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Review
. 2015 Jan-Feb;62(1):3-11.
doi: 10.1111/jeu.12149. Epub 2014 Sep 25.

Twenty years of acanthamoeba diagnostics in Austria

Julia Walochnik  1 , Ute Scheikl, Eva-Maria Haller-Schober
Affiliations
Review

Twenty years of acanthamoeba diagnostics in Austria

Julia Walochnik et al. J Eukaryot Microbiol. 2015 Jan-Feb.

Abstract

Acanthamoebae are the causative agents of an often seriously progressing keratitis (AK) occurring predominantly in contact lens wearers and can cause several disseminating infections potentially resulting in granulomatous amoebic encephalitis (GAE) in the immunocompromised host. Our institution is the Austrian reference laboratory for Acanthamoeba diagnostics and the aim of this study was to give an overview of proven cases of Acanthamoeba infections in Austria during the past 20 yr. All samples of patients with suspected AK or GAE were screened for Acanthamoeba spp. by culture and/or PCR and the detected amoebae were genotyped. Altogether, 154 cases of AK and three cases of GAE were diagnosed. Age of the AK patients ranged from 8 to 82 yr (mean 37.8) and 58% of the patients were female. Approximately 89% of the AK patients were contact lens wearers, almost all cases were unilateral and 19% of the patients required a keratoplasty. Age of the GAE patients ranged from 2 to 25 yr (mean 14.7), all were HIV-negative, but two were severely immunosuppressed at the time of diagnosis. The predominant genotype in the AK cases was T4, other genotypes found were T3, T5, T6, T10 and T11. The three GAE cases involved genotypes T2, T4 and T5.

Keywords: SSU; characterisation; contact lens; infection; protozoa; typing.

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Figures

Figure 1
Figure 1
Age and sex distribution of AK patients in Austria (1993–2013).
Figure 2
Figure 2
AK cases per month over the period 1993–2013.
Figure 3
Figure 3
Acanthamoeba trophozoites. A. In phase contrast microscopy (magnification: X1,000), B. in interference contrast microscopy (magnification: X1,000) and C. On agar plate 48 h after inoculation of clinical sample in inverted phase contrast microscopy (magnification: X200).
Figure 4
Figure 4
Acanthamoeba immunostaining. A. Trophozoite with characteristic nucleus (large central nucleolus) in superficial tissue layers (magnification: X1,000), B. Mature double-walled cyst in cornea tissue (magnification: X400) and C. Immature cysts in brain tissue around vessel (magnification: X400).
Figure 5
Figure 5
Acanthamoeba cysts. A. morphological group II: polygonal with wrinkled outer cyst wall (magnification: X1,000), B. Morphological group III: slightly smaller and rounded with ectocyst closely apposed to endocyst (magnification: X1,000).
See this image and copyright information in PMC

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