Abstract
Background and aims: Acanthamoeba spp. as opportunistic microorganisms are widespread in a wide range of environmental sources in the world and may cause severe diseases in immune-deficient patients. The aim of this study was to determine the prevalence and genotypes of Acanthamoeba spp. in hemodialysis patients in Shahrekord county of Chaharmahal and Bakhtiari province.Methods: In this cross-sectional study, 79 oral swabs were collected from the mouth of patients with chronic renal disorder undergoing hemodialysis from June to October 2018. The samples were then cultured on non-nutrient agar and examined by Giemsa staining, polymerase chain reaction (PCR), sequencing, and tolerance testing methods.Results: Morphological investigations indicated that 30.4% (24/79) of the subjects were infected with some free-living amoebae (FLA), and the PCR showed that only 3 samples contained Acanthamoeba spp. The sequencing of the latter samples demonstrated that these isolates belonged to T2 and T4 genotypes. After performing the assay tolerance test, 2 of these 3 isolates were related to T4 genotypes representing a high pathogenic potance.Conclusion: The infection of hemodialysis patients with some of Acanthamoeba spp. particularly, the T4 genotype should be considered important for these patients. Therefore, it is recommended that dialysis machines and dialysis units in hospitals be checked and disinfected periodically.
Highlights
Acanthamoeba is a genus of free-living amoebae (FLA) that is widely distributed in different environments including water resources, soil, swimming pools, dust, vegetables, air conditioning systems, and the like
After the Giemsa staining of these samples, 15 cases were similar to the trophozoite and cyst of Acanthamoeba spp. and were a candidate for polymerase chain reaction (PCR) assay in order to confirm Acanthamoeba (Figure 1)
The PCR examination of these samples amplified a fragment with a length of 423 to 460 bp of the 18S rRNA gene corresponding to the Acanthamoeba genus, indicating that 3 (3.8%) isolates were Acanthamoeba spp. (Figure 2)
Summary
Acanthamoeba is a genus of free-living amoebae (FLA) that is widely distributed in different environments including water resources, soil, swimming pools, dust, vegetables, air conditioning systems, and the like This amoeba has been isolated from the clinical samples of humans and animals, including the throat and nasal mucosa of healthy individuals throughout the world.[1,2,3] As an opportunistic pathogen amoeba, some species of Acanthamoeba may cause severe and even fatal diseases such as amoebic keratitis (AK), cutaneous acanthamoebiasis, and fatal granulomatous amoebic encephalitis (GAE) in individuals with intact or weakened immune systems.[4,5] In addition, the FLA can act as a ‘Trojan horse’ for a diverse group of microorganisms called ‘endosymbionts’, including amoeba-resisting bacteria.
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