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      Prevalence of free-living amoebae in swimming pools and recreational waters, a systematic review and meta-analysis

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          Abstract

          Free-living amoebae (FLA) are cosmopolitan microorganisms known to be pathogenic to humans who often have a history of contact with contaminated water. Swimming pools and recreational waters are among the environments where the greatest human exposure to FLA occurs. This study aimed to determine the prevalence of FLA in swimming pools and recreational waters, through a systematic review and meta-analysis that included studies published between 1977 and 2022. A total of 106 studies were included and an overall prevalence of FLA in swimming pools and recreational waters of 44.34% (95% CI = 38.57–50.18) was found. Considering the studies published up to 2010 (1977–2010), between 2010 and 2015, and those published after 2010 (> 2010–2022), the prevalence was 53.09% (95% CI = 43.33–62.73) and 37.07% (95% CI = 28.87–45.66) and 45.40% (95% CI = 35.48–55.51), respectively. The highest prevalence was found in the American continent (63.99%), in Mexico (98.35%), and in indoor hot swimming pools (52.27%). The prevalence varied with the variation of FLA detection methods, morphology (57.21%), PCR (25.78%), and simultaneously morphology and PCR (43.16%). The global prevalence by genera was Vahlkampfia spp. (54.20%), Acanthamoeba spp. (33.47%), Naegleria spp. (30.95%), Hartmannella spp./ Vermamoeba spp. (20.73%), Stenamoeba spp . (12.05%), and Vannella spp. (10.75%). There is considerable risk of FLA infection in swimming pools and recreational waters. Recreational water safety needs to be routinely monitored and, in case of risk, locations need to be identified with warning signs and users need to be educated. Swimming pools and artificial recreational water should be properly disinfected. Photolysis of NaOCl or NaCl in water by UV-C radiation is a promising alternative to disinfect swimming pools and artificial recreational waters.

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          Supplementary information

          The online version contains supplementary material available at 10.1007/s00436-022-07631-3.

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          Is Open Access

          The PRISMA 2020 statement: an updated guideline for reporting systematic reviews

          Matthew J L Page, Joanne E McKenzie, Patrick Bossuyt … (2024)
          The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement, published in 2009, was designed to help systematic reviewers transparently report why the review was done, what the authors did, and what they found. Over the past decade, advances in systematic review methodology and terminology have necessitated an update to the guideline. The PRISMA 2020 statement replaces the 2009 statement and includes new reporting guidance that reflects advances in methods to identify, select, appraise, and synthesise studies. The structure and presentation of the items have been modified to facilitate implementation. In this article, we present the PRISMA 2020 27-item checklist, an expanded checklist that details reporting recommendations for each item, the PRISMA 2020 abstract checklist, and the revised flow diagrams for original and updated reviews.
          Article 0 comments Cited 12943 times – based on 0 reviews     Review now
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            Microorganisms resistant to free-living amoebae.

            G Greub, D Raoult (2004)
            Free-living amoebae feed on bacteria, fungi, and algae. However, some microorganisms have evolved to become resistant to these protists. These amoeba-resistant microorganisms include established pathogens, such as Cryptococcus neoformans, Legionella spp., Chlamydophila pneumoniae, Mycobacterium avium, Listeria monocytogenes, Pseudomonas aeruginosa, and Francisella tularensis, and emerging pathogens, such as Bosea spp., Simkania negevensis, Parachlamydia acanthamoebae, and Legionella-like amoebal pathogens. Some of these amoeba-resistant bacteria (ARB) are lytic for their amoebal host, while others are considered endosymbionts, since a stable host-parasite ratio is maintained. Free-living amoebae represent an important reservoir of ARB and may, while encysted, protect the internalized bacteria from chlorine and other biocides. Free-living amoebae may act as a Trojan horse, bringing hidden ARB within the human "Troy," and may produce vesicles filled with ARB, increasing their transmission potential. Free-living amoebae may also play a role in the selection of virulence traits and in adaptation to survival in macrophages. Thus, intra-amoebal growth was found to enhance virulence, and similar mechanisms seem to be implicated in the survival of ARB in response to both amoebae and macrophages. Moreover, free-living amoebae represent a useful tool for the culture of some intracellular bacteria and new bacterial species that might be potential emerging pathogens.
            Article 0 comments Cited 270 times – based on 0 reviews     Review now
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              Diagnosis, Clinical Course, and Treatment of Primary Amoebic Meningoencephalitis in the United States, 1937-2013.

              Linda Capewell, Aaron Harris, Jonathan Yoder … (2015)
              Primary amoebic meningoencephalitis (PAM) is a rapidly progressing waterborne illness that predominately affects children and is nearly always fatal. PAM is caused by Naegleria fowleri, a free-living amoeba found in bodies of warm freshwater worldwide.
              Article 0 comments Cited 47 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Beni Jequicene Mussengue Chaúque: benichauq@gmail.com
                Denise Leal dos Santos: delealsantos@yahoo.com.br
                Davood Anvari: davood_anvari@live.com
                Marilise Brittes Rott: marilise.rott@ufrgs.br
                Journal
                Journal ID (nlm-ta): Parasitol Res
                Journal ID (iso-abbrev): Parasitol Res
                Title: Parasitology Research
                Publisher: Springer Berlin Heidelberg (Berlin/Heidelberg )
                ISSN (Print): 0932-0113
                ISSN (Electronic): 1432-1955
                Publication date (Electronic): 30 August 2022
                Pages: 1-18
                Affiliations
                [1 ]GRID grid.8532.c, ISNI 0000 0001 2200 7498, Laboratory of Protozoology, Department of Microbiology, Immunology and Parasitology, , Institute of Basic Health Sciences, Universidade Federal Do Rio Grande Do Sul, ; Porto Alegre, Brazil
                [2 ]GRID grid.513448.f, Department of Science, Technology, Engineering and Mathematics, Niassa Branch, , Universidade Rovuma, ; Lichinga City, Mozambique
                [3 ]GRID grid.512728.b, ISNI 0000 0004 5907 6819, Faculty of Medicine, , Iranshahr University of Medical Sciences, ; Iranshahr, Iran
                [4 ]GRID grid.8532.c, ISNI 0000 0001 2200 7498, Laboratory 311, Department of Microbiology, Immunology and Parasitology, , Institute of Basic Health Sciences, Universidade Federal Do Rio Grande Do Sul, ; Sarmento Leite Street, N 500, Porto Alegre, Rio Grande do Sul 90050-170 Brazil
                Author notes

                Handling Editor: Sutherland Maciver

                Article
                Publisher ID: 7631
                DOI: 10.1007/s00436-022-07631-3
                PMC ID: 9424809
                PubMed ID: 36040629
                SO-VID: 4d0309cd-db09-4dd6-b882-5ce8548f2e04
                Copyright © © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2022, Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
                License:

                This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

                History
                Date received : 28 May 2022
                Date accepted : 16 August 2022
                Categories
                Subject: Review

                ScienceOpen disciplines: Parasitology
                Keywords: free-living amoebae,risk of infection,swimming pool,recreational waters
                Data availability:
                ScienceOpen disciplines: Parasitology
                Keywords: free-living amoebae, risk of infection, swimming pool, recreational waters

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