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Borkens Y. The Pathology of the Brain Eating Amoeba Naegleria fowleri. Indian J Microbiol 2024; 64:1384-1394. [PMID: 39282207 PMCID: PMC11399382 DOI: 10.1007/s12088-024-01218-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 02/02/2024] [Indexed: 09/18/2024] Open
Abstract
The genus Naegleria is a taxonomic subfamily consisting of 47 free-living amoebae. The genus can be found in warm aqueous or soil habitats worldwide. The species Naegleria fowleri is probably the best-known species of this genus. As a facultative parasite, the protist is not dependent on hosts to complete its life cycle. However, it can infect humans by entering the nose during water contact, such as swimming, and travel along the olfactory nerve to the brain. There it causes a purulent meningitis (primary amoebic meningoencephalitis or PAME). Symptoms are severe and death usually occurs within the first week. PAME is a frightening infectious disease for which there is neither a proven cure nor a vaccine. In order to contain the disease and give patients any chance to survival, action must be taken quickly. A rapid diagnosis is therefore crucial. PAME is diagnosed by the detection of amoebae in the liquor and later in the cerebrospinal fluid. For this purpose, CSF samples are cultured and stained and finally examined microscopically. Molecular techniques such as PCR or ELISA support the microscopic analysis and secure the diagnosis.
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Affiliation(s)
- Yannick Borkens
- Institut für Pathologie, Charité Campus Mitte, Virchowweg 15, Charité, 10117 Berlin, Germany
- Humboldt-Universität zu Berlin, Unter den Linden 6, 10117 Berlin, Germany
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Malinowski N, Morgan MJ, Wylie J, Walsh T, Domingos S, Metcalfe S, Kaksonen AH, Barnhart EP, Mueller R, Peyton BM, Puzon GJ. Prokaryotic microbial ecology as an ecosurveillance tool for eukaryotic pathogen colonisation: Meiothermus and Naegleria fowleri. WATER RESEARCH 2024; 254:121426. [PMID: 38471203 DOI: 10.1016/j.watres.2024.121426] [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: 11/28/2023] [Revised: 02/21/2024] [Accepted: 03/04/2024] [Indexed: 03/14/2024]
Abstract
Naegleria fowleri has been detected in drinking water distribution systems (DWDS) in Australia, Pakistan and the United States and is the causative agent of the highly fatal disease primary amoebic meningoencephalitis. Previous small scale field studies have shown that Meiothermus may be a potential biomarker for N. fowleri. However, correlations between predictive biomarkers in small sample sizes often breakdown when applied to larger more representative datasets. This study represents one of the largest and most rigorous temporal investigations of Naegleria fowleri colonisation in an operational DWDS in the world and measured the association of Meiothermus and N. fowleri over a significantly larger space and time in the DWDS. A total of 232 samples were collected from five sites over three-years (2016-2018), which contained 29 positive N. fowleri samples. Two specific operational taxonomic units assigned to M. chliarophilus and M. hypogaeus, were significantly associated with N. fowleri presence. Furthermore, inoculation experiments demonstrated that Meiothermus was required to support N. fowleri growth in field-collected biofilms. This validates Meiothermus as prospective biological tool to aid in the identification and surveillance of N. fowleri colonisable sites.
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Affiliation(s)
- Natalia Malinowski
- CSIRO Environment, Floreat Park, WA, Australia; Water Corporation of Western Australia, Leederville, WA, Australia
| | | | - Jason Wylie
- CSIRO Environment, Floreat Park, WA, Australia
| | - Tom Walsh
- CSIRO Environment, Canberra, ACT, Australia
| | - Sergio Domingos
- Water Corporation of Western Australia, Leederville, WA, Australia
| | | | | | - Elliott P Barnhart
- U.S. Geological Survey, Wyoming-Montana Water Science Center, Helena, Montana (MT), USA
| | - Rebecca Mueller
- Centre for Biofilm Engineering, and Thermal Biology Institute, Montana State University, Bozeman, MT, USA
| | - Brent M Peyton
- Centre for Biofilm Engineering, and Thermal Biology Institute, Montana State University, Bozeman, MT, USA
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Maciver SK, Piñero JE, Lorenzo-Morales J. Is Naegleria fowleri an Emerging Parasite? Trends Parasitol 2020; 36:19-28. [DOI: 10.1016/j.pt.2019.10.008] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 10/19/2019] [Accepted: 10/21/2019] [Indexed: 12/20/2022]
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Miller HC, Morgan MJ, Walsh T, Wylie JT, Kaksonen AH, Puzon GJ. Preferential feeding in Naegleria fowleri; intracellular bacteria isolated from amoebae in operational drinking water distribution systems. WATER RESEARCH 2018; 141:126-134. [PMID: 29783165 DOI: 10.1016/j.watres.2018.05.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 05/04/2018] [Accepted: 05/04/2018] [Indexed: 06/08/2023]
Abstract
The amoeba Naegleria fowleri is the causative agent of the highly fatal disease, primary amoebic meningoencephalitis, and estimated to cause 16 deaths per year in the United States alone. Colonisation of drinking water distribution systems (DWDSs) by the N. fowleri is a significant public health issue. Understanding the factors which enable this pathogen to colonise and thrive in DWDSs is critical for proper management. The microbial ecology within DWDSs may influence the ability of N. fowleri to colonise DWDSs by facilitating the availability of an appropriate food source. Using biofilm samples obtained from operational DWDSs, 16S rRNA amplicon metabarcoding was combined with genus-specific PCR and Sanger sequencing of intracellular associated bacteria from isolated amoeba and their parental biofilms to identify Meiothermus chliarophilus as a potential food source for N. fowleri. Meiothermus was confirmed as a food source for N. fowleri following successful serial culturing of axenic N. fowleri with M. chliarophilus or M. ruber as the sole food source. The ability to identify environmental and ecological conditions favourable to N. fowleri colonisation, including the detection of appropriate food sources such as Meiothermus, could provide water utilities with a predictive tool for managing N. fowleri colonisation within the DWDS.
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Affiliation(s)
- Haylea C Miller
- CSIRO Land and Water, Private Bag No.5, Wembley, Western Australia 6913, Australia; School of Biomedical Sciences, University of Western Australia, 35 Stirling Highway, Crawley, Western Australia 6009, Australia
| | - Matthew J Morgan
- CSIRO Land and Water, Black Mountain Laboratories, P.O. Box 1700, Canberra, ACT, 2601, Australia
| | - Tom Walsh
- CSIRO Land and Water, Black Mountain Laboratories, P.O. Box 1700, Canberra, ACT, 2601, Australia
| | - Jason T Wylie
- CSIRO Land and Water, Private Bag No.5, Wembley, Western Australia 6913, Australia
| | - Anna H Kaksonen
- CSIRO Land and Water, Private Bag No.5, Wembley, Western Australia 6913, Australia; School of Biomedical Sciences, University of Western Australia, 35 Stirling Highway, Crawley, Western Australia 6009, Australia
| | - Geoffrey J Puzon
- CSIRO Land and Water, Private Bag No.5, Wembley, Western Australia 6913, Australia.
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Peterson K, Barbel P, Heavey E. Nurse's guide to primary amebic meningoencephalitis. Nursing 2018; 48:42-45. [PMID: 29561369 DOI: 10.1097/01.nurse.0000529806.68041.61] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Kathleen Peterson
- At the College at Brockport, State University of New York, Kathleen Peterson and Elizabeth Heavey are professors of nursing, and Paula Barbel is an assistant professor of nursing
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Miller HC, Wylie JT, Kaksonen AH, Sutton D, Puzon GJ. Competition between Naegleria fowleri and Free Living Amoeba Colonizing Laboratory Scale and Operational Drinking Water Distribution Systems. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2018; 52:2549-2557. [PMID: 29390181 DOI: 10.1021/acs.est.7b05717] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Free living amoebae (FLA), including pathogenic Naegleria fowleri, can colonize and grow within pipe wall biofilms of drinking water distribution systems (DWDSs). Studies on the interactions between various FLA species in biofilms are limited. Understanding the interaction between FLA and the broader biofilm ecology could help better predict DWDS susceptibility to N. fowleri colonization. The aim of this study was to determine if N. fowleri and other FLAs ( Naegleria, Vermamoeba, Willaertia, and Vahlkampfia spp.) cocolonize DWDS biofilm. FLAs commonly isolated from DWDSs ( N. fowleri, V. vermiformis, and N. lovaniensis) were introduced into laboratory-scale biomonitors to determine the impact of these amoebae on N. fowleri's presence and viability. Over 18 months, a single viable amoebae ( N. fowleri, N. lovaniensis, or V. vermiformis) was detected in each biofilm sample, with the exception of N. lovaniensis and N. fowleri, which briefly cocolonized biofilm following their coinoculation. The analysis of biofilm and bulk water samples from operational DWDSs revealed a similar lack of cocolonization with a single FLA detected in 99% ( n = 242) of samples. Interestingly, various Naegleria spp. did colonize the same DWDS locations but at different times. This knowledge furthers the understanding of ecological factors which enable N. fowleri to colonize and survive within operational DWDSs and could aid water utilities to control its occurrence.
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Affiliation(s)
- Haylea C Miller
- CSIRO Land and Water , Private Bag No. 5 , Wembley , Western Australia 6913 , Australia
- School of Biomedical Sciences , University of Western Australia , 35 Stirling Highway , Crawley , Western Australia 6009 , Australia
| | - Jason T Wylie
- CSIRO Land and Water , Private Bag No. 5 , Wembley , Western Australia 6913 , Australia
| | - Anna H Kaksonen
- CSIRO Land and Water , Private Bag No. 5 , Wembley , Western Australia 6913 , Australia
- School of Biomedical Sciences , University of Western Australia , 35 Stirling Highway , Crawley , Western Australia 6009 , Australia
| | - David Sutton
- School of Biomedical Sciences , University of Western Australia , 35 Stirling Highway , Crawley , Western Australia 6009 , Australia
| | - Geoffrey J Puzon
- CSIRO Land and Water , Private Bag No. 5 , Wembley , Western Australia 6913 , Australia
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Waso M, Dobrowsky PH, Hamilton KA, Puzon G, Miller H, Khan W, Ahmed W. Abundance of Naegleria fowleri in roof-harvested rainwater tank samples from two continents. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2018; 25:5700-5710. [PMID: 29230646 DOI: 10.1007/s11356-017-0870-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 11/28/2017] [Indexed: 05/24/2023]
Abstract
Roof-harvested rainwater (RHRW) has been used as an alternative source of water in water scarce regions of many countries. The microbiological and chemical quality of RHRW has been questioned due to the presence of bacterial and protozoan pathogens. However, information on the occurrence of pathogenic amoeba in RHRW tank samples is needed due to their health risk potential and known associations with opportunistic pathogens. Therefore, this study aims to determine the quantitative occurrence of Naegleria fowleri in RHRW tank samples from Southeast Queensland (SEQ), Australia (AU), and the Kleinmond Housing Scheme located in Kleinmond, South Africa (SA). In all, 134 and 80 RHRW tank samples were collected from SEQ, and the Kleinmond Housing Scheme, Western Cape, SA, respectively. Quantitative PCR (qPCR) assays were used to measure the concentrations of N. fowleri, and culture-based methods were used to measure fecal indicator bacteria (FIB) Escherichia coli (E. coli) and Enterococcus spp. Of the 134 tank water samples tested from AU, 69 and 62.7% were positive for E. coli, and Enterococcus spp., respectively. For the SA tank water samples, FIB analysis was conducted for samples SA-T41 to SA-T80 (n = 40). Of the 40 samples analyzed from SA, 95 and 35% were positive for E. coli and Enterococcus spp., respectively. Of the 134 water samples tested in AU, 15 (11.2%) water samples were positive for N. fowleri, and the concentrations ranged from 1.7 × 102 to 3.6 × 104 gene copies per 100 mL of water. Of the 80 SA tank water samples screened for N. fowleri, 15 (18.8%) tank water samples were positive for N. fowleri and the concentrations ranged from 2.1 × 101 to 7.8 × 104 gene copies per 100 mL of tank water. The prevalence of N. fowleri in RHRW tank samples from AU and SA thus warrants further development of dose-response models for N. fowleri and a quantitative microbial risk assessment (QMRA) to inform and prioritize strategies for reducing associated public health risks.
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Affiliation(s)
- Monique Waso
- Department of Microbiology, Faculty of Science, Stellenbosch University, Private Bag X1, Stellenbosch, 7602, South Africa
| | - Penelope Heather Dobrowsky
- Department of Microbiology, Faculty of Science, Stellenbosch University, Private Bag X1, Stellenbosch, 7602, South Africa
| | - Kerry Ann Hamilton
- Drexel University, 3141 Chestnut Street, Philadelphia, PA, 19104, USA
- CSIRO Land and Water, Ecosciences Precinct, 41 Boggo Road, Brisbane, QLD, 4102, Australia
| | - Geoffrey Puzon
- CSIRO Land and Water, Private Bag No.5, Wembley, WA, 6913, Australia
| | - Haylea Miller
- CSIRO Land and Water, Private Bag No.5, Wembley, WA, 6913, Australia
| | - Wesaal Khan
- Department of Microbiology, Faculty of Science, Stellenbosch University, Private Bag X1, Stellenbosch, 7602, South Africa
| | - Warish Ahmed
- CSIRO Land and Water, Ecosciences Precinct, 41 Boggo Road, Brisbane, QLD, 4102, Australia.
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Miller HC, Morgan MJ, Wylie JT, Kaksonen AH, Sutton D, Braun K, Puzon GJ. Elimination of Naegleria fowleri from bulk water and biofilm in an operational drinking water distribution system. WATER RESEARCH 2017; 110:15-26. [PMID: 27974249 DOI: 10.1016/j.watres.2016.11.061] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 10/07/2016] [Accepted: 11/25/2016] [Indexed: 06/06/2023]
Abstract
Global incidence of primary amoebic meningoencephalitis cases associated with domestic drinking water is increasing. The need for understanding disinfectant regimes capable of eliminating the causative microorganism, Naegleria fowleri, from bulk water and pipe wall biofilms is critical. This field study demonstrated the successful elimination of N. fowleri from the bulk water and pipe wall biofilm of a persistently colonised operational drinking water distribution system (DWDS), and the prevention of further re-colonisation. A new chlorination unit was installed along the pipe line to boost the free chlorine residual to combat the persistence of N. fowleri. Biofilm and bulk water were monitored prior to and after re-chlorination (RCl), pre-rechlorination (pre-RCl) and post-rechlorination (post-RCl), respectively, for one year. A constant free chlorine concentration of > 1 mg/L resulted in the elimination of N. fowleri from both the bulk water and biofilm at the post-RCl site. Other amoeba species were detected during the first two months of chlorination, but all amoebae were eliminated from both the bulk water and biofilm at post-RCl after 60 days of chlorination with free chlorine concentrations > 1 mg/L. In addition, a dynamic change in the biofilm community composition and a four log reduction in biofilm cell density occurred post-RCl. The pre-RCl site continued to be seasonally colonised by N. fowleri, but the constant free chlorine residual of > 1 mg/L prevented N. fowleri from recolonising the bulk and pipe wall biofilm at the post-RCl site. To our knowledge, this is the first study to demonstrate successful removal of N. fowleri from both the bulk and pipe wall biofilm and prevention of re-colonisation of N. fowleri in an operational DWDS. The findings of this study are of importance to water utilities in addressing the presence of N. fowleri and other amoeba in susceptible DWDSs.
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Affiliation(s)
- Haylea C Miller
- CSIRO Land and Water, Private Bag No.5, Wembley, Western Australia 6913, Australia; School of Pathology and Laboratory Medicine, University of Western Australia, 35 Stirling Highway, Crawley, Western Australia 6009, Australia
| | - Matthew J Morgan
- CSIRO Land and Water, Black Mountain Laboratories, P.O. Box 1700, Canberra, ACT 2601, Australia
| | - Jason T Wylie
- CSIRO Land and Water, Private Bag No.5, Wembley, Western Australia 6913, Australia
| | - Anna H Kaksonen
- CSIRO Land and Water, Private Bag No.5, Wembley, Western Australia 6913, Australia; School of Pathology and Laboratory Medicine, University of Western Australia, 35 Stirling Highway, Crawley, Western Australia 6009, Australia
| | - David Sutton
- School of Pathology and Laboratory Medicine, University of Western Australia, 35 Stirling Highway, Crawley, Western Australia 6009, Australia
| | - Kalan Braun
- Water Corporation of Western Australia, 629 Newcastle Street, Leederville, Western Australia 6007, Australia
| | - Geoffrey J Puzon
- CSIRO Land and Water, Private Bag No.5, Wembley, Western Australia 6913, Australia.
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