Pathogenic Amoebae Research Articles

A preliminary study on amphizoic amoebae with special reference to their preference for bacterial food

The present study was planned to screen the growth pattern of six different species of pathogenic and non pathogenic amphizoic amoebae viz. Naegleria fowleri, N. gruberi, Acanthamoeba culbertsoni, A. rhysodes, A. polyphaga and A. glebae using six different bacterial species like Escherichia coli (Strain E1 and E2 and E. coli lactose +ve), Proteus, Klebsiella and Pseudomonas as food in their in vitro growth on non-nutrient agar medium. It was observed that out of six amoebae used; the pathogenic N. fowleri and A. culbertsoni were feeding on E. coli (all the strains). Feeding these two species of bacteria, the growth of these two amoebae was luxuriant, but not so good while feeding other strains of bacteria though they fed, survived and formed cysts. The remaining four amoebae were found to feed and survive only on E. coli (all the strain) and formed cysts but showed very poor growth while feeding on other four bacterial strains. It was inferred that E. coli is the most suitable bacterial species for in vitro growth of amphizoic amoebae for various purposes. This also reiterates that there exists a complex inter-relationship between amoebae and bacteria in different habitats.

Proteomic aspects of Parachlamydia acanthamoebae infection in Acanthamoeba spp.

The free-living but facultatively pathogenic amoebae of the genus Acanthamoeba are frequently infected with bacterial endosymbionts that can have a profound influence on the physiology and viability of their host. Parachlamydia acanthamoebae, a chlamydial endosymbiont in acanthamoebae, is known to be either symbiotic or lytic to its host, depending on the ambient conditions, for example, temperature. Moreover, parachlamydiae can also inhibit the encystment process in Acanthamoeba, an essential survival strategy of their host for the evasion of chemotherapeutic agents, heat, desiccation and radiation. To obtain a more detailed picture of the intracellular interactions of parachlamydiae and acanthamoebae, we studied parachlamydial infection in several Acanthamoeba isolates at the proteomic level by means of two-dimensional gel electrophoresis (2DE) and mass spectrometry. We observed that P. acanthamoebae can infect all three morphological subtypes of the genus Acanthamoeba and that the proteome pattern of released P. acanthamoebae elementary bodies was always practically identical regardless of the Acanthamoeba strain infected. Moreover, by comparing proteome patterns of encysting cells from infected and uninfected Acanthamoeba cultures, it was shown that encystment is blocked by P. acanthamoebae at a very early stage. Finally, on 2D-gels of purified P. acanthamoebae from culture supernatants, a subunit of the NADH-ubiquinone oxidoreductase complex, that is, an enzyme that has been described as an indicator for bacterial virulence was identified by a mass spectrometric and bioinformatic approach.

Acanthamoeba castellanii: Cellular changes induced by chlorination

Chlorination is a well-known disinfection method, used in water treatment to inactivate various microorganisms, it induces numerous cellular changes. Even though Acanthamoebae are frequently found in water, the cellular changes induced in Acanthamoebae have not been described in the literature. Acanthamoebae are pathogenic amoebae and may provide a reservoir for pathogenic bacteria such as Legionella pneumophila; it is consequently important to understand the response of this amoeba to chlorination, and our study was indeed aimed at examining cellular changes in Acanthamoebae following chlorination. Acanthamoeba trophozoites were treated at various chlorine concentrations (1–5 mg/L). A 3-log reduction in Acanthamoebae population was achieved with 5 mg/L of free chlorine. Confocal microscopy and flow cytometry experiments indicated that chlorination induced cell permeabilization, size reduction and likely intracellular thiol concentration. Our data show that among the non-cultivable cells some remained impermeabilized (negative staining with propidium iodide), thereby suggesting that these cells might remained viable. A similar state is described in other microorganisms as a VBNC (viable but not cultivable) state. Electron microscopy observations illustrate drastic morphological changes: the pseudopods disappeared and subcellular components, such as mitochondrion, were pronouncedly affected. In conclusion, depending on the concentration used, chlorination leads to many cellular effects on Acanthamoeba that could well arise in cell inactivation.

Occurrence of small free-living amoebae from natural water resources

Small free-living amoebae are also called as amphizoic amoebae, because of their capability to exist both as free-living as well as opportunistically pathogenic. Some of the species of Naegleria and Acanthamoeba are known to cause fatal disease (Primary Amoebic Meningoencephalitis= PAM and Granulomatous Amoebic Encephalitis= GAE) of central nervous system affecting brain and amoebic keratitis affecting eyes. The purpose of our study was to find out whether small free-living amoebae were also found in natural resource of water such as river and pond from Lucknow region. A total 68 samples of water were collected from six different sites of Gomti River and four different ponds from Lucknow city. A total 38 samples were found to be positive for small free-living amoebae. The most common amoebae present were species of Naegleria, Schizopyrenus, Acanthamoeba, Hartmennella and Vannella. Out of total 47 water samples from Gomti River, 27 samples were positive for amoebae and out of 21 samples of ponds examined 11 were found to be positive. The occurrence of these amoebae in natural water sources such as river and pond in Lucknow region poses a threat to human being for meddling with water without taking adequate care. Since the pathogenic strains of amoebae are known to infect human being via nasal route during swimming and/or via. cut in the skin/ body via haematogenous route. Exposure of eyes with contaminated water may cause amoebic keratitis in human being. A great awareness among masses is essential to educate about these new amoebic disease. their possible preventive measures and occurrence of these pathogenic amoebae from natural water resources.

Acanthamoeba Interaction with Extracellular Matrix Glycoproteins: Biological and Biochemical Characterization and Role in Cytotoxicity and Invasiveness

Acanthamoeba are free-living amoebae that are dispersed in most environments. Occasionally, Acanthamoeba cause serious human infections, such as keratitis and encephalitis. During the infection process, amoebic adhesion to, and degradation of, host cells and their extracellular matrix (ECM) appear to be important requirements. We examined the interaction of Acanthamoeba with the ECM, and related this event to host cell destruction and tissue invasion. Pathogenic Acanthamoeba culbertsoni differentially attached on the ECM glycoproteins laminin-1, collagen-I, and fibronectin, as compared with non-pathogenic Acanthamoeba astronyxis. Binding to collagen-I and laminin-1 induced A. culbertsoni to become flattened and elongated. Because attachment on laminin-1 was higher in A. culbertsoni, laminin-1 was chosen for further analysis. A 55-kDa laminin-binding protein was identified in pathogenic amoebae, but it was not found in non-pathogenic amoebae. No differential cytotoxicity against distinct cell types was observed between A. culbertsoni incubated with or without ECM. On the other hand, binding on collagen-I or matrigel scaffolds induced a differential effect where A. culbertsoni invaded collagen-I matrices more rapidly. These results indicate that ECM recognition, as an antecedent to tissue invasion, may be a trait characteristic of pathogenic Acanthamoeba.

Development of a liquid chromatography-based screening methodology for proteolytic enzyme activity

A new methodology for the detection and isolation of serine proteases in complex mixtures has been developed. It combines the characterization of crude samples by electrospray tandem mass spectrometry (ESI-MS/MS) in a multi-substrate assay and the differentiated sensitive detection of the responsible enzymes by means of liquid chromatography hyphenated online to biochemical detection (BCD). First, active samples are identified in the multi-substrate assay monitoring the conversion of eight substrates in multiple reaction monitoring in parallel within 60 s. Hereby, the product patterns are investigated and the suitable peptide as substrate for BCD analysis is selected. Subsequently, the active proteases are identified online in the continuous-flow reactor serving as BCD after non-denaturing separation by size-exclusion chromatography and ion-exchange chromatography. For BCD, the selected para-nitroaniline ( pNA) labeled peptide is added post-column and is cleaved by eluting proteases under release of the coloured pNA in a reaction coil (reaction time 5 min). The method was optimized and the figures of merit were characterized with trypsin and chymotrypsin serving as the model proteases. For trypsin, a limit of detection in LC–BCD of 0.1 U/mL corresponding to an injected amount of 0.4 ng protein (∼18 fmol) was observed. The BCD signal remained linear for an injected enzyme concentration of 0.3–10 U/mL (1.3–42 ng enzyme). The method was applied to the characterization of the crude venom of the pit viper Bothrops moojeni and the extracellular protease of the pathogenic amoeba Acanthamoeba castellanii. In the two samples, fractions with proteolytic activity potentially interfering with the blood coagulation cascade were identified. The described methodology represents a tool for serine protease screening in complex mixtures by a fast ESI-MS/MS identification of active samples followed by the separation and isolation of active sample constituents in LC–BCD.

Gene silencing of nfa1 affects the in vitro cytotoxicity of Naegleria fowleri in murine macrophages

The gene nfa1 was isolated from the free-living pathogenic amoeba Naegleria fowleri. The protein Nfa1 is located in pseudopodia and specifically in food-cups. It is also involved in cytotoxicity. In this study, we used synthetic small interfering RNAs (siRNA) to examine the effects of nfa1 down-regulation. We observed the expression of nfa1 mRNA and Nfa1 protein using Northern and Western blots. We also examined the effects of nfa1 down-regulation on the in vitro cytotoxicity of N. fowleri. Four synthetic siRNAs were constructed, and of those, sinfa1-1 showed the highest down-regulation of an nfa1 mRNA and Nfa1 protein by 70 and 43%, respectively. In order to achieve long-lasting silencing of the transfected genes, we constructed two vectors which were pAct/SAGAH and pAct/asnfa1AGAH cloned with the sinfa1-1 and an antisense RNA to the nfa1 gene. In N. fowleri transfected with pAct/SAGAH, FACS revealed a 60 and 57% reduction in nfa1 mRNA and Nfa1 protein levels, respectively. To determine whether the Nfa1 proteins were related with in vitro cytotoxicity, LDH assays were used and showed that the cytotoxicity of these transfectants to macrophages was reduced by 26.4 and 36.2% at 17 and 24h, respectively. Moreover, after transfection with pAct/asnfa1AGAH, amoebic cytotoxicity decreased by 8.2 and 10% at 17 and at 24h, respectively. This is the first report to show the RNA interference in N. folweri trophozoites and also demonstrate the Nfa1 function in vitro for its cytotoxicity.

The role of free-living pathogenic amoeba in the transmission of leprosy: a proof of principle

Leprosy transmission remains poorly understood, though, prolonged skin contact and/or infection via nasal mucosa, are considered likely. Problematic in any transmission hypothesis is the fastidious nature of Mycobacterium leprae outside its host cell and the requirement for temporary survival in the environment, soil or water. Experiments were carried out to test the hypothesis that free living pathogenic amoeba might serve as host cells for M. leprae, protecting them from adverse environmental conditions. In this study we employed cultures of Acanthamoeba castellanii, a free-living pathogenic soil amoeba, to determine whether these protozoa can ingest M. leprae and whether the intracellular bacilli remain viable. More than 90% of cultured amoeba ingested M. leprae at a 20:1 multiplicity of infection while the infected amoebae thrived and multiplied normally. The ingested M. leprae were not degraded and remained viable for at least 72 hours as determined by their metabolic activity (radiorespirometry) and cell wall integrity (viability staining). M. leprae isolated from infected amoebae multiplied at the same rate as freshly harvested bacilli in the foot pads of nu/nu mice. These findings provide proof of principle that free-living pathogenic amoebae are capable of ingesting and supporting the viability of M. leprae expelled into the environment. Studies are underway to determine whether M. leprae-infected A. castellanii and other pathogenic amoebae may also play a role in transporting leprosy bacilli through broken skin or the nasal mucosa.

Wastewater Disinfection Using Ozone to Remove Free-Living, Highly Pathogenic Bacteria and Amoebae

This project set out to determine the effectiveness of ozone as a disinfectant against highly resistant micro-organisms in wastewaters. An ozone dose of 51.5 mg/L for different lengths of time and at pH 5 and 7 was applied to both synthetic and natural samples of V. cholerae and S. typhi bacteria and the Acanthamoeba protozoa, as well as to biological pollution indicators such as total coliform (TC) and fecal coliform (FC) bacteria. Simultaneous analysis was also made of various physical-chemical parameters that might interfere with the disinfection process. Results showed at 14 minutes, all bacteria and amoeba were completely destroyed. Results also demonstrated a clear reduction in some physical/chemical parameters.

Invasive Amebiasis in Men Who Have Sex with Men, Australia

Entamoeba histolytica is a pathogenic ameba that has recently been recognized as an emerging pathogen in men who have sex with men (MSM) in Asia-Pacific countries where it is not endemic, i.e., Japan, Taiwan, and Republic of Korea. We report locally acquired invasive amebiasis in Sydney, Australia, exclusively in MSM.

Drug Effects on Drug Targets: Inhibition of Enzymes by Neuroleptics, Antimycotics,Antibiotics and Other Drugs on Human Pathogenic Amoebas and their Antiproliferative Effects

This paper reviews the inhibition of various enzymes by neuroleptics, anti-mycotics, antibiotics and other drugs on three species of human pathogenic amoebas, mainly Entamoeba histolytica, Acanthamoeba polyphaga and Naegleria fowleri, and their antiproliferative effects. A recent patent registered by Philip relates to the combination of an antibacterial formulation and antifungal agent for producing a therapeutically effective quantity of an antimicrobial that is suitable for suppressing or treating fungal growth. The rationale behind this patent focused on essential and valid targets with a description of the main pathogenic characteristics of these amoebas. The study of new targets, such as trypanothione and trypanothione reductase, and the drug effects of selected agents were arranged into six main groups: A) Inhibition of disulfide reducing enzymes by neuroleptics, antimycotics and antibiotics; B) Comparative evaluation of the efficacies of several drugs with antiproliferative activities; C) Inhibition of the enzymes for the synthesis of trypanothione, such as ornithine decarboxylase, spermidine synthase and trypanothione synthetase; D) Inhibition of the glycolytic enzyme PPi-dependent phosphofructokinase (PFK) from Entamoeba and Naegleria by pyrophosphate analogues, different from the host enzyme; E) Inhibition of enzymes secreted by these parasites to invade the human host, for example cysteine proteinases; and F) Inhibition of encystment pathways and cyst-wall assembly proteins.

The Ameba Balamuthia mandrillaris Feeds by Entering into Mammalian Cells in Culture

Microscopic observations of live cultures of the pathogenic ameba Balamuthia mandrillaris and mammalian cells showed that amebic feeding involved the invasion of the pseudopodia, and/or the whole ameba into the cells. The ameba, recognized by their size and flow of organelles in the cytosol, was seen to extend the tip of a pseudopodium into the cytoplasm of a cell where it moved about leaving visible damage when retracted. In rounded cells, whole amebas were seen to enter into and move around before exiting a cell and then remain quiescent for hours. The invaded mammalian cells retained their turgidity and excluded vital dyes until only their denuded nuclei remained. The cytoplasm of the cells was consumed first, then the nuclei, but not their mitotic chromosomes. The feeding pattern of four isolates of B. mandrillaris, two from humans and two from soil samples, was by amebic invasion into the mammalian cells. The resulting ameba population included cysts, amebas on the surface, and free-floating amebas as individuals or in dense-packed clusters. There was no morphologic indication of a cytopathic change in the mammalian cells before their invasion by the amebas. Feeding by cell invasion is a distinctive feature of B. mandrillaris.

PROFILES OF A PATHOGENIC ENTAMOEBA HISTOLYTICA–LIKE VARIANT WITH VARIATIONS IN THE NUCLEOTIDE SEQUENCE OF THE SMALL SUBUNIT RIBOSOMAL RNA ISOLATED FROM A PRIMATE (DE BRAZZA'S GUENON)

A pathogenic Entamoeba histolytica-like variant (JSK2004) with genetic variations and a novel isoenzyme pattern was isolated from a De Brazza's guenon. A homology of 99.1% was found between the clones of E. histolytica (HM-1:IMSS) and JSK2004 in the 1,893 nucleotide bases of the small subunit rRNA (SSU-rRNA) gene. The DNA of the pathogenic amoeba species was also extracted from two sterile liver abscesses during the autopsies of an Abyssinian colobus and a Geoffroy's spider monkey occurring in the same institution in which JSK2004 was isolated, and the homology of the nucleotide sequences in the SSU-rRNA gene of the DNAs was identical to that of JSK2004.

Balamuthia mandrillaris amebic encephalitis

Amebic encephalitis caused by Balamuthia spp is an increasingly recognized chronic granulomatous central nervous system infectious process, which may affect both immunocompetent and immunocompromised individuals. The course of the disease is insidious and fatal in most cases, mainly due to delayed diagnosis, difficulty in isolation and/or identification of the organism, and lack of well-established amebicidal therapeutic regimens. This article reviews the clinicopathologic characteristics of infections caused by Balamuthia mandrillaris compared to other pathogenic free-living amebae and summarizes the latest diagnostic and therapeutic advances in infections caused by Balamuthia spp.

Biological characterization of a clinical and an environmental isolate of Acanthamoeba polyphaga: analysis of relevant parameters to decode pathogenicity

Acanthamoeba spp. consists of free-living amoebae, widespread in nature, which occasionally can cause human infections including granulomatous amoebic encephalitis and amoebic keratitis. Acanthamoeba pathogenesis is not entirely known and correlations between pathogenic potential and taxonomy are complex issues. In order to decipher the definition of a pathogenic amoeba, the objective of this work was to decipher the definition of pathogenic amoeba by characterizing two isolates of Acanthamoeba polyphaga obtained from different origins (a keratitis patient and freshwater), looking for differences among them. The clinical isolate grew faster in Peptone-yeast extract-glucose (PYG) medium, transformed more rapidly from a trophozoite to cyst and exhibited increased cytopathic effect on cultured cells. Morphological differences were also noted, since freshwater amoebae presented more acanthopodia than the clinical isolate. Moreover, actin labeling demonstrated that microfilament organization varies between isolates, with the presence of locomotory structures as lobopodia and lamellipodia in the keratitis isolate, which were less adherent on plastic. Zymography demonstrated that the keratitis isolates presented higher proteolytic activity and also were more able to invade collagen matrices. Altogether, we conclude that a group of stable physiological characteristics exist in Acanthamoeba that can be related to pathogenicity.

Rationale for the Design of Shortened Derivatives of the NK-lysin-derived Antimicrobial Peptide NK-2 with Improved Activity against Gram-negative Pathogens

The peptide NK-2 is an effective antimicrobial agent with low hemolytic and cytotoxic activities and is thus a promising candidate for clinical applications. It comprises the alpha-helical, cationic core region of porcine NK-lysin a homolog of human granulysin and of amoebapores of pathogenic amoeba. Here we visualized the impact of NK-2 on Escherichia coli by electron microscopy and used NK-2 as a template for sequence variations to improve the peptide stability and activity and to gain insight into the structure/function relationships. We synthesized 18 new peptides and tested their activities on seven Gram-negative and one Gram-positive bacterial strains, human erythrocytes, and HeLa cells. Although all peptides appeared unordered in buffer, those active against bacteria adopted an alpha-helical conformation in membrane-mimetic environments like trifluoroethanol and negatively charged phosphatidylglycerol (PG) liposomes that mimick the cytoplasmic membrane of bacteria. This conformation was not observed in the presence of liposomes consisting of zwitterionic phosphatidylcholine (PC) typical for the human cell plasma membrane. The interaction was paralleled by intercalation of these peptides into PG liposomes as determined by FRET spectroscopy. A comparative analysis between biological activity and the calculated peptide parameters revealed that the decisive factor for a broad spectrum activity is not the peptide overall hydrophobicity or amphipathicity, but the possession of a minimal positive net charge plus a highly amphipathic anchor point of only seven amino acid residues (two helical turns).

Transcriptional and secretory responses of Entamoeba histolytica to mucins, epithelial cells and bacteria

Invasive intestinal amebiasis, caused by Entamoeba histolytica, is initiated with attachment of trophozoites to the colonic mucous layer, mucous disruption and/or depletion, and adherence to and cytolysis of host epithelial and inflammatory cells. A current working model of intestinal amebiasis suggests that the microenvironment of the host intestine, particularly intestinal mucins and the bacterial biofilm, may influence the behavior of pathogenic amebae. The invasive phenotype is dependent on expression of a number of virulence factors of which cysteine proteases provide the most convenient experimental probe because their activity is readily monitored. In the present study, we examined the interaction of E. histolytica with GalNAc, mucin, different epithelial cell lines and bacteria both by biochemical assays of protease release and transcriptional profiling using a previously validated genomic microarray. A significant down-regulation of released cysteine protease activity was observed when amebic trophozoites were grown with GalNAc, specific colonic cell lines and bacteria. Transcriptional profiling during GalNAc interaction revealed enhanced expression of the 170-kDa Gal/GalNAc lectin. Decreased protease activity during GalNAc interaction and enhanced expression of the Gal/GalNAc lectin gene are consistent with a program of commensal infection and mucus coat colonization mediated by the lectin. The down-regulation of cysteine protease activity following interaction with a colonic epithelial cell line parallels the presence of secretory mucin having a complex carbohydrate structure rich in Gal and GalNAc. In contrast, interaction of E. histolytica trophozoites with stomach porcine mucin enhanced cysteine protease (EhCP1 and EhCP2) secretion 3-fold. This suggests the specific composition of mucins may affect the Entamoeba phenotype. Transcriptional profiling revealed interaction of Entamoeba with intestinal bacteria induced protein kinase, ABC transporter, Rab family GTPase and hsp 90 gene expression. The enhanced expression of this gene cluster is consistent with enhanced phagocytosis of E. histolytica during interaction with bacteria.

Free-living Acanthamoeba and Naegleria spp. amebae in water sources of León, Nicaragua

Free-living amebae (FLA) are known to occur worldwide in water-related biotopes, but only limited information is available on these organisms in developing countries and so far no information on their presence is available from Nicaragua. The aims of this study were to evaluate the prevalence of potentially pathogenic Acanthamoeba spp. and Naegleria spp. in different water sources to which the population of Le6n municipality is exposed. Since pathogenic amebae are thermotolerant, we were especially interested in the occurrence of FLA in geothermal areas. Water samples were collected from Le6n area in Nicaragua: 88 samples were from rivers and springs, 111 from wells, 74 from water taps and 21 from water tanks in urban and suburban Le6n and from three nearby geothermal areas of San Jacinto, Posoltega and Tipitapa. Amebae were identified using morphological and physiological criteria, immunohistochemical staining procedures and molecular methods. Indirect immunofluorescent test was performed on cysts and trophozoites fixed on microscopical slides and incubated for 30 min at room temperature in separate experiments with the following antibodies: rabbit-anti N fowleri/N lovanensis (Nf-Pab), mouse monoclonal antibody anti N. fowleri (Nf-5D12u), rabbit antibodies against Acanthamoeba spp. And fluorescent in situ hybridization (FISH) was performed using 18S rRNA-targeted fluorescent oligonucleotide probes. Probes: GSP for the detection of Acanthamoeba and NAEG1088 for the detection of Naegleria. Free-living amebae were recovered from approximately 43 % of the samples. Acanthamoeba spp was found in 21% of samples from León municipality and in 2% of samples from geothermal areas. Amoeboflagellates were found in 10 % of samples from Le6n and in 19% in geothermal areas. Fifty three percent of tested wells in the geothermal area contained thermotolerant amoeboflagellates. Naegleria spp. was identified in 24 out of 39 (61.5 %) of isolated amoeboflagellates. Twelve of them were assigned to N. lovanenesis while none of the isolates could be identified as N fowleri. However, the common presence of thermotolerant Naegleria in water, specially N. lovanensis, which is an indicator species for N. fowleri, suggests that also this pathogenic amoeba may pose a risk to public health in the area. On the other side, direct pathogenicity, free-living amebae are receiving increasing attention as reservoirs and potential vehicles for the transmission of bacteria in the environment. Thus the information provided in this study may serve as base-line for future studies on the role of free-living amebae e.g. in waterborne-disease outbreaks in the region. Among such potentially important enteropathgens are Vibrio cholerae, E. coli 0157, and Helicobacterpylori.

A novel nested multiplex polymerase chain reaction (PCR) assay for differential detection of Entamoeba histolytica, E. moshkovskii and E. dispar DNA in stool samples

BackgroundE. histolytica, a pathogenic amoeba, is indistinguishable in its cyst and trophozoite stages from those of non-pathogenic E. moshkovskii and E. dispar by light microscopy. We have developed a nested multiplex PCR targeting a 16S-like rRNA gene for differential detection of all the three morphologically similar forms of E. histolytica, E. moshkovskii and E. dispar simultaneously in stool samples.ResultsThe species specific product size for E. histolytica, E. moshkovskii and E. dispar was 439, 553 and 174 bp respectively, which was clearly different for all the three Entamoeba species. The nested multiplex PCR showed a sensitivity of 94% and specificity of 100% for the demonstration of E. histolytica, E. moshkovskii and E. dispar DNA in stool samples. The PCR was positive for E. histolytica, E. moshkovskii and E. dispar in a total of 190 out of 202 stool specimens (94% sensitive) that were positive for E. histolytica/E. dispar/E. moshkovskii by examination of stool by microscopy and/or culture. All the 35 negative control stool samples that were negative for E. histolytica/E. dispar/E. moshkovskii by microscopy and culture were also found negative by the nested multiplex PCR (100% specific). The result from the study shows that only 34.6% of the patient stool samples that were positive for E. histolytica/E. dispar/E. moshkovskii by examination of stool by microscopy and/or culture, were actually positive for pathogenic E. histolytica and the remaining majority of the stool samples were positive for non-pathogenic E. dispar or E. moshkovskii as demonstrated by the use of nested multiplex PCR.ConclusionThe present study reports a new nested multiplex PCR strategy for species specific detection and differentiation of E. histolytica, E. dispar and E. moshkovskii DNA in stool specimens. The test is highly specific, sensitive and also rapid, providing the results within 12 hours of receiving stool specimens.

Oral infection of immunocompetent and immunodeficient mice with Balamuthia mandrillaris amebae

Balamuthia mandrillaris is an opportunistic agent of lethal granulomatous amebic encephalitis (GAE). In mice, we have shown that intranasally instilled B. mandrillaris amebae infect the brain via the olfactory nerve pathway. In this study, we raised the question whether this ameba might also reach the brain after an oral/gastrointestinal infection. Immunocompetent (WT) and immunodeficient (RAG) mice received B. mandrillaris amebae by gavage into the esophagus. Mice of both groups became ill and some died (WT 20%, RAG 40%) within 42 days. All orally infected mice revealed B. mandrillaris amebae in the central nervous system. Outwardly intact amebae and/or specific antigen were found widely distributed in various organs and the stool. The data indicate that oral infection with B. mandrillaris leading to GAE is possible. Exit from the gastrointestinal tract and dissemination remains unresolved. Though stool cultures were negative, transmission of this highly pathogenic ameba via stool cannot be ruled out.