis (AK) is a rare but potentially sight-threatening corneal infection caused by the Acanthamoeba parasite. This microorganism is found ubiquitously in the environment, often in freshwater, soil, and other sources of moisture. Despite its low incidence, AK presents significant challenges due to delayed diagnosis and the complex nature of therapeutic management. Early recognition is crucial to prevent severe ocular complications, including corneal ulceration and vision loss. Diagnostic modalities and treatment strategies may vary greatly depending on the clinical manifestation and the available tools. With the growing reported cases of Acanthamoeba keratitis, it is essential for the ophthalmic community to thoroughly understand this condition for its effective management and improved outcomes. This review provides a comprehensive overview of AK, encompassing its epidemiology, risk factors, pathophysiology, clinical manifestations, diagnosis, and treatment.
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Affiliation(s)
- Francesco Petrillo
- Department of Surgical Sciences, University of Turin, 10126 Turin, Italy; (V.V.); (A.M.F.); (U.D.S.); (M.R.)
- Department of Ophthalmology, “City of Health and Science” Hospital, 10126 Turin, Italy
| | - Antonia Tortori
- Ophthalmology Unit, Surgery Department, Piacenza Hospital, 29121 Piacenza, Italy;
| | - Veronica Vallino
- Department of Surgical Sciences, University of Turin, 10126 Turin, Italy; (V.V.); (A.M.F.); (U.D.S.); (M.R.)
- Department of Ophthalmology, “City of Health and Science” Hospital, 10126 Turin, Italy
| | - Marilena Galdiero
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 81100 Naples, Italy;
| | - Antonio M. Fea
- Department of Surgical Sciences, University of Turin, 10126 Turin, Italy; (V.V.); (A.M.F.); (U.D.S.); (M.R.)
- Department of Ophthalmology, “City of Health and Science” Hospital, 10126 Turin, Italy
| | - Ugo De Sanctis
- Department of Surgical Sciences, University of Turin, 10126 Turin, Italy; (V.V.); (A.M.F.); (U.D.S.); (M.R.)
- Department of Ophthalmology, “City of Health and Science” Hospital, 10126 Turin, Italy
| | - Michele Reibaldi
- Department of Surgical Sciences, University of Turin, 10126 Turin, Italy; (V.V.); (A.M.F.); (U.D.S.); (M.R.)
- Department of Ophthalmology, “City of Health and Science” Hospital, 10126 Turin, Italy
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4
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Raghavan A, Rammohan R. Acanthamoeba keratitis - A review. Indian J Ophthalmol 2024; 72:473-482. [PMID: 38454853 PMCID: PMC11149514 DOI: 10.4103/ijo.ijo_2627_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 12/23/2023] [Indexed: 03/09/2024] Open
Abstract
This is a comprehensive review after a thorough literature search in PubMed-indexed journals, incorporating current information on the pathophysiology, clinical features, diagnosis, medical and surgical therapy, as well as outcomes of Acanthamoeba keratitis (AK). AK is a significant cause of ocular morbidity, and early diagnosis with timely institution of appropriate therapy is the key to obtaining good outcomes. The varied presentations result in frequent misdiagnosis, and co-infections can increase the morbidity of the disease. The first line of therapy continues to be biguanides and diamidines, with surgery as a last resort.
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Affiliation(s)
- Anita Raghavan
- Cornea & Refractive Surgery, Department of Microbiology, Aravind Eye Hospital and Post-Graduate Institute of Ophthalmology, Coimbatore, Tamil Nadu, India
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Mthethwa-Hlongwa NP, Amoah ID, Gomez A, Davison S, Reddy P, Bux F, Kumari S. Profiling pathogenic protozoan and their functional pathways in wastewater using 18S rRNA and shotgun metagenomics. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 912:169602. [PMID: 38154626 DOI: 10.1016/j.scitotenv.2023.169602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 12/20/2023] [Accepted: 12/20/2023] [Indexed: 12/30/2023]
Abstract
Despite extensive research, little is known about the composition of eukaryotic protists in environmental samples. This is due to low parasite concentrations, the complexity of parasite diversity, and a lack of suitable reference databases and standardized protocols. To bridge this knowledge gap, this study used 18S rRNA short amplicon and shotgun metagenomic sequencing approaches to profile protozoan microbial communities as well as their functional pathways in treated and untreated wastewater samples collected from different regions of South Africa. Results demonstrated that protozoan diversity (Shannon index P-value = 0.03) and taxonomic composition (PERMANOVA, P-value = 0.02) was mainly driven by the type of wastewater samples (treated & untreated) and geographic location. However, these WWTPs were also found to contain a core community of protozoan parasites. The untreated wastewater samples revealed a predominant presence of free-living, parasitic, and potentially pathogenic protists typically found in humans and animals, ranging from Alveolata (27 %) phylum (Apicomplexa and Ciliophora) to Excavata (3.88 %) (Discoba and Parasalia) and Amoebozoa (2.84 %) (Entamoeba and Acanthamoeba). Shotgun metagenomics analyses in a subset of the untreated wastewater samples confirmed the presence of public health-importance protozoa, including Cryptosporidium species (3.48 %), Entamoeba hystolitica (6.58 %), Blastocystis hominis (2.91 %), Naegleria gruberi (2.37 %), Toxoplasma gondii (1.98 %), Cyclospora cayetanensis (1.30 %), and Giardia intestinalis (0.31 %). Virulent gene families linked to pathogenic protozoa, such as serine/threonine protein phosphatase and mucin-desulfating sulfatase were identified. Additionally, enriched pathways included thiamine diphosphate biosynthesis III, heme biosynthesis, Methylerythritol 4-Phosphate Pathway, methyl erythritol phosphate (MEP), and pentose phosphate pathways. These findings suggest that protozoan pathogens may possess metabolic and growth potential within WWTPs, posing a severe risk of transmission to humans and animals if inadequately disinfected before release. This study provides a baseline for the future investigation of diverse protozoal communities in wastewater, which are of public health importance.
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Affiliation(s)
- Nonsikelelo P Mthethwa-Hlongwa
- Institute for Water and Wastewater Technology, Durban University of Technology, Durban 4000, South Africa; Department Community Health Studies, Faculty of Health Sciences, Durban University of Technology, Durban 4000, South Africa
| | - Isaac D Amoah
- Institute for Water and Wastewater Technology, Durban University of Technology, Durban 4000, South Africa; Department of Environmental Science, The University of Arizona, Shantz Building Rm 4291177 E 4th St., Tucson, AZ 85721, USA
| | - Andres Gomez
- Department of Animal Science, University of Minnesota, St. Paul, MN, USA
| | - Sam Davison
- Department of Animal Science, University of Minnesota, St. Paul, MN, USA
| | - Poovendhree Reddy
- Department Community Health Studies, Faculty of Health Sciences, Durban University of Technology, Durban 4000, South Africa
| | - Faizal Bux
- Institute for Water and Wastewater Technology, Durban University of Technology, Durban 4000, South Africa
| | - Sheena Kumari
- Institute for Water and Wastewater Technology, Durban University of Technology, Durban 4000, South Africa.
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Ilyas M, Stapleton F, Willcox MDP, Henriquez F, Peguda HK, Rayamajhee B, Zahid T, Petsoglou C, Carnt NA. Epidemiology of and Genetic Factors Associated with Acanthamoeba Keratitis. Pathogens 2024; 13:142. [PMID: 38392880 PMCID: PMC10892102 DOI: 10.3390/pathogens13020142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/14/2024] [Accepted: 01/31/2024] [Indexed: 02/25/2024] Open
Abstract
Acanthamoeba keratitis (AK) is a severe, rare protozoal infection of the cornea. Acanthamoeba can survive in diverse habitats and at extreme temperatures. AK is mostly seen in contact lens wearers whose lenses have become contaminated or who have a history of water exposure, and in those without contact lens wear who have experienced recent eye trauma involving contaminated soil or water. Infection usually results in severe eye pain, photophobia, inflammation, and corneal epithelial defects. The pathophysiology of this infection is multifactorial, including the production of cytotoxic proteases by Acanthamoeba that degrades the corneal epithelial basement membrane and induces the death of ocular surface cells, resulting in degradation of the collagen-rich corneal stroma. AK can be prevented by avoiding risk factors, which includes avoiding water contact, such as swimming or showering in contact lenses, and wearing protective goggles when working on the land. AK is mostly treated with an antimicrobial therapy of biguanides alone or in combination with diaminidines, although the commercial availability of these medicines is variable. Other than anti-amoeba therapies, targeting host immune pathways in Acanthamoeba disease may lead to the development of vaccines or antibody therapeutics which could transform the management of AK.
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Affiliation(s)
- Muhammad Ilyas
- Primary & Secondary Healthcare Department, Punjab 54000, Pakistan; (M.I.)
| | - Fiona Stapleton
- School of Optometry and Vision Science, University of NSW, Sydney, NSW 2052, Australia (H.K.P.)
| | - Mark D. P. Willcox
- School of Optometry and Vision Science, University of NSW, Sydney, NSW 2052, Australia (H.K.P.)
| | - Fiona Henriquez
- School of Health and Life Sciences, The University of the West of Scotland, Glasgow G72 0LH, UK
| | - Hari Kumar Peguda
- School of Optometry and Vision Science, University of NSW, Sydney, NSW 2052, Australia (H.K.P.)
| | - Binod Rayamajhee
- School of Optometry and Vision Science, University of NSW, Sydney, NSW 2052, Australia (H.K.P.)
| | - Tasbiha Zahid
- Primary & Secondary Healthcare Department, Punjab 54000, Pakistan; (M.I.)
| | | | - Nicole A. Carnt
- School of Optometry and Vision Science, University of NSW, Sydney, NSW 2052, Australia (H.K.P.)
- Centre for Vision Research, Westmead Institute for Medical Research, Sydney, NSW 2145, Australia
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7
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Ahmed U, Sivasothy Y, Khan KM, Khan NA, Wahab SMA, Awang K, Othman MA, Anwar A. Malabaricones from the fruit of Myristica cinnamomea King as potential agents against Acanthamoeba castellanii. Acta Trop 2023; 248:107033. [PMID: 37783284 DOI: 10.1016/j.actatropica.2023.107033] [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: 07/20/2023] [Revised: 09/13/2023] [Accepted: 09/29/2023] [Indexed: 10/04/2023]
Abstract
Acanthamoeba castellanii is an opportunistic free-living amoeba (FLA) pathogen which can cause fatal central nervous system (CNS) infection, granulomatous amoebic encephalitis (GAE) and potentially blinding ocular infection, Acanthamoeba keratitis (AK). Acanthamoeba species remain a challenging protist to treat due to the unavailability of safe and effective therapeutic drugs and their ability to protect themselves in the cyst stage. Natural products and their secondary metabolites play a pivotal role in drug discovery against various pathogenic microorganisms. In the present study, the ethyl acetate extract of Myristica cinnamomea King fruit was evaluated against A. castellanii (ATCC 50492), showing an IC50 of 45.102 ± 4.62 µg/mL. Previously, the bio-guided fractionation of the extract resulted in the identification of three active compounds, namely Malabaricones (A-C). The isolated and thoroughly characterized acylphenols were evaluated for their anti-amoebic activity against A. castellanii for the first time. Among tested compounds, Malabaricone B (IC50 of 101.31 ± 17.41 µM) and Malabaricone C (IC50 of 49.95 ± 6.33 µM) showed potent anti-amoebic activity against A. castellanii trophozoites and reduced their viability up-to 75 and 80 %, respectively. Moreover, both extract and Malabaricones also significantly (p < 0.05) inhibit the encystation and excystation of A. castellanii, while showed minimal toxicity against human keratinocyte cells (HaCaT cells) at lower tested concentrations. Following that, the explanation of the possible mechanism of action of purified compounds were assessed by detection of the state of chromatin. Hoechst/PI 33342 double staining showed that necrotic cell death occurred in A. castellanii trophozoites after 8 h treatment of Malabaricones (A-C). These findings demonstrate that Malabaricones B and C could serve as promising therapeutic options against A. castellanii infections.
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Affiliation(s)
- Usman Ahmed
- Department of Biological Sciences, School of Medical and Life Sciences, Sunway University, Subang Jaya, 47500, Selangor, Malaysia
| | - Yasodha Sivasothy
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, 47500, Selangor, Malaysia
| | - Khalid Mohammed Khan
- H. E. J. Research Institute of Chemistry, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, 75270, Pakistan
| | - Naveed Ahmed Khan
- Microbiota Research Center, Istinye University, Istanbul, 34010, Turkey
| | - Siti Mariam Abdul Wahab
- Faculty of Pharmacy and Health Sciences, Royal College of Medicine Perak, Universiti Kuala Lumpur, Ipoh, 30450, Malaysia
| | - Khalijah Awang
- Department of Chemistry, Faculty of Science, Universiti Malaya, 50603, Kuala Lumpur, Malaysia; Centre for Natural Products and Drug Discovery (CENAR), Universiti Malaya, 50603, Kuala Lumpur, Malaysia
| | - Muhamad Aqmal Othman
- Department of Chemistry, Faculty of Science, Universiti Malaya, 50603, Kuala Lumpur, Malaysia; Centre for Natural Products and Drug Discovery (CENAR), Universiti Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Ayaz Anwar
- Department of Biological Sciences, School of Medical and Life Sciences, Sunway University, Subang Jaya, 47500, Selangor, Malaysia.
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Celis CM, Caburnay IM, Avila FI, Conol HM, Cuevas A, Cunan MA, Blanco JP, Banal KB, Hapan MFZ, Manahan EP, Padua MFFE, Masangkay FR, Milanez GDJ. First report of Acanthamoebae spp. isolation from a volcanic mud spring in the Philippines. JOURNAL OF WATER AND HEALTH 2023; 21:1735-1740. [PMID: 38017603 PMCID: wh_2023_360 DOI: 10.2166/wh.2023.360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
Acanthamoebae spp. is considered highly adaptive. The present study aims to establish the occurrence of free-living amoebae, particularly Acanthamoebae, to exist in extreme environments such as volcanic mud springs. Fifty surface water samples were collected from mud springs (34 samples), and flat rocks (16 samples) were collected, processed, and cultured. After 14 days of incubation, 32 (64%) plates showed positive amoebic growth. Nineteen (55.8%) of these plates came from the mud spring collection site, while 13 (81.2%) samples are from flat rock sources. DNAs from positive samples were made to react to polymerase chain reaction (PCR) using primer sets JDP1 5'GGCCCAGATCGTTTACCGTGAA-3' and JDP2 5'TCTCACAAGCTGCTAGGGAGTCA-3' for cells that resemble Acanthamoebae. Sequencing and basic local alignment search tool (BLAST) revealed a 99% similarity of isolates to Acanthamoebae spp. Identification of Acanthamoebae spp that can survive in higher temperatures is important public health information. The existence of such isolates in the environment has dire health implications, which suggests revisitation of water treatment protocols. Detection of such organisms in environmental sources used for recreational purposes provides information to local and international tourists who frequent them. This will result in the mitigation of potential future infection.
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Affiliation(s)
- Crisselle Marie Celis
- Department of Medical Technology, Faculty of Pharmacy, University of Santo Tomas, Manila 1008, Philippines E-mail:
| | - Isabella Marie Caburnay
- Department of Medical Technology, Faculty of Pharmacy, University of Santo Tomas, Manila 1008, Philippines
| | - Fritz Irish Avila
- Department of Medical Technology, Faculty of Pharmacy, University of Santo Tomas, Manila 1008, Philippines
| | - Hannah Mica Conol
- Department of Medical Technology, Faculty of Pharmacy, University of Santo Tomas, Manila 1008, Philippines
| | - Aleli Cuevas
- Department of Medical Technology, Faculty of Pharmacy, University of Santo Tomas, Manila 1008, Philippines
| | - Maria Angela Cunan
- Department of Medical Technology, Faculty of Pharmacy, University of Santo Tomas, Manila 1008, Philippines
| | - J Piolo Blanco
- Department of Medical Technology, Faculty of Pharmacy, University of Santo Tomas, Manila 1008, Philippines
| | - Kenneth Bryan Banal
- Department of Medical Technology, Faculty of Pharmacy, University of Santo Tomas, Manila 1008, Philippines
| | - Ma Frieda Z Hapan
- Department of Medical Technology, Faculty of Pharmacy, University of Santo Tomas, Manila 1008, Philippines
| | - Edilberto P Manahan
- Department of Medical Technology, Faculty of Pharmacy, University of Santo Tomas, Manila 1008, Philippines
| | - Mark F F E Padua
- Department of Medical Technology, Institute of Allied Health Sciences, Far Eastern University, Manila 1008, Philippines
| | - Frederick R Masangkay
- Department of Medical Technology, Faculty of Pharmacy, University of Santo Tomas, Manila 1008, Philippines
| | - Giovanni D Jesus Milanez
- Department of Medical Technology, Faculty of Pharmacy, University of Santo Tomas, Manila 1008, Philippines
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Milanez GD, Carlos KB, Adao ME, Ayson BB, Dicon AV, Gahol RAM, Lacre SKS, Marquez FPE, Perez AJM, Karanis P. Epidemiology of free-living amoebae infections in Africa: a review. Pathog Glob Health 2023; 117:527-534. [PMID: 36562083 PMCID: PMC10392319 DOI: 10.1080/20477724.2022.2160890] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
FLA-related conditions are a rare medical occurrence. Despite their rarity, they are considered a public health concern for two reasons: the absence of a regular treatment regimen in the case of central nervous system infections and the fast progression of the symptoms leading to fatal outcomes. A total of 358 articles were retrieved from different databases (91 from PubMed, 26 from NCBI, 138 from Academia, 102 from Science Direct, and one from IJMED). 7 (46.6%) clinical cases came from Egypt, 2 (13.3%) cases of FLA infection came from Nigeria, 3 (20%) cases came from the Gambia, and 1 (6.6%) case was reported from African countries like Algeria, Tunisia, South Africa, and Zambia. Medical conditions caused by free-living amoeba are considered significant public health concerns. These ubiquitous organisms can cause both fatal and debilitating health conditions. Immediate diagnosis of cases and proper hygienic practices are necessary to provide direct medical intervention. They may be the key to reducing the morbidity and mortality rates from FLA-acquired infections. Although several government-led initiatives have been implemented to mitigate a plethora of parasitic diseases, the case of FLA-related conditions in African countries has yet to be realized.
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Affiliation(s)
- Giovanni D. Milanez
- Department of Medical Technology, Faculty of Pharmacy, University of Santo Tomas, Manila, Philippines
| | - Karlo B. Carlos
- School of Medicine, Saint Louis University, Baguio, Philippines
| | - Mary Erika Adao
- Department of Medical Technology, Far Eastern University, Manila, Philippines
| | - Bernadette B Ayson
- Department of Medical Technology, Far Eastern University, Manila, Philippines
| | - Ariela V. Dicon
- Department of Medical Technology, Far Eastern University, Manila, Philippines
| | | | | | | | - April Jane M. Perez
- Department of Medical Technology, Far Eastern University, Manila, Philippines
| | - Panagiotis Karanis
- Medical Faculty, University of Cologne, Cologne, Germany
- Department of Basic and Clinical Science, University of Nicosia Medical School, Nicosia, Cyprus
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10
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Azzopardi M, Chong YJ, Ng B, Recchioni A, Logeswaran A, Ting DSJ. Diagnosis of Acanthamoeba Keratitis: Past, Present and Future. Diagnostics (Basel) 2023; 13:2655. [PMID: 37627913 PMCID: PMC10453105 DOI: 10.3390/diagnostics13162655] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/04/2023] [Accepted: 08/09/2023] [Indexed: 08/27/2023] Open
Abstract
Acanthamoeba keratitis (AK) is a painful and sight-threatening parasitic corneal infection. In recent years, the incidence of AK has increased. Timely and accurate diagnosis is crucial during the management of AK, as delayed diagnosis often results in poor clinical outcomes. Currently, AK diagnosis is primarily achieved through a combination of clinical suspicion, microbiological investigations and corneal imaging. Historically, corneal scraping for microbiological culture has been considered to be the gold standard. Despite its technical ease, accessibility and cost-effectiveness, the long diagnostic turnaround time and variably low sensitivity of microbiological culture limit its use as a sole diagnostic test for AK in clinical practice. In this review, we aim to provide a comprehensive overview of the diagnostic modalities that are currently used to diagnose AK, including microscopy with staining, culture, corneal biopsy, in vivo confocal microscopy, polymerase chain reaction and anterior segment optical coherence tomography. We also highlight emerging techniques, such as next-generation sequencing and artificial intelligence-assisted models, which have the potential to transform the diagnostic landscape of AK.
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Affiliation(s)
- Matthew Azzopardi
- Department of Ophthalmology, Royal London Hospital, London E1 1BB, UK;
| | - Yu Jeat Chong
- Birmingham and Midland Eye Centre, Birmingham B18 7QH, UK; (B.N.); (A.R.)
| | - Benjamin Ng
- Birmingham and Midland Eye Centre, Birmingham B18 7QH, UK; (B.N.); (A.R.)
| | - Alberto Recchioni
- Birmingham and Midland Eye Centre, Birmingham B18 7QH, UK; (B.N.); (A.R.)
- Academic Unit of Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, Birmingham B15 2TT, UK
| | | | - Darren S. J. Ting
- Birmingham and Midland Eye Centre, Birmingham B18 7QH, UK; (B.N.); (A.R.)
- Academic Unit of Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, Birmingham B15 2TT, UK
- Academic Ophthalmology, School of Medicine, University of Nottingham, Nottingham NG7 2RD, UK
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11
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Abstract
Infectious keratitis is a rare but potentially severe sight-threatening disease, associated with considerable societal burden, cost and morbidity. This review summarises the most recent evidence for the incidence, risk factors and impact of disease, all of which vary widely according to region, access to health care, socioeconomic and environmental factors, predisposing conditions and causative organisms. The frequency and societal impact of infectious keratitis are significantly higher in low-income countries. In non-viral infectious keratitis, bacterial causes predominate in most regions. Fungi, particularly linked with agricultural trauma, are more frequently associated with infectious keratitis in low-income regions, particularly in India and certain African countries. The disease impact is compounded by poverty and limited access to services and treatment. Early diagnosis, access to appropriate treatment, prophylaxis in ocular trauma, availability of eye protection, awareness of risk factors may be associated with reduced disease severity and vision loss. Evidence for the incidence and burden of disease is lacking in certain regions and well-designed epidemiological studies to identify independent risk factors for the disease and those associated with more severe outcomes may better identify causation and guide resource allocation and preventative strategies.
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Affiliation(s)
- Fiona Stapleton
- School of Optometry and Vision Science, UNSW, Level 3, North Wing, RMB, Gate 14, Barker St, Sydney, NSW, 2052, Australia.
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12
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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: 24] [Impact Index Per Article: 24.0] [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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13
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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: 19] [Impact Index Per Article: 19.0] [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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14
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Campolo A, Pifer R, Walters R, Thomas M, Miller E, Harris V, King J, Rice CA, Shannon P, Patterson B, Crary M. Acanthamoeba spp. aggregate and encyst on contact lens material increasing resistance to disinfection. Front Microbiol 2022; 13:1089092. [PMID: 36601401 PMCID: PMC9806144 DOI: 10.3389/fmicb.2022.1089092] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022] Open
Abstract
Introduction Acanthamoeba keratitis is often caused when Acanthamoeba contaminate contact lenses and infect the cornea. Acanthamoeba is pervasive in the environment as a motile, foraging trophozoite or biocide-resistant and persistent cyst. As contact lens contamination is a potential first step in infection, we studied Acanthamoeba's behavior and interactions on different contact lens materials. We hypothesized that contact lenses may induce aggregation, which is a precursor to encystment, and that aggregated encystment would be more difficult to disinfect than motile trophozoites. Methods Six clinically and/or scientifically relevant strains of Acanthamoeba (ATCC 30010, ATCC 30461, ATCC 50370, ATCC 50702, ATCC 50703, and ATCC PRA-115) were investigated on seven different common silicone hydrogel contact lenses, and a no-lens control, for aggregation and encystment for 72 h. Cell count and size were used to determine aggregation, and fluorescent staining was used to understand encystment. RNA seq was performed to describe the genome of Acanthamoeba which was individually motile or aggregated on different lens materials. Disinfection efficacy using three common multi-purpose solutions was calculated to describe the potential disinfection resistance of trophozoites, individual cysts, or spheroids. Results Acanthamoeba trophozoites of all strains examined demonstrated significantly more aggregation on specific contact lens materials than others, or the no-lens control. Fluorescent staining demonstrated encystment in as little as 4 hours on contact lens materials, which is substantially faster than previously reported in natural or laboratory settings. Gene expression profiles corroborated encystment, with significantly differentially expressed pathways involving actin arrangement and membrane complexes. High disinfection resistance of cysts and spheroids with multi-purpose solutions was observed. Discussion Aggregation/encystment is a protective mechanism which may enable Acanthamoeba to be more disinfection resistant than individual trophozoites. This study demonstrates that some contact lens materials promote Acanthamoeba aggregation and encystment, and Acanthamoeba spheroids obstruct multi-purpose solutions from disinfecting Acanthamoeba.
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Affiliation(s)
| | - Reed Pifer
- Alcon Research, LLC, Fort Worth, TX, United States
| | | | - Megan Thomas
- Alcon Research, LLC, Fort Worth, TX, United States
| | - Elise Miller
- Alcon Research, LLC, Fort Worth, TX, United States
| | | | - Jamie King
- Alcon Research, LLC, Fort Worth, TX, United States
| | - Christopher A. Rice
- Department of Comparative Pathobiology, College of Veterinary Medicine, Purdue University, West Lafayette, IN, United States,Purdue Institute for Drug Discovery (PIDD), Purdue University, West Lafayette, IN, United States,Purdue Institute of Inflammation, Immunology and Infectious Disease (PI4D), Purdue University, West Lafayette, IN, United States
| | - Paul Shannon
- Alcon Research, LLC, Fort Worth, TX, United States
| | | | - Monica Crary
- Alcon Research, LLC, Fort Worth, TX, United States,*Correspondence: Monica Crary,
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15
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McCoy C, Patel S, Thulasi P. Update on the Management of Acanthamoeba Keratitis. CURRENT OPHTHALMOLOGY REPORTS 2022. [DOI: 10.1007/s40135-022-00296-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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16
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Cabrera‐Aguas M, Khoo P, Watson SL. Infectious keratitis: A review. Clin Exp Ophthalmol 2022; 50:543-562. [PMID: 35610943 PMCID: PMC9542356 DOI: 10.1111/ceo.14113] [Citation(s) in RCA: 68] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 05/05/2022] [Accepted: 05/06/2022] [Indexed: 12/29/2022]
Abstract
Globally, infectious keratitis is the fifth leading cause of blindness. The main predisposing factors include contact lens wear, ocular injury and ocular surface disease. Staphylococcus species, Pseudomonas aeruginosa, Fusarium species, Candida species and Acanthamoeba species are the most common causal organisms. Culture of corneal scrapes is the preferred initial test to identify the culprit organism. Polymerase chain reaction (PCR) tests and in vivo confocal microscopy can complement the diagnosis. Empiric therapy is typically commenced with fluoroquinolones, or fortified antibiotics for bacterial keratitis; topical natamycin for fungal keratitis; and polyhexamethylene biguanide or chlorhexidine for acanthamoeba keratitis. Herpes simplex keratitis is mainly diagnosed clinically; however, PCR can also be used to confirm the initial diagnosis and in atypical cases. Antivirals and topical corticosteroids are indicated depending on the corneal layer infected. Vision impairment, blindness and even loss of the eye can occur with a delay in diagnosis and inappropriate antimicrobial therapy.
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Affiliation(s)
- Maria Cabrera‐Aguas
- Save Sight Institute, Discipline of Ophthalmology, Faculty of Medicine and Health The University of Sydney Sydney New South Wales Australia
- Corneal Unit Sydney Eye Hospital Sydney New South Wales Australia
| | - Pauline Khoo
- Save Sight Institute, Discipline of Ophthalmology, Faculty of Medicine and Health The University of Sydney Sydney New South Wales Australia
- Corneal Unit Sydney Eye Hospital Sydney New South Wales Australia
| | - Stephanie L. Watson
- Save Sight Institute, Discipline of Ophthalmology, Faculty of Medicine and Health The University of Sydney Sydney New South Wales Australia
- Corneal Unit Sydney Eye Hospital Sydney New South Wales Australia
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17
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Change in Risk Score and Behaviors of Soft Contact Lens Wearers After Targeted Patient Education. Eye Contact Lens 2022; 48:347-354. [PMID: 35580482 DOI: 10.1097/icl.0000000000000900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To determine if targeted education can influence the behaviors and scores of soft contact lens (SCL) wearers via the Contact Lens Risk Survey (CLRS). METHODS This was a multicenter, prospective, case-control study. Cases were symptomatic red eye SCL wearers (age, 18-39 years), and controls were age , sex, and site matched. Participants completed the CLRS and were provided targeted patient education at three time points: baseline, one, and six months. Change in scores and behaviors were analyzed using the Wilcoxon signed rank test. RESULTS Forty-one cases and 71 controls were analyzed. The mean risk score (mean±SE) from baseline to follow-up improved (reduced) for all participants (-1.96±0.73; P=0.01), mostly driven by the improvement among cases (-2.55±1.32; P=0.05). Case subjects reported a decrease in frequency of wearing lenses while showering (-0.32±0.07; P<0.0001), discarding lens solution (-0.13±0.06; P=0.03), and rinsing lenses with tap water (-0.19±0.08; P=0.02) after targeted education. CONCLUSIONS Targeted patient education can influence some behaviors of SCL wearers, especially those who experienced a red eye event. Further study is needed to determine how to improve other risk behaviors and whether these changes are sustained long term.
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18
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Kaufman AR, Tu EY. Advances in the management of Acanthamoeba keratitis: A review of the literature and synthesized algorithmic approach. Ocul Surf 2022; 25:26-36. [DOI: 10.1016/j.jtos.2022.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 04/10/2022] [Accepted: 04/12/2022] [Indexed: 01/01/2023]
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19
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Das S, D’Souza S, Gorimanipalli B, Shetty R, Ghosh A, Deshpande V. Ocular Surface Infection Mediated Molecular Stress Responses: A Review. Int J Mol Sci 2022; 23:ijms23063111. [PMID: 35328532 PMCID: PMC8952005 DOI: 10.3390/ijms23063111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 03/09/2022] [Accepted: 03/10/2022] [Indexed: 12/16/2022] Open
Abstract
Infection mediated ocular surface stress responses are activated as early defense mechanisms in response to host cell damage. Integrated stress responses initiate the host response to different types of infections and modulate the transcription of key genes and translation of proteins. The crosstalk between host and pathogen results in profound alterations in cellular and molecular homeostasis triggering specific stress responses in the infected tissues. The amplitude and variations of such responses are partly responsible for the disease severity and clinical sequelae. Understanding the etiology and pathogenesis of ocular infections is important for early diagnosis and effective treatment. This review considers the molecular status of infection mediated ocular surface stress responses which may shed light on the importance of the host stress-signaling pathways. In this review, we collated literature on the molecular studies of all ocular surface infections and summarize the results from such studies systematically. Identification of important mediators involved in the crosstalk between the stress response and activation of diverse signaling molecules in host ocular surface infection may provide novel molecular targets for maintaining the cellular homeostasis during infection. These targets can be then explored and validated for diagnostic and therapeutic purposes.
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Affiliation(s)
- Samayitree Das
- GROW Research Laboratory, Narayana Nethralaya Foundation, Bangalore 560 099, India;
| | - Sharon D’Souza
- Cornea and Refractive Services, Narayana Nethralaya, Bangalore 560 010, India; (S.D.); (B.G.); (R.S.)
| | - Bhavya Gorimanipalli
- Cornea and Refractive Services, Narayana Nethralaya, Bangalore 560 010, India; (S.D.); (B.G.); (R.S.)
| | - Rohit Shetty
- Cornea and Refractive Services, Narayana Nethralaya, Bangalore 560 010, India; (S.D.); (B.G.); (R.S.)
| | - Arkasubhra Ghosh
- GROW Research Laboratory, Narayana Nethralaya Foundation, Bangalore 560 099, India;
- Correspondence: (A.G.); (V.D.)
| | - Vrushali Deshpande
- GROW Research Laboratory, Narayana Nethralaya Foundation, Bangalore 560 099, India;
- Correspondence: (A.G.); (V.D.)
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20
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Kim MJ, Chu KB, Lee HA, Quan FS, Kong HH, Moon EK. Detection of Acanthamoeba spp. using carboxylesterase antibody and its usage for diagnosing Acanthamoeba-keratitis. PLoS One 2022; 17:e0262223. [PMID: 34986189 PMCID: PMC8730387 DOI: 10.1371/journal.pone.0262223] [Citation(s) in RCA: 3] [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: 09/30/2021] [Accepted: 12/20/2021] [Indexed: 11/30/2022] Open
Abstract
Contact lens usage has contributed to increased incidence rates of Acanthamoeba keratitis (AK), a serious corneal infection that can lead to blindness. Since symptoms associated with AK closely resemble those incurred by bacterial or fungal keratitis, developing a diagnostic method enabling rapid detection with a high degree of Acanthamoeba-specificity would be beneficial. Here, we produced a polyclonal antibody targeting the carboxylesterase (CE) superfamily protein secreted by the pathogenic Acanthamoeba and evaluated its diagnostic potential. Western blot analysis revealed that the CE antibody specifically interacts with the cell lysates and conditioned media of pathogenic Acanthamoeba, which were not observed from the cell lysates and conditioned media of human corneal epithelial (HCE) cells, Fusarium solani, Staphylococcus aureus, and Pseudomonas aeruginosa. High titers of A. castellanii-specific antibody production were confirmed sera of immunized mice via ELISA, and these antibodies were capable of detecting A. castellanii from the cell lysates and their conditioned media. The specificity of the CE antibody was further confirmed on A. castellanii trophozoites and cysts co-cultured with HCE cells, F. solani, S. aureus, and P. aeruginosa using immunocytochemistry. Additionally, the CE antibody produced in this study successfully interacted with 7 different Acanthamoeba species. Our findings demonstrate that the polyclonal CE antibody specifically detects multiple species belong to the genus Acanthamoeba, thus highlighting its potential as AK diagnostic tool.
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Affiliation(s)
- Min-Jeong Kim
- Department of Biomedical Science, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Ki-Back Chu
- Department of Biomedical Science, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Hae-Ahm Lee
- Medical Research Center for Bioreaction to Reactive Oxygen Species and Biomedical Science Institute, School of Medicine, Graduate school, Kyung Hee University, Seoul, Republic of Korea
| | - Fu-Shi Quan
- Medical Research Center for Bioreaction to Reactive Oxygen Species and Biomedical Science Institute, School of Medicine, Graduate school, Kyung Hee University, Seoul, Republic of Korea
- Department of Medical Zoology, Kyung Hee University School of Medicine, Seoul, Republic of Korea
| | - Hyun-Hee Kong
- Department of Parasitology, Dong-A University College of Medicine, Busan, Republic of Korea
| | - Eun-Kyung Moon
- Department of Medical Zoology, Kyung Hee University School of Medicine, Seoul, Republic of Korea
- * E-mail:
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21
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Nadia BA, Anis M, Ali SM, Ahmed M, Sana R, Mohamed G, Hechemi M, Leila K, Fethi K. Acanthamoeba keratitis in contact lens wearers in a tertiary center of Tunisia, North Africa. Ann Med Surg (Lond) 2021; 70:102834. [PMID: 34567549 PMCID: PMC8449026 DOI: 10.1016/j.amsu.2021.102834] [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: 08/16/2021] [Revised: 09/06/2021] [Accepted: 09/06/2021] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To analyze the epidemiological and clinical features of Acanathamoeba keratitis AK and to assess the risk factors of this corneal infection in contact lens CL wearers in a tertiary center of Tunisia, North Africa. METHODS We carried out a retrospective study between January 2008 and December 2019 in the ophthtalmology department of a referral center, Sousse, Tunisia. A review of the chart of 248 patients using CL and diagnosed with presumed infectious keratitis was done.Socio demographic, risk behaviors and microbiological findings in case of AK were analyzed. The mean follow-up was 18 months (1 month-4 years). RESULTS AK was diagnosed in 29 cases (11.7% of contact lens wearers with infectious keratitis). These 29 cases were analyzed. The mean age at the time of diagnosis was 33, 44 ± 26, 9 years. Almost of the patients (13; 44.82%) used soft monthly disposable contact lenses. Some risk behaviors related to contact lens wearing were found in our study like not washing and drying hands before CL wear, sleeping in CL, topping off, not respecting the adequate replacement frequency and showering or swimming in CL.After treatment, visual acuity improved only in 10 cases (34.48%), remained the same in 11 cases (37.93%) and worsened in 8 cases (27.58%). CONCLUSION Clinicians must suspect AK in each CL wearer with suggestive clinical signs to allow earlier treatment and better prognosis. Public prevention messages that encourage CL wearers to respect the hygiene rules should be broadly applicable to each person using any type of CL, to minimize the risk of AK.
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Affiliation(s)
- Ben Abdesslem Nadia
- Department of Ophthalmology, Farhat Hached Hospital, Faculty of Medicine of Sousse, Sousse, 4000, Tunisia
| | - Mahjoub Anis
- Department of Ophthalmology, Farhat Hached Hospital, Faculty of Medicine of Sousse, Sousse, 4000, Tunisia
| | - Seghaier Mohamed Ali
- Department of Ophthalmology, Farhat Hached Hospital, Faculty of Medicine of Sousse, Sousse, 4000, Tunisia
| | - Mahjoub Ahmed
- Department of Ophthalmology, Farhat Hached Hospital, Faculty of Medicine of Sousse, Sousse, 4000, Tunisia
| | - Romdhani Sana
- Department of Ophthalmology, Farhat Hached Hospital, Faculty of Medicine of Sousse, Sousse, 4000, Tunisia
| | - Ghorbel Mohamed
- Department of Ophthalmology, Farhat Hached Hospital, Faculty of Medicine of Sousse, Sousse, 4000, Tunisia
| | - Mahjoub Hechemi
- Department of Ophthalmology, Farhat Hached Hospital, Faculty of Medicine of Sousse, Sousse, 4000, Tunisia
| | - Knani Leila
- Department of Ophthalmology, Farhat Hached Hospital, Faculty of Medicine of Sousse, Sousse, 4000, Tunisia
| | - Krifa Fethi
- Department of Ophthalmology, Farhat Hached Hospital, Faculty of Medicine of Sousse, Sousse, 4000, Tunisia
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22
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Fabros MRL, Diesta XRS, Oronan JA, Verdejo KS, Garcia JASM, Sophia Romey M, Milanez GDJ. Current report on the prevalence of free-living amoebae (FLA) in natural hot springs: a systematic review. JOURNAL OF WATER AND HEALTH 2021; 19:563-574. [PMID: 34371494 DOI: 10.2166/wh.2021.101] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The occurrence of potentially pathogenic free-living amoebae (FLA) in natural hot springs is considered a public health concern. FLAs are known to cause serious health outcomes to a wide spectrum of mammalian hosts. The present study aimed to provide the distribution of isolated cases of FLAs in hot springs through a systematic review process of available published articles online. Relevant studies are published between January 2010 and January 2020 involving the isolation of Naegleria spp., Acanthamoeba spp., Balamuthia spp., Sappinia spp., and Vermamoeba spp. in natural hot springs in the United States, South America, North America, Europe, Asia, and Africa. Articles were identified through a search of PubMed and Google Scholar databases. Out of 94 articles screened, a total of 20 articles are included in the study with consideration of established inclusion and exclusion criteria. The most common FLAs isolated in hot springs are Acanthamoeba spp. (134; 48.5%) and Naegleria spp. (127; 46.0%). Other FLAs isolated in hot springs include Balamuthia spp. (2; 0.7%) and Vermamoeba spp. (13; 4.7%). FLA in hot springs used for recreational and medical purposes is a potential source of infection. It is recommended that strict surveillance and maintenance of hot springs be implemented to prevent potential future infection.
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Affiliation(s)
| | | | - John Anthony Oronan
- Department of Medical Technology, Far Eastern University, Manila 1015, Philippines E-mail:
| | - Kim Sofia Verdejo
- Department of Medical Technology, Far Eastern University, Manila 1015, Philippines E-mail:
| | | | - Ma Sophia Romey
- Department of Medical Technology, Far Eastern University, Manila 1015, Philippines E-mail:
| | - Giovanni De Jesus Milanez
- Department of Medical Technology, Far Eastern University, Manila 1015, Philippines E-mail: ; Division III (Medical Sciences), National Research Council of the Philippines, Manila, Philippines
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23
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Stapleton F. Contact lens‐related corneal infection in Australia. Clin Exp Optom 2021; 103:408-417. [DOI: 10.1111/cxo.13082] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 03/31/2020] [Indexed: 12/20/2022] Open
Affiliation(s)
- Fiona Stapleton
- School of Optometry and Vision Science, The University of New South Wales, Sydney, Australia,
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24
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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: 43] [Impact Index Per Article: 14.3] [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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25
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Steele KR, Wagner H, Lai N, Zimmerman AB. Gas-Permeable Contact Lenses and Water Exposure: Practices and Perceptions. Optom Vis Sci 2021; 98:258-265. [PMID: 33771955 DOI: 10.1097/opx.0000000000001660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
SIGNIFICANCE This study provides insight into the current recommendations, clinical behaviors, and risk assessments of eye care professionals on the topic of rigid contact lens exposure to tap water. This knowledge may motivate professional organizations to develop initiatives to educate eye care professionals on the dangers of contact lens exposure to water. PURPOSE The purpose of this study was to investigate the practice patterns and risk perceptions of eye care professionals regarding gas-permeable contact lens exposure to tap water. METHODS A branched-logic survey was started by 320 clinicians, vision scientists, and industry personnel and was fully completed by 272 participants. The survey queried participants about their current practices, recommendations, and perceptions of risk regarding exposure of gas-permeable contact lenses to tap water. RESULTS Of those who prescribe gas-permeable contact lenses, 57.4% reported rinsing lenses with tap water, whereas only 32.7% reported engaging in this same behavior in front of patients. Of those who reported never rinsing lenses with tap water, 85.6% indicated that rinsing lenses with water increases infection risk, whereas 52.1% of those who rinse lenses with water reported the same perceived risk (P < .001). Of all participants, 60% indicated that wearing contact lenses while showering increases infection risk, and 50.2% of all participants advised patients to avoid this behavior. CONCLUSIONS A discrepancy exists between perceptions of risk concerning exposure of contact lenses to water and both clinical practices and patient education provided by professionals.
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Affiliation(s)
| | - Heidi Wagner
- The Ohio State University, College of Optometry, Columbus, Ohio
| | - Nicky Lai
- The Ohio State University, College of Optometry, Columbus, Ohio
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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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Crary MJ, Walters R, Shannon P, Gabriel MM. Variables Affecting the Recovery of Acanthamoeba Trophozoites. Pathogens 2021; 10:221. [PMID: 33670669 PMCID: PMC7922685 DOI: 10.3390/pathogens10020221] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 02/15/2021] [Accepted: 02/16/2021] [Indexed: 11/28/2022] Open
Abstract
While the results of Acanthamoeba testing have been extensively published, laboratories conducting such testing are left to develop their own methods in the absence of a standardized methodology. The wide disparity of methods has resulted in equally inconsistent reported results for contact lens care (CLC) products. This study's objective was to determine the source of these discrepancies by evaluating basic Acanthamoeba biology and their impact on antimicrobial efficacy testing, including the ability of a recovery method to stimulate a single trophozoite to proliferate. Antimicrobial efficacy testing was conducted using well-published Acanthamoeba strains, storage conditions, and growth-based recovery methods. To identify variables that influence results, test solutions with low Acanthamoeba disinfection rates were utilized to prevent differences from being masked by high log reductions. In addition, single-cell proliferation assays were executed to understand the growth requirements to stimulate trophozoite propagation in two recovery methods. These studies indicated that both nutrient density (>106 CFU) and the length of plate incubation (at least 14 days) could significantly influence the accurate recovery of trophozoites. Together, this study emphasizes the need to understand how Acanthamoeba trophozoites biology can impact test methods to create divergent results.
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Affiliation(s)
- Monica J. Crary
- R&D Microbiology, Alcon Research, LLC, Fort Worth, TX 76134, USA; (R.W.); (P.S.); (M.M.G.)
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Establishment of an Acanthamoeba keratitis mouse model confirmed by amoebic DNA amplification. Sci Rep 2021; 11:4183. [PMID: 33603075 PMCID: PMC7892866 DOI: 10.1038/s41598-021-83738-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 02/04/2021] [Indexed: 11/08/2022] Open
Abstract
Acanthamoeba castellanii, the causative agent of Acanthamoeba keratitis (AK), occurs mainly in contact lens users with poor eye hygiene. The findings of many in vitro studies of AK, as well as the testing of therapeutic drugs, need validation in in vivo experiments. BALB/c mice were used in this study to establish in vivo AK model. A. castellanii cell suspensions (equal mixtures of trophozoites and cysts) were loaded onto 2-mm contact lens pieces and inserted into mouse eyes that were scratched using an ophthalmic surgical blade under anesthesia and the eyelids of the mice were sutured. The AK signs were grossly observed and PCR was performed using P-FLA primers to amplify the Acanthamoeba 18S-rRNA gene from mouse ocular tissue. The experimental AK mouse model was characterized by typical hazy blurring and melting of the mouse cornea established on day 1 post-inoculation. AK was induced with at least 0.3 × 105 A. castellanii cells (optimal number, 5 × 104), and the infection persisted for two months. The PCR products amplified from the extracted mouse eye DNA confirmed the development of Acanthamoeba-induced keratitis during the infection periods. In conclusion, the present AK mouse model may serve as an important in vivo model for the development of various therapeutic drugs against AK.
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Dean K, Tamrakar S, Huang Y, Rose JB, Mitchell J. Modeling the Dose Response Relationship of Waterborne Acanthamoeba. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2021; 41:79-91. [PMID: 33047815 DOI: 10.1111/risa.13603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 06/30/2020] [Accepted: 07/26/2020] [Indexed: 06/11/2023]
Abstract
This study developed dose response models for determining the probability of eye or central nervous system infections from previously conducted studies using different strains of Acanthamoeba spp. The data were a result of animal experiments using mice and rats exposed corneally and intranasally to the pathogens. The corneal inoculations of Acanthamoeba isolate Ac 118 included varied amounts of Corynebacterium xerosis and were best fit by the exponential model. Virulence increased with higher levels of C. xerosis. The Acanthamoeba culbertsoni intranasal study with death as an endpoint of response was best fit by the beta-Poisson model. The HN-3 strain of A. castellanii was studied with an intranasal exposure and three different endpoints of response. For all three studies, the exponential model was the best fit. A model based on pooling data sets of the intranasal exposure and death endpoint resulted in an LD50 of 19,357 amebae. The dose response models developed in this study are an important step towards characterizing the risk associated with free-living amoeba like Acanthamoeba in drinking water distribution systems. Understanding the human health risk posed by free-living amoeba will allow for quantitative microbial risk assessments that support building design decisions to minimize opportunities for pathogen growth and survival.
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Affiliation(s)
- Kara Dean
- Department of Biosystems and Agricultural Engineering, Michigan State University, East Lansing, MI, USA
| | - Sushil Tamrakar
- Department of Fisheries and Wildlife, Michigan State University, East Lansing, MI, USA
- Freelancer
| | - Yin Huang
- Department of Fisheries and Wildlife, Michigan State University, East Lansing, MI, USA
- Current address: Office of Biostatistics and Epidemiology, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD, USA
| | - Joan B Rose
- Department of Fisheries and Wildlife, Michigan State University, East Lansing, MI, USA
| | - Jade Mitchell
- Department of Biosystems and Agricultural Engineering, Michigan State University, East Lansing, MI, USA
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Mitchell GL, Richdale K, Lam D, Wagner H, Kinoshita BT, Zimmerman AB, Sorbara L, Rosner B. Development of a contact Lens risk survey. Cont Lens Anterior Eye 2020; 44:101383. [PMID: 33281075 DOI: 10.1016/j.clae.2020.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 10/29/2020] [Accepted: 11/09/2020] [Indexed: 11/18/2022]
Abstract
PURPOSE To describe the development and report psychometric properties of the Contact Lens Risk Survey (CLRS) to identify patients at risk for soft contact lens-related complications. METHODS Psychometric properties of the CLRS, a web-based survey with branching logic, were determined using data from 5 multi-site fieldings (n = 1059), including re-fielding to sub groups. Responses from participants with and without an active red eye were used to identify risk factors of a red eye event and calculate an overall risk score. A 6th fielding of the CLRS (n = 171) was used to assess discriminate validity. RESULTS Participants needed 11-12 min to complete the survey with a negligible difference by age. Internal consistency was excellent (Cronbach's α ≥ 0.70) for 3 of the 5 constructs identified by factor analysis. Twelve of the 17 survey items exhibited excellent within-subject repeatability (Kappa ≥ 0.61). Between-subject agreement, assessed in 18-25 year olds, was high for the majority of items, suggesting good generalizability across different populations of SCL wearers. The ability of the model using individual items of the CLRS to discriminate Controls and participants with a red eye was good with an area under the curve of 0.779. CONCLUSION The CLRS tool is a repeatable and valid instrument to standardize documentation of demographic, behavior, and exposure factors which appear to drive the greatest risk of a contact lens related red eye event.
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Affiliation(s)
- G Lynn Mitchell
- Ohio State University, College of Optometry, Columbus, OH, United States.
| | - Kathryn Richdale
- University of Houston, College of Optometry, Houston, TX, United States
| | - Dawn Lam
- Marshall B. Ketchum University, College of Optometry, Fullerton, CA, United States
| | - Heidi Wagner
- Ohio State University, College of Optometry, Columbus, OH, United States
| | - Beth T Kinoshita
- Pacific University, College of Optometry, Forest Grove, OR, United States
| | - Aaron B Zimmerman
- Ohio State University, College of Optometry, Columbus, OH, United States
| | - Luigina Sorbara
- University of Waterloo, School of Optometry, Waterloo, ON, Canada
| | - Bernard Rosner
- Harvard University, T. H Chan School of Public Health, Boston, MA, United States
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31
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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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32
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Khan SA, Lee CS. Recent progress and strategies to develop antimicrobial contact lenses and lens cases for different types of microbial keratitis. Acta Biomater 2020; 113:101-118. [PMID: 32622052 DOI: 10.1016/j.actbio.2020.06.039] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 06/24/2020] [Accepted: 06/25/2020] [Indexed: 12/16/2022]
Abstract
Although contact lenses are widely used for vision correction, they are also the primary cause of a number of ocular diseases such as microbial keratitis (MK), etc. and inflammatory events such as infiltrative keratitis (IK), contact lens acute red eye (CLARE), contact lens-induced peripheral ulcer (CLPU), etc. These diseases and infiltrative events often result from microbial contamination of lens care solutions and lens cases that can be exacerbated by unsanitary lens care and extended lens wear. The treatment of microbial biofilms (MBs) on lens cases and contact lenses are complicated and challenging due to their resistance to conventional antimicrobial lens care solutions. More importantly, MK caused by MBs can lead to acute visual damage or even vision impairment. Therefore, the development of lens cases, lens care solutions, and contact lenses with effective antimicrobial performance against MK will contribute to the safe use of contact lenses. This review article summarizes and discusses different chemical approaches for the development of antimicrobial contact lenses and lens cases employing passive surface modifications, antimicrobial peptides, free-radical fabricating agents, quorum sensing quenchers, antibiotics, antifungal drugs and various metals and coatings with antimicrobial nanomaterials. The benefits and shortcomings of these approaches are assessed, and alternative solutions for future developments are discussed.
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Affiliation(s)
- Shakeel Ahmad Khan
- Center of Super-Diamond and Advanced Films (COSDAF), Department of Chemistry, City University of Hong Kong, 83 Tat Chee Avenue, Kowloon, Hong Kong
| | - Chun-Sing Lee
- Center of Super-Diamond and Advanced Films (COSDAF), Department of Chemistry, City University of Hong Kong, 83 Tat Chee Avenue, Kowloon, Hong Kong.
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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: 18] [Impact Index Per Article: 4.5] [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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Avdagic E, Chew HF, Veldman P, Tu EY, Jafri M, Doshi R, Boggild AK, Reidy JJ, Farooq AV. Resolution of Acanthamoeba Keratitis with Adjunctive Use of Oral Miltefosine. Ocul Immunol Inflamm 2019; 29:278-281. [PMID: 31829774 DOI: 10.1080/09273948.2019.1695853] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Purpose: To report a series of cases demonstrating the resolution of Acanthamoeba keratitis (AK) with adjunctive use of oral miltefosine.Methods: Retrospective case series.Results: The first case was a 27-year-old female who presented with severe pain and photophobia. The diagnosis of AK was made with confocal microscopy, which revealed a significant burden of stromal cysts. After approximately 2 weeks of adjunctive oral miltefosine therapy, there was a severe inflammatory response within the cornea followed by quick resolution of the AK. The second case was a 31-year-old male in whom the diagnosis of AK was confirmed by culture and polymerase chain reaction. Adjunctive oral miltefosine was started 3 months after presentation, leading to a quick resolution.Conclusions: Oral miltefosine may have cysticidal properties and should be considered as adjunctive therapy for the treatment of AK, particularly in cases with a significant burden of cysts or in cases recalcitrant to other treatments.
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Affiliation(s)
- Ema Avdagic
- Department of Ophthalmology and Visual Science, University of Chicago, Chicago, Illinois, USA
| | - Hall F Chew
- Department of Ophthalmology and Vision Science, University of Toronto, Toronto, Canada
| | - Peter Veldman
- Department of Ophthalmology and Visual Science, University of Chicago, Chicago, Illinois, USA
| | - Elmer Y Tu
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Mansab Jafri
- Kansas City University of Medicine and Biosciences, Kansas City, Missouri, USA
| | - Rutvi Doshi
- Department of Ophthalmology and Visual Science, University of Chicago, Chicago, Illinois, USA
| | - Andrea K Boggild
- Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto, Canada.,Tropical Disease Unit, Toronto General Hospital, Toronto, Canada.,Public Health Ontario Laboratory, Public Health Ontario, Toronto, Canada
| | - James J Reidy
- Department of Ophthalmology and Visual Science, University of Chicago, Chicago, Illinois, USA
| | - Asim V Farooq
- Department of Ophthalmology and Visual Science, University of Chicago, Chicago, Illinois, USA
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Khan NA, Anwar A, Siddiqui R. Acanthamoeba Keratitis: Current Status and Urgent Research Priorities. Curr Med Chem 2019; 26:5711-5726. [DOI: 10.2174/0929867325666180510125633] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 01/10/2018] [Accepted: 05/01/2018] [Indexed: 12/13/2022]
Abstract
Background:First discovered in the early 1970s, Acanthamoeba keratitis has remained a major eye infection and presents a significant threat to the public health, especially in developing countries. The aim is to present a timely review of our current understanding of the advances made in this field in a comprehensible manner and includes novel concepts and provides clear directions for immediate research priorities.Methods:We undertook a search of bibliographic databases for peer-reviewed research literature and also summarized our published results in this field.Results:The present review focuses on novel diagnostic and therapeutic strategies in details which can provide access to management and treatment of Acanthamoeba keratitis. This coupled with the recently available genome sequence information together with high throughput genomics technology and innovative approaches should stimulate interest in the rational design of preventative and therapeutic measures. Current treatment of Acanthamoeba keratitis is problematic and often leads to infection recurrence. Better understanding of diagnosis, pathogenesis, pathophysiology and therapeutic regimens, would lead to novel strategies in treatment and prophylaxis.
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Affiliation(s)
- Naveed Ahmed Khan
- Department of Biology, Chemistry and Environmental Sciences, College of Arts and Sciences, American University of Sharjah, University City, Sharjah, United Arab Emirates
| | - Ayaz Anwar
- Department of Biology, Chemistry and Environmental Sciences, College of Arts and Sciences, American University of Sharjah, University City, Sharjah, United Arab Emirates
| | - Ruqaiyyah Siddiqui
- Department of Biology, Chemistry and Environmental Sciences, College of Arts and Sciences, American University of Sharjah, University City, Sharjah, United Arab Emirates
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Contact Lens Versus Non–Contact Lens–Related Corneal Ulcers at an Academic Center. Eye Contact Lens 2019; 45:301-305. [DOI: 10.1097/icl.0000000000000568] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Amoebicidal and Amoebistatic Effects of Artemisia argyi Methanolic Extracts on Acanthamoeba castellanii Trophozoites and Cysts. Acta Parasitol 2019; 64:63-70. [PMID: 30689190 DOI: 10.2478/s11686-018-00009-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Accepted: 11/23/2018] [Indexed: 02/07/2023]
Abstract
PURPOSE : The present study aimed to investigate the amoebicidal and amoebistatic efects of Artemisia argyi leaf methanolic extract by testing the effects on trophozoites and on cysts. We also determined cytotoxic effect, enzymatic and non-enzymatic antioxidant activities, total phenolic, lavonoid and antioxidative contents of A. argyi. METHODS A. argyi was harvested from various geographic sites in Ordu province in Turkey. The fresh leaves were subjected to methanolic extraction. In 100 μl culture, different concentrations of A. argyi methanolic extract (in quantities from 1.2, 2.3, 4.7, 9.4, 18.7, 37.4, 74.8 mg/ml) and the same volume of trophozoite/cyst suspension were mixed for the determination of the amoebicidal activity of the plant extract. Human bronchial epithelial cells were treated with the same concentrations of Artemisia extracts to determine cytotoxic potential. RESULTS Total phenolic and lavonoid contents of the extract were calculated as 261 mg gallic acid/g dry extract and 29 mg quercetin/g dry extract, respectively. Total antioxidant activity was also calculated as 367 mg ascorbic acid/g dry extract. The growth of trophozoites stopped in A. argyi methanolic extract with 50% inhibitory concentrations (IC50)/8 h for 37.4 mg/ ml and 74.8 mg/ml extract solution and had stronger amoebicidal activity on the cysts with IC50/72 h. Artemisia showed stronger inhibitory effects on bronchial epithelial cells at the concentrations of 9.4, 18.7, 37.4 and 74.8 mg/ml. CONCLUSION The study indicated that A. argyi leaf extract has cytotoxic and anti-amoebic activities.
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Acanthamoeba: An Overview of the Challenges to the Development of a Consensus Methodology of Disinfection Efficacy Testing for Contact Lens Care Products. Eye Contact Lens 2018; 44:351-354. [PMID: 29697492 DOI: 10.1097/icl.0000000000000470] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
With the increasing incidence of more pathogens that can cause microbial keratitis (MK), it is necessary to periodically reassess disinfection multipurpose solutions testing requirements to ensure that relevant organisms to challenge them are being used. Current testing protocols have included common pathogens such as Pseudomonas aeruginosa, Staphylococcus aureus, Serratia marcescens, Candida albicans, and Fusarium solani but have omitted less common pathogens such as Acanthamoeba. Specifically, Acanthamoeba sp. has recently been identified as a prevalent cause of MK in certain countries. Developing an appropriate protocol for this unique organism presents a challenge, given its two distinct life stages, methods to grow the organism, encystment techniques, and many other parameters that can affect testing outcomes. Therefore, the appropriate combination of these parameters is crucial to developing a protocol that ensures consistent, accurate results. The FDA has recognized the importance of establishing a standardized testing protocol for this pathogen and embarked on research efforts to provide a recommended testing protocol for testing contact lens care products.
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Risk Factors for Acanthamoeba Keratitis-A Multistate Case-Control Study, 2008-2011. Eye Contact Lens 2018; 44 Suppl 1:S173-S178. [PMID: 28099282 DOI: 10.1097/icl.0000000000000365] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To identify modifiable risk factors contributing to Acanthamoeba keratitis (AK) infection. METHODS A case-control investigation was conducted. Case patients were soft contact lens wearers with laboratory-confirmed AK. Control were soft contact lens wearers ≥12 years of age, with no history of AK. Case patients were recruited from 14 ophthalmology referral centers and a clinical laboratory. Control were matched on state of residence and type of primary eye care provider (ophthalmologist or optometrist). Participants were interviewed using a standardized questionnaire. Univariable and multivariable conditional logistic regression analyses were conducted. Matched odds ratios (mORs) were calculated. RESULTS Participants included 88 case patients and 151 matched control. Case patients were more likely to be aged <25 years (unadjusted mOR 2.7, 95% confidence interval 1.3-5.5) or aged >53 years (mOR 2.5, 1.1-5.7), and more likely to be men (mOR 2.6, 1.4-4.8). Unadjusted analyses identified multiple risk factors: rinsing (mOR 6.3, 1.3-29.9) and storing lenses in tap water (mOR 3.9, 1.2-12.3), topping off solution in the lens case (mOR 4.0, 2.0-8.0), having worn lenses ≤5 years (mOR 2.4, 1.3-4.4), rinsing the case with tap water before storing lenses (mOR 2.1, 1.1-4.1), and using hydrogen peroxide (mOR 3.6, 1.1-11.7) versus multipurpose solution. Significant risk factors in multivariable modeling included age >53 years, male sex, topping off, and using saline solution. CONCLUSIONS Numerous modifiable risk factors for AK were identified, mostly involving hygiene practices. To reduce the risk of AK, lens wearers should observe recommended lens care practices.
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Carnt N, Hoffman JJ, Verma S, Hau S, Radford CF, Minassian DC, Dart JKG. Acanthamoeba keratitis: confirmation of the UK outbreak and a prospective case-control study identifying contributing risk factors. Br J Ophthalmol 2018; 102:1621-1628. [PMID: 30232172 DOI: 10.1136/bjophthalmol-2018-312544] [Citation(s) in RCA: 104] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Revised: 07/27/2018] [Accepted: 08/07/2018] [Indexed: 11/04/2022]
Abstract
BACKGROUND/AIMS Acanthamoeba keratitis (AK) is a chronic debilitating corneal infection principally affecting contact lens (CL) users. Studies were designed to test claims that the UK incidence may have increased in 2012-2014 and to evaluate potential causes. METHODS Annualised incidence data were collected from January 1984 to December 2016. Case-control study subjects were recruited between 14 April 2011 and 05 June 2017. Reusable CL users with AK were recruited retrospectively and prospectively. Controls were reusable CL users, recruited prospectively, with any disorder other than AK. Multivariable analysis of questionnaire data measured independent risk factors for AK. RESULTS The current outbreak of AK started in 2010-2011 with an incidence threefold higher than in 2004-2009. Risk factors for AK were: Oxipol disinfection, CLs made of group IV CL materials, poor CL hygiene, deficient hand hygiene, use of CLs while swimming or bathing, being white British, and for those in social classes 4-9. CONCLUSION AK is a largely preventable disease. The current outbreak is unlikely to be due to any one of the identified risk factors in isolation. Improving CL and hand hygiene, avoiding CLs contamination with water and use of effective CL disinfection solutions, or daily disposable CLs, will reduce the incidence of AK. In the longer-term, water avoidance publicity for CL users can be expected to reduce the incidence further. Ongoing surveillance of AK numbers will identify changes in incidence earlier. Evaluation of Acanthamoeba contamination in end-user drinking water would contribute to our understanding of regional variations in the risk of exposure.
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Affiliation(s)
- Nicole Carnt
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia.,Centre for Vision Research, Westmead Institute for Medical Research, Westmead, Australia.,Corneal and External Disease Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Jeremy J Hoffman
- Corneal and External Disease Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Seema Verma
- Corneal and External Disease Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Scott Hau
- Corneal and External Disease Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Cherry F Radford
- Corneal and External Disease Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | | | - John K G Dart
- Corneal and External Disease Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK .,National Institute of Health Research (NIHR) Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
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Ramirez DA, Porco TC, Lietman TM, Keenan JD. Ocular Injury in United States Emergency Departments: Seasonality and Annual Trends Estimated from a Nationally Representative Dataset. Am J Ophthalmol 2018; 191:149-155. [PMID: 29750945 DOI: 10.1016/j.ajo.2018.04.020] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 04/19/2018] [Accepted: 04/20/2018] [Indexed: 11/25/2022]
Abstract
PURPOSE To determine whether ocular trauma occurs more frequently in the summer months. DESIGN Retrospective, cross-sectional study. METHODS The Nationwide Emergency Department Sample (NEDS) is a large, publicly available administrative database that provides nationally representative estimates of emergency department (ED) visits in the United States. Billing codes from NEDS from 2006 to 2013 were used to identify all cases of ocular trauma, and the United States decennial census was used to estimate the population at risk for visiting an ED. The main outcome measures were the seasonal and annual trends in the incidence of ED-diagnosed eye trauma. RESULTS Eye trauma was the primary diagnosis for an estimated 5 615 532 ED encounters over the 8-year study period. Those with an eye trauma encounter were predominantly male (66%) and under 60 years of age (91%). The most common ocular trauma presentations were superficial injury of eye and adnexa (101 ED-diagnosed cases per 100 000 population), extraocular foreign body (54 per 100 000 population), contusion of eye and adnexa (27 per 100 000 population), and ocular adnexal open wound (26 per 100 000 population). Each exhibited a statistically significant annual cycle, with a mean annual peak between May and July (P < .01 for each, Edwards test). Eye trauma visits decreased by an average of 4% per year over the study period, with a similar pattern of decline during each calendar month (incidence rate ratio 0.96, 95% confidence interval 0.94-0.98). CONCLUSIONS Eye trauma, although decreasing in incidence, is a seasonal condition. Prevention efforts would likely be most effective if implemented in the spring or summer months. Further study to identify other individual-level or regional-level factors that would most benefit from public health efforts is warranted.
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Leal DAG, Souza DSM, Caumo KS, Fongaro G, Panatieri LF, Durigan M, Rott MB, Barardi CRM, Franco RMB. Genotypic characterization and assessment of infectivity of human waterborne pathogens recovered from oysters and estuarine waters in Brazil. WATER RESEARCH 2018; 137:273-280. [PMID: 29550730 DOI: 10.1016/j.watres.2018.03.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 03/02/2018] [Accepted: 03/09/2018] [Indexed: 06/08/2023]
Abstract
Waterborne, food-borne and sewage-borne pathogens are a major global concern, with the annual recurrence, most notably during the summer, of outbreaks of gastroenteritis of unconfirmed etiology associated with recreational activities in marine environments. The consumption of contaminated water-based foodstuffs is also related to outbreaks of human illness. The main goals of the present study were: i) to identify the genetic assemblages of Giardia duodenalis cysts in growing and depurated oysters destined for human consumption on the southern coast of São Paulo, Brazil; ii) to verify the main circulating G. duodenalis assemblages and their subtypes in different brackish waters used for the production of mollusks and for recreational purposes; iii) to track the contamination of growing and depurated oysters by the human adenovirus and identify the infectivity of adenoviral particles recovered from oysters before and after depuration; iv) to evaluate the occurrence and genotype of the free-living amoebae of the genus Acanthamoeba in brackish water and oysters from all the sites described above. Four sampling sites in the Cananeia estuary were selected to search for pathogenic and amphizoic protozoa (Giardia and Acanthamoeba respectively): site 1: oyster growth, site 2: catchment water (before UV depuration procedure), site 3: filter backwash (filtration stage of water treatment) and site 4: oyster depuration tank. Oysters at sites 1 and 4 were evaluated for the presence of adenovirus (HAdV). Analysis consisted of conventional microbiological as well as molecular methods. Giardia duodenalis were detected in all the water sites analyzed and the molecular analysis revealed that sub-assemblage AII was the most frequently distributed throughout the estuarine environment, although one sample was identified as belonging to the assemblage C. Acanthamoeba were also isolated from different locations of the estuarine area, and were detected at all the analyzed sites. The majority of isolates belonged to the T3 genotype, while the T4 genotype was identified once. The sequencing reaction of Giardia duodenalis revealed the contamination of three batches of depurated oysters by the sub-assemblage AII. With respect to viruses, seven batches of oysters (four growing and three depurated) were found to be harboring infectious HAdV particles when submitted to plaque assay. Overall, the results of the sequencing reactions combined with the plaque assay revealed that the isolates of Giardia duodenalis and the infectious HAdV particles identified in oyster tissues have the potential to infect humans and pose a threat if consumed raw or lightly cooked. This is the first report on the sub-assemblage AII identified in oysters which are submitted to a cleaning and disinfection procedure prior to human consumption in Brazil. Acanthamoeba specific genotypes were also identified for the first time in a recreational estuarine area in Brazil, contributing to knowledge of their molecular and environmental epidemiology, which is considered scarce even in marine and estuarine areas of the world.
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Affiliation(s)
- Diego Averaldo Guiguet Leal
- Universidade Federal do Paraná (UFPR), Setor de Ciências Biológicas, Departamento de Patologia Básica, Laboratório de Parasitologia Ambiental, Curitiba, Paraná PO Box: 19031, CEP: 81531-980, Brazil.
| | - Doris Sobral Marques Souza
- Universidade Federal de Santa Catarina (UFSC), Centro de Ciências Biológicas, Departamento de Microbiologia e Parasitologia, Laboratório de Virologia Aplicada, Florianópolis, Santa Catarina CEP: 88040-970, Brazil
| | - Karin Silva Caumo
- Universidade Federal de Santa Catarina (UFSC), Centro de Ciências da Saúde, Departamento de Análises Clínicas, Laboratório de Estudos de Protozoários Emergentes, Florianópolis, Santa Catarina CEP: 88040-970, Brazil; Universidade Federal do Rio Grande do Sul (UFRGS), Instituto de Ciências Básicas da Saúde, Departamento de Microbiologia, Imunologia e Parasitologia, Porto Alegre, Rio Grande do Sul CEP: 900035-190, Brazil
| | - Gislaine Fongaro
- Universidade Federal de Santa Catarina (UFSC), Centro de Ciências Biológicas, Departamento de Microbiologia e Parasitologia, Laboratório de Virologia Aplicada, Florianópolis, Santa Catarina CEP: 88040-970, Brazil
| | - Lua Ferreira Panatieri
- Universidade Federal do Rio Grande do Sul (UFRGS), Instituto de Ciências Básicas da Saúde, Departamento de Microbiologia, Imunologia e Parasitologia, Porto Alegre, Rio Grande do Sul CEP: 900035-190, Brazil
| | | | - Marilise Brittes Rott
- Universidade Federal do Rio Grande do Sul (UFRGS), Instituto de Ciências Básicas da Saúde, Departamento de Microbiologia, Imunologia e Parasitologia, Porto Alegre, Rio Grande do Sul CEP: 900035-190, Brazil
| | - Célia Regina Monte Barardi
- Universidade Federal de Santa Catarina (UFSC), Centro de Ciências Biológicas, Departamento de Microbiologia e Parasitologia, Laboratório de Virologia Aplicada, Florianópolis, Santa Catarina CEP: 88040-970, Brazil
| | - Regina Maura Bueno Franco
- Universidade Estadual de Campinas, Instituto de Biologia, Departamento de Biologia Animal, Laboratório de Protozoologia, Campinas, São Paulo CEP 13083-970, Brazil
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Abstract
PURPOSE To understand soft contact lens (SCL) and gas-permeable (GP) lens wearers' behaviors and knowledge regarding exposure of lenses to water. METHODS The Contact Lens Risk Survey (CLRS) and health behavior questions were completed online by a convenience sample of 1056 SCL and 85 GP lens wearers aged 20 to 76 years. Participants were asked about exposing their lenses to water and their understanding of risks associated with these behaviors. Chi-square analyses examined relationships between patient behaviors and perceptions. RESULTS GP lens wearers were more likely than SCL wearers to ever rinse or store lenses in water (rinsing: 91% GP, 31% SCL, P < 0.001; storing: 33% GP, 15% SCL P < 0.001). Among SCL wearers, men were more likely to store (24% vs. 13%, P = 0.003) or rinse (41% vs. 29%, P = 0.012) their lenses in water. Showering while wearing lenses was more common in SCL wearers (86%) than GP lens wearers (67%) (P < 0.0001). Swimming while wearing lenses was reported by 62% of SCL wearers and 48% of GP lens wearers (P = 0.027). Wearers who rinsed (SCL; P < 0.0001, GP; P = 0.11) or stored lenses in water (SCL; P < 0.0001, GP P = 0.007) reported that this behavior had little or no effect on their infection risk, compared with those who did not. Both SCL (P < 0.0001) and GP lens wearers (P < 0.0001) perceived that distilled water was safer than tap water for storing or rinsing lenses. CONCLUSIONS Despite previously published evidence of Acanthamoeba keratitis' association with water exposure, most SCL, and nearly all GP lens wearers, regularly expose their lenses to water, with many unaware of the risk.
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Xiao A, Dhand C, Leung CM, Beuerman RW, Ramakrishna S, Lakshminarayanan R. Strategies to design antimicrobial contact lenses and contact lens cases. J Mater Chem B 2018; 6:2171-2186. [PMID: 32254560 DOI: 10.1039/c7tb03136j] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Contact lens wear is a primary risk factor for developing ocular complications, such as contact lens acute red eye (CLARE), contact lens-induced peripheral ulcer (CLPU) and microbial keratitis (MK). Infections occur due to microbial contamination of contact lenses, lens cases and lens care solution, which are exacerbated by extended lens wear and unsanitary lens care practices. The development of microbial biofilms inside lens cases is an additional complication, as the developed biofilms are resistant to conventional lens cleaning solutions. Ocular infections, particularly in the case of MK, can lead to visual impairment or even blindness, so there is a pressing need for the development of antimicrobial contact lenses and cases. Additionally, with the increasing use of bandage contact lenses and contact lenses as drug depots and with the development of smart contact lenses, contact lens hygiene becomes a therapeutically important issue. In this review, we attempt to compile and summarize various chemical strategies for developing antimicrobial contact lenses and lens cases by using silver, free-radical producing agents, antimicrobial peptides or by employing passive surface modification approaches. We also evaluated the advantages and disadvantages of each system and tried to provide input to future directions. Finally, we summarize the developing technologies of therapeutic contact lenses to shed light on the future of contact lens applications.
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Affiliation(s)
- Amy Xiao
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland 21218, USA
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Wojtkowiak-Giera A, Derda M, Kosik-Bogacka D, Kolasa-Wołosiuk A, Solarczyk P, Cholewiński M, Wandurska-Nowak E, Jagodziński PP, Hadaś E. Influence of Artemisia annua L. on toll-like receptor expression in brain of mice infected with Acanthamoeba sp. Exp Parasitol 2018; 185:17-22. [PMID: 29317241 DOI: 10.1016/j.exppara.2018.01.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 12/16/2017] [Accepted: 01/05/2018] [Indexed: 01/10/2023]
Abstract
The treatment of acanthamoebiasis is a still a problem. Our previous studies showed that the application of extracts from Artemisia annua L. significantly prolonged the survival of mice infected by Acanthamoeba. This plant has medicinal properties in the treatment of human parasitic diseases. The aim of this study was to evaluate the effects of A. annua on expression of Toll-like receptors (TLRs) 2 and 4 in brain of mice with Acanthamoeba infection. Mice were infected with Acanthamoeba sp. strain Ac309 (KY203908) by intranasal inoculation without and after application of A. annua extract. The administration of extract from A. annua significantly reduced the level of expression of TLR2 and modified the level of expression of TLR4. A. annua extract is a natural substance that is well tolerated in animals and may be considered as a combination therapy in treatment of acanthamoebiasis. Our study suggested that A. annua extract may be used as an alternative therapeutic tool.
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Affiliation(s)
- Agnieszka Wojtkowiak-Giera
- Department of Biology and Medical Parasitology, Poznan University of Medical Sciences, 10 Fredry Street, 61-701 Poznan, Poland
| | - Monika Derda
- Department of Biology and Medical Parasitology, Poznan University of Medical Sciences, 10 Fredry Street, 61-701 Poznan, Poland.
| | - Danuta Kosik-Bogacka
- Department of Biology and Medical Parasitology, Pomeranian Medical University, 72 Powstancow Wielkopolskich Street, 70-111 Szczecin, Poland
| | - Agnieszka Kolasa-Wołosiuk
- Department of Histology and Embryology, Pomeranian Medical University, 71 Powstancow Wielkopolskich Street, 70-111 Szczecin, Poland
| | - Piotr Solarczyk
- Department of Biology and Medical Parasitology, Poznan University of Medical Sciences, 10 Fredry Street, 61-701 Poznan, Poland
| | - Marcin Cholewiński
- Department of Biology and Medical Parasitology, Poznan University of Medical Sciences, 10 Fredry Street, 61-701 Poznan, Poland
| | - Elżbieta Wandurska-Nowak
- Department of Biology and Medical Parasitology, Poznan University of Medical Sciences, 10 Fredry Street, 61-701 Poznan, Poland
| | - Paweł P Jagodziński
- Department of Biochemistry and Molecular Biology, Poznan University of Medical Sciences, 6 Swiecickiego Street, 60-781 Poznań, Poland
| | - Edward Hadaś
- Department of Biology and Medical Parasitology, Poznan University of Medical Sciences, 10 Fredry Street, 61-701 Poznan, Poland
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Refractive Errors & Refractive Surgery Preferred Practice Pattern®. Ophthalmology 2018; 125:P1-P104. [DOI: 10.1016/j.ophtha.2017.10.003] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 10/02/2017] [Indexed: 11/19/2022] Open
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Carnt N, Samarawickrama C, White A, Stapleton F. The diagnosis and management of contact lens-related microbial keratitis. Clin Exp Optom 2017; 100:482-493. [PMID: 28815736 DOI: 10.1111/cxo.12581] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 05/22/2017] [Accepted: 05/27/2017] [Indexed: 01/10/2023] Open
Abstract
Contact lens-associated microbial keratitis poses a diagnostic dilemma for optometrists on two fronts. The distinction between sterile inflammation and microbial infection is often blurred. In addition, there is a requirement with nearly 50 per cent of the Australian and New Zealand optometric profession being therapeutically endorsed, to distinguish between cases of infection that can be managed in the community verses those that require escalation to public hospitals that have access to laboratory diagnostic tools and advanced imaging techniques, such as in vivo confocal microscopy. Pattern recognition and incorporation of knowledge of aetiology and risk factors assists optometrists to decide on optimal management strategies. Skilled optometrists will utilise emerging diagnostic and therapeutic technologies to ensure safe management strategies and better outcomes for these cases.
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Affiliation(s)
- Nicole Carnt
- School of Optometry and Vision Science, The University of New South Wales, Sydney, New South Wales, Australia.,The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia
| | - Chameen Samarawickrama
- The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia
| | - Andrew White
- The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia
| | - Fiona Stapleton
- School of Optometry and Vision Science, The University of New South Wales, Sydney, New South Wales, Australia
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Boost M, Cho P, Wang Z. Disturbing the balance: effect of contact lens use on the ocular proteome and microbiome. Clin Exp Optom 2017; 100:459-472. [PMID: 28771841 DOI: 10.1111/cxo.12582] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Revised: 05/29/2017] [Accepted: 06/05/2017] [Indexed: 12/17/2022] Open
Abstract
Contact lens wear is a popular, convenient and effective method for vision correction. In recent years, contact lens practice has expanded to include new paradigms, including orthokeratology; however, their use is not entirely without risk, as the incidence of infection has consistently been reported to be higher in contact lens wearers. The explanations for this increased susceptibility have largely focused on physical damage, especially to the cornea, due to a combination of hypoxia, mechanical trauma, deposits and solution cytotoxicity, as well as poor compliance with care routines leading to introduction of pathogens into the ocular environment. However, in recent years, with the increasing availability and reduced cost of molecular techniques, the ocular environment has received greater attention with in-depth studies of proteins and other components. Numerous proteins were found to be present in the tears and their functions and interactions indicate that the tears are far more complex than formerly presumed. In addition, the concept of a sterile or limited microbial population on the ocular surface has been challenged by analysis of the microbiome. Ocular microbiome was not considered as one of the key sites for the Human Microbiome Project, as it was thought to be limited compared to other body sites. This was proven to be fallacious, as a wide variety of micro-organisms were identified in the analyses of human tears. Thus, the ocular environment is now recognised to be more complicated and interference with this ecological balance may lead to adverse effects. The use of contact lenses clearly changes the situation at the ocular surface, which may result in consequences which disturb the balance in the healthy eye.
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Affiliation(s)
- Maureen Boost
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong.,Squina International Centre for Infection Control, Hong Kong
| | - Pauline Cho
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong.,Squina International Centre for Infection Control, Hong Kong
| | - Zhaoran Wang
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong
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Carnt N, Montanez VM, Galatowicz G, Veli N, Calder V. Tear Cytokine Levels in Contact Lens Wearers With Acanthamoeba Keratitis. Cornea 2017; 36:791-798. [PMID: 28489721 DOI: 10.1097/ico.0000000000001238] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
PURPOSE To determine differences in key tear film cytokines between mild and severe cases of acanthamoeba keratitis (AK) and control contact lens (CL) wearers. METHODS This was a prospective study of CL wearers with AK attending Moorfields Eye Hospital and control CL wearers from the Institute of Optometry, London. Basal tear specimens were collected by 10-μL capillary tubes (BLAUBRAND intraMark, Wertheim, Germany), and tear protein levels were measured with a multiplex magnetic bead array (Luminex 100; Luminex Corporation, Austin, TX) for cytokines interleukin (IL)-1β, IL-6, IL-8, IL-10, IL-17A, IL-17E, IL-17F, IL-22, and interferon gamma and with enzyme-linked immunosorbent assay (Abcam, Cambridge, United Kingdom) for CXCL2. Severe cases of AK were defined as having active infection for over 12 months and at least 1 severe inflammatory event. RESULTS One hundred and thirty-two tear samples were collected from a total of 61 cases (15 severe and 46 mild-moderate) and 22 controls. IL-8, part of the Toll-like receptor 4 cytokine cascade, was found to be expressed at a detectable level more often in cases of AK than in control CL wearers (P = 0.003) and in higher concentrations in severe cases than in milder forms of the disease (z = -2.35). IL-22, part of the IL-10 family, and a proinflammatory Th17 cytokine, was detected more often in severe cases than in milder forms of AK (P < 0.02). CONCLUSIONS Profiling patients with AK during disease shows differences in cytokine levels between severe and milder disease that may inform clinical management. The Toll-like receptor 4 and IL-10/Th17 inflammatory pathways should be included in further investigations of this disease.
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Affiliation(s)
- Nicole Carnt
- *UCL Institute of Ophthalmology, London, United Kingdom; †Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom; ‡The Westmead Institute for Medical Research, The University of Sydney, Sydney, Australia; and §National Institute of Health Research (NIHR) Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
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