Acanthamoeba are widespread free-living amoebae which may cause granulomatous amoebic encephalitis (GAE), keratitis, skin ulcerations and disseminated tissue infection. An important diagnostic and prognostic factor for the treatment of infection is a quick and correct diagnosis of amoebae strains. The aim of our study was to develop a rapid method for detection and identification of pathogenic Acanthamoeba spp. strains from diagnostic material collected from water. In this study we analysed five amplification-based genetic markers (Aca 16S, Ac6/210, GP, JDP, Nelson) used for identification of pathogenic Acanthamoeba spp. strains isolated in water sources in Poland, Iceland and Sweden. Our results demonstrated the presence of pathogenic Acanthamoeba strains in tap water. PCR assay appeared to be a more rapid and sensitive method to detect the presence of amoebae than the limited conventional techniques. Based on our observations, we can confirm that the use of four out of five genetic markers (Aca 16S, Ac 6/210, JDP, GP, Nelson) may be helpful in identification of Acanthamoeba spp. strains, but only one Aca 16S primer pair is a highly specific marker that distinguishes between pathogenic strains of Acanthamoeba and other free-living amoeba families.
Acanthamoeba keratitis is a blinding infection that is becoming increasingly important in human health. Early diagnosis is a prerequisite for successful treatment and requires identification of Acanthamoeba at the genotypic level. The genus Acanthamoeba consists of both pathogenic and non-pathogenic species and has been recently classified into 13 different genotypes, T1-T12 and T14. More importantly, 95% of Acanthamoeba isolates that produce keratitis belong to T4 genotypes. In this study, we attempted to determine whether predominance of T4 isolates in Acanthamoeba keratitis is due to greater virulence or greater prevalence. We isolated 18 Acanthamoeba isolates from environmental samples in Ankara, Turkey and determined their pathogenic potential by means osmotolerance, temperature tolerance and in vitro cytotoxicity assays using corneal epithelial cells. Ribosomal DNA sequencing revealed that 10 isolates belong to T2, 5 belong to T3,2 belong to T4 and one belongs to T7 genotype. As expected, T3 and T4 isolates exhibited the most pathogenic traits and were osmotolerant, temperature tolerant and exhibited severe corneal epithelial cell cytotoxicity indicating their pathogenic potential. Overall these data indicate that high frequency of T4 isolates in keratitis cases may well be due to their greater virulence. This is the first report presenting environmental distribution of Acanthamoeba in Ankara, Turkey.