Abstract

Acanthamoeba Keratitis (AK) can lead to substantial vision loss and morbidity among contact lens wearers. Misdiagnosis or delayed diagnosis is a major factor contributing to poor outcomes of AK. This study aimed to assess the effect of two antibiotics and one anaesthetic drug used in the diagnosis and nonspecific management of keratitis on the autofluorescence patterns of Acanthamoeba and two common bacteria that may also cause keratitis. Acanthamoeba castellanii ATCC 30868, Pseudomonas aeruginosa ATCC 9027, and Staphylococcus aureus ATCC 6538 were grown then diluted in either PBS (bacteria) or ¼ strength Ringer’s solution (Acanthamoeba) to give final concentrations of 0.1 OD at 660 nm or 104 cells/mL. Cells were then treated with ciprofloxacin, tetracycline, tetracaine, or no treatment (naïve). Excitation–emission matrices (EEMs) were collected for each sample with excitation at 270–500 nm with increments in 5 nm steps and emission at 280–700 nm at 2 nm steps using a Fluoromax-4 spectrometer. The data were analysed using MATLAB software to produce smoothed color-coded images of the samples tested. Acanthamoeba exhibited a distinctive fluorescence pattern compared to bacteria. The addition of antibiotics and anaesthetic had variable effects on autofluorescence. Tetracaine altered the fluorescence of all three microorganisms, whereas tetracycline did not show any effect on the fluorescence. Ciprofloxacin produced changes to the fluorescence pattern for the bacteria, but not Acanthamoeba. Fluorescence spectroscopy was able to differentiate Acanthamoeba from P. aeruginosa and S. aureus in vitro. There is a need for further assessment of the fluorescence pattern for different strains of Acanthamoeba and bacteria. Additionally, analysis of the effects of anti-amoebic drugs on the fluorescence pattern of Acanthamoeba and bacteria would be prudent before in vivo testing of the fluorescence diagnostic approach in the animal models.

Highlights

  • Licensee MDPI, Basel, Switzerland.Acanthamoeba keratitis (AK) is a severe sight-threatening condition, predominantly occurring in contact lens wearers [1,2]

  • The primary objective of this study was to assess the autofluorescence pattern of Acanthamoeba castellanii and to examine its differentiating features from two bacterial types that are more commonly isolated from keratitis

  • This study has confirmed that Acanthamoeba can be differentiated from bacteria (i.e., P. aeruginosa and S. aureus) based on its autofluorescence pattern [17] in vitro, and has shown that, for bacteria only, the autofluorescence pattern changed after exposure to ciprofloxacin

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Summary

Introduction

Acanthamoeba keratitis (AK) is a severe sight-threatening condition, predominantly occurring in contact lens wearers [1,2]. Visual outcomes from AK depend on early diagnosis [3]. AK is often misdiagnosed (approximately 50% of the cases), with exacerbation of the infection and vision loss as a result [4]. Culturing of Acanthamoeba in the laboratory is considered the gold standard for diagnosis [5]. Microbial culture is only positive in approximately 55% of cases [6] and a small amount of sample

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