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Isolation of Acanthamoeba Spp. from Drinking Waters in Several Hospitals of Iran

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      Abstract

      Background

      Acanthamoeba is an opportunistic amphizoic protozoan found in different water sources including swimming pool as well as in sewage. The aim of this study was to investigate the prevalence of Acanthamoeba in tap-water samples in Iran.

      Method

      In this descriptive cross-sectional study, 94 samples of cold and warm tap-water were collected from different wards of hospitals in 13 cities of Iran in 2007–2008. Free residual chlorine, pH, and temperature of samples were measured. After filtration through multipore nylon membrane, samples were cultured on non-nutrient agar. Then we investigated existence of Acanthamoeba by reverse contrast phase microscope.

      Results

      Acanthamoeba was found in 45 samples (48%). Thirty-four and 11 positive samples were collected from cold and warm tap water, respectively. The samples belonged to the category of 20–30°C temperature with 0–2 ppm free residual chlorine and pH 6–7.4 showed the most coincidence to the positive cases. The greatest proportion of positive samples was obtained from Mashhad hospitals, while all samples collected from Arak and Semnan hospitals were negative.

      Conclusion

      considering the results of this study and the pathogenic role of this protozoan on patients with immunodeficiency, as well as capability of this microorganism in carrying other pathogens such as Legionella, further studies are needed. What is more important, potable water in hospitals should follow the procedure of treatment and sanitation, in order to prevent the relevant nosocomial infections.

      Related collections

      Most cited references 32

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      Acanthamoeba spp. as agents of disease in humans.

      Acanthamoeba spp. are free-living amebae that inhabit a variety of air, soil, and water environments. However, these amebae can also act as opportunistic as well as nonopportunistic pathogens. They are the causative agents of granulomatous amebic encephalitis and amebic keratitis and have been associated with cutaneous lesions and sinusitis. Immuno compromised individuals, including AIDS patients, are particularly susceptible to infections with Acanthamoeba. The immune defense mechanisms that operate against Acanthamoeba have not been well characterized, but it has been proposed that both innate and acquired immunity play a role. The ameba's life cycle includes an active feeding trophozoite stage and a dormant cyst stage. Trophozoites feed on bacteria, yeast, and algae. However, both trophozoites and cysts can retain viable bacteria and may serve as reservoirs for bacteria with human pathogenic potential. Diagnosis of infection includes direct microscopy of wet mounts of cerebrospinal fluid or stained smears of cerebrospinal fluid sediment, light or electron microscopy of tissues, in vitro cultivation of Acanthamoeba, and histological assessment of frozen or paraffin-embedded sections of brain or cutaneous lesion biopsy material. Immunocytochemistry, chemifluorescent dye staining, PCR, and analysis of DNA sequence variation also have been employed for laboratory diagnosis. Treatment of Acanthamoeba infections has met with mixed results. However, chlorhexidine gluconate, alone or in combination with propamidene isethionate, is effective in some patients. Furthermore, effective treatment is complicated since patients may present with underlying disease and Acanthamoeba infection may not be recognized. Since an increase in the number of cases of Acanthamoeba infections has occurred worldwide, these protozoa have become increasingly important as agents of human disease.
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        Preliminary report on the pathogenicity of Legionella pneumophila for freshwater and soil amoebae.

         T Rowbotham (1980)
        Legionella pneumophila, the causative organism of Legionnaires' disease, is pathogenic for free living, ubiquitous, freshwater, and soil amoebae of the genera Acanthamoeba and Naegleria. Some species support the growth of strains from serogroups 1 to 6, others only strains from certain serogroups. Initial studies with seeded material indicate that amoebal enrichment could be utilised for the isolation of legionellae from clinical specimens and natural habitats. It is suggested that a vacuole, or amoeba, full of legionellae, rather than free legionellae, could be the infective particle for man.
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          Cultivation of pathogenic and opportunistic free-living amebas.

          Free-living amebas are widely distributed in soil and water, particularly members of the genera Acanthamoeba and NAEGLERIA: Since the early 1960s, they have been recognized as opportunistic human pathogens, capable of causing infections of the central nervous system (CNS) in both immunocompetent and immunocompromised hosts. Naegleria is the causal agent of a fulminant CNS condition, primary amebic meningoencephalitis; Acanthamoeba is responsible for a more chronic and insidious infection of the CNS termed granulomatous amebic encephalitis, as well as amebic keratitis. Balamuthia sp. has been recognized in the past decade as another ameba implicated in CNS infections. Cultivation of these organisms in vitro provides the basis for a better understanding of the biology of these amebas, as well as an important means of isolating and identifying them from clinical samples. Naegleria and Acanthamoeba can be cultured axenically in cell-free media or on tissue culture cells as feeder layers and in cultures with bacteria as a food source. Balamuthia, which has yet to be isolated from the environment, will not grow on bacteria. Instead, it requires tissue culture cells as feeder layers or an enriched cell-free medium. The recent identification of another ameba, Sappinia diploidea, suggests that other free-living forms may also be involved as causal agents of human infections.
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            Author and article information

            Affiliations
            [1 ]Dept. of Microbiology, Center of Research Cellular and Molecular Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran
            [2 ]Dept. of Medical Parasitology and Mycology, Shiraz University of Medical Sciences, Iran
            [3 ]Health Center of Khorasan Razavi Province, Iran
            [4 ]Dept. of Environmental Health, Gonabad University of Medical Sciences, Iran
            Author notes
            [* ] Corresponding author: Tel: 09157029331, Email address: reza_shafi@ 123456yahoo.com
            Journal
            Iran J Parasitol
            IJP
            Iranian Journal of Parasitology
            Tehran University of Medical Sciences
            1735-7020
            2008-238X
            June 2010
            : 5
            : 2
            : 19-25
            3279834
            22347240
            IJP-5-019
            © 2010 Iranian Society of Parasitology & Tehran University of Medical Sciences

            This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

            Categories
            Original Article

            Parasitology

            iran, water, hospital, protozoa, acanthamoeba

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