KoreaMed Synapse
 
About Synapse
Overview
Help
Disclaimer
Advanced Search
 
 
   
       Journal List > Korean J Parasitol > v.46(3); Sep 2008
  |    |  Full-text      |    |  
Korean J Parasitol. 2008 Sep;46(3):157-164.
Published online 2008 September 20.  doi: 10.3347/kjp.2008.46.3.157.
Copyright © 2008 by The Korean Society for Parasitology
Keratitis by Acanthamoeba triangularis: Report of Cases and Characterization of Isolates
Ying-Hua Xuan,1 Byung-Suk Chung,1 Yeon-Chul Hong,1 Hyun-Hee Kong,1 Tae-Won Hahn,2 and Dong-Il Chung1
1Department of Parasitology, Kyungpook National University School of Medicine, Daegu 700-422, Korea.
2Apgujung St. Mary's Eye Center, Seoul, Korea.

Corresponding author (Email: dichung@knu.ac.kr )
Received July 16, 2008; Accepted August 25, 2008.

Abstract

Three Acanthamoeba isolates (KA/E9, KA/E17, and KA/E23) from patients with keratitis were identified as Acanthamoeba triangularis by analysis of their molecular characteristics, a species not previously recognized to be a corneal pathogen. Epidemiologic significance of A. triangularis as a keratopathogen in Korea has been discussed. Morphologic features of Acanthamoeba cysts were examined under a microscope with differential interference contrast (DIC) optics. Mitochondrial DNA (mtDNA) of the ocular isolates KA/E9, KA/E17, and KA/E23 were digested with restriction enzymes, and the restriction patterns were compared with those of reference strains. Complete nuclear 18S and mitochondrial (mt) 16S rDNA sequences were subjected to phylogenetic analysis and species identification. mtDNA RFLP of 3 isolates showed very similar patterns to those of SH621, the type strain of A. triangularis. 16S and 18S rDNA sequence analysis confirmed 3 isolates to be A. triangularis. 18S rDNA sequence differences of the isolates were 1.3% to 1.6% and those of 16S rDNA, 0.4% to 0.9% from A. triangularis SH621. To the best of our knowledge, this is the first report, confirmed by 18S and 16S rDNA sequence analysis, of keratitis caused by A. triangularis of which the type strain was isolated from human feces. Six isolates of A. triangularis had been reported from contaminated contact lens cases in south eastern Korea.

Keywords: Acanthamoeba, keratitis, contact lenses, Acanthamoeba triangularis.
References
1. Marciano-Cabral F,Cabral G. Acanthamoeba spp. as agents of disease in humans. Clin Microbiol Rev 2003;16:273–307.
2. Moore MB,McCulley JP,Newton C,Cobo LM,Foulks GN,O'day DM,Johns KJ,Driebe WT,Wilson LA,Epstein RJ,et al. Acanthamoeba keratitis. A growing problem in soft and hard contact lens wearers. Ophthalmology 1987;94:1654–1661.
3. Illingworth CD,Cook SD. Acanthamoeba keratitis. Surv Ophthalmol 1998;42:493–508.
4. Schaumberg DA,Snow KK,Dana MR. The epidemic of Acanthamoeba keratitis: where do we stand?. Cornea 1998;17:3–10.
5. Yu HS,Kong HH,Kim SY,Hahn YH,Hahn TW,Chung DI. Laboratory investigation of Acanthamoeba lugdunensis from patients with keratitis. Invest Ophthalmol Vis Sci 2004;45:1418–1426.
6. Ledee DR,Hay J,Byers TJ,Seal DV,Kirkness CM. Acanthamoeba griffini. Molecular characterization of a new corneal pathogen. Invest Ophthalmol Vis Sci 1996;37:544–550.
7. Pussard M,Pons R. Morphologie de la paroi kystique et taxonomie du gene Acanthamoeba (Protozoa, Amoebida). Protistologica 1977;13:557–598.
8. Chung DI,Kong HH,Yu HS,Oh YM,Yee ST,Lim YJ. Biochemical and molecular characterization of a strain KA/S2 of Acanthamoeba castellanii isolated from Korean soil. Korean J Parasitol 1996;34:79–85.
9. Kong HH,Shin JY,Yu HS,Kim J,Hahn TW,Hahn YH,Chung DI. Mitochondrial DNA restriction fragment length polymorphism (RFLP) and 18S small-subunit ribosomal DNA PCR-RFLP analyses of Acanthamoeba isolated from contact lens storage cases of residents in southwestern Korea. J Clin Microbiol 2002;40:1199–1206.
10. Stothard DR,Schroeder-Diedrich JM,Awwad MH,Gast RJ,Ledee DR,Rodriguez-Zaragoza S,Dean CL,Fuerst PA,Byers TJ. The evolutionary history of the genus Acanthamoeba and the identification of eight new 18S rRNA gene sequence types. J Eukaryot Microbiol 1998;45:45–54.
11. Ledee DR,Booton GC,Awwad MH,Sharma S,Aggarwal RK,Niszl IA,Markus MB,Fuerst PA,Byers TJ. Advantages of using mitochondrial 16S rDNA sequences to classify clinical isolates of Acanthamoeba. Invest Ophthalmol Vis Sci 2003;44:1142–1149.
12. Chung DI,Yu HS,Hwang MY,Kim TH,Kim TO,Yun HC,Kong HH. Subgenus classification of Acanthamoeba by riboprinting. Korean J Parasitol 1998;36:69–80.
13. Yu HS,Hwang MY,Kim TO,Yun HC,Kim TH,Kong HH,Chung DI. Phylogenetic relationships among Acanthamoeba spp. based on PCR-RFLP analyses of mitochondrial small subunit rRNA gene. Korean J Parasitol 1999;37:181–188.
14. Yagita K,Endo T. Restriction enzyme analysis of mitochondrial DNA of Acanthamoeba strains in Japan. J Protozool 1990;37:570–575.
15. Kong HH,Chung DI. PCR and RFLP variation of conserved region of small subunit ribosomal DNA among Acanthamoeba isolates assigned to either A. castellanii or A. polyphaga. Korean J Parasitol 1996;34:127–134.
16. Gunderson JH,Sogin ML. Length variation in eukaryotic rRNAs: small subunit rRNAs from the protists Acanthamoeba castellanii and Euglena gracilis. Gene 1986;44:63–70.
17. Altschul SF,Gish W,Miller W,Myers EW,Lipman DJ. Basic local alignment search tool. J Mol Biol 1990;215:403–410.
18. Thompson JD,Gibson TJ,Plewniak F,Jeanmougin F,Higgins DG. The CLUSTAL_X windows interface: flexible strategies for multiple sequence alignment aided by quality analysis tools. Nucleic Acids Res 1997;25:4876–4882.
19. Naginton J,Watson PG,Playfair TJ,McGill J,Jones BR,Steele AD. Amoebic infection of the eye. Lancet 1974;2:1537–1540.
20. Jones DB,Visvesvara GS,Robinson NM. Acanthamoeba polyphaga keratitis and Acanthamoeba uveitis associated with fatal meningoencephalitis. Trans Ophthalmol Soc U K 1975;95:221–232.
21. Walochnik J,Haller-Schober E,Kolli H,Picher O,Obwaller A,Aspock H. Discrimination between clinically relevant and nonrelevant Acanthamoeba strains isolated from contact lens- wearing keratitis patients in Austria. J Clin Microbiol 2000;38:3932–3936.
22. Walochnik J,Obwaller A,Aspock H. Correlations between morphological, molecular biological, and physiological characteristics in clinical and nonclinical isolates of Acanthamoeba spp. Appl Environ Microbiol 2000;66:4408–4413.
23. Yu HS,Choi KH,Kim HK,Kong HH,Chung DI. Genetic analyses of Acanthamoeba isolates from contact lens storage cases of students in Seoul, Korea. Korean J Parasitol 2001;39:161–170.
24. Lee SM,Choi YJ,Ryu HW,Kong HH,Chung DI. Species identification and molecular characterization of Acanthamoeba isolated from contact lens paraphernalia. Korean J Ophthalmol 1997;11:39–50.
25. Stevens AR,Willaert E. Drug sensitivity and resistance of four Acanthamoeba species. Trans R Soc Trop Med Hyg 1980;74:806–808.
26. Jongwutiwes S,Pariyakanok L,Charoenkorn M,Yagita K,Endo T. Heterogeneity in cyst morphology within isolates of Acanthamoeba from keratitis patients in Thailand. Trop Med Int Health 2000;5:335–340.
27. Seal DV. Acanthamoeba keratitis update-incidence, molecular epidemiology and new drugs for treatment. Eye 2003;17:893–905.
28. Kong HH,Park JH,Chung DI. Interstrain polymorphisms of isoenzyme profiles and mitochondrial DNA fingerprints among seven strains assigned to Acanthamoeba polyphaga. Korean J Parasitol 1995;33:331–340.
29. Xuan YH,Yu HS,Jeong HJ,Seol SY,Chung DI,Kong HH. Molecular characterization of bacterial endosymbionts of Acanthamoeba isolates from infected corneas of Korean patients. Korean J Parasitol 2007;45:1–9.
30. Schuster FL,Visvesvara GS. Free-living amoebae as opportunistic and non-opportunistic pathogens of humans and animals. Int J Parasitol 2004;34:1001–1027.
31. Liu H,Moon EK,Yu HS,Jeong HJ,Hong YC,Kong HH,Chung DI. Evaluation of taxonomic validity of four species of Acanthamoeba: A. divionensis,A. paradivionensis,A. mauritaniensis, and A. rhysodes, inferred from molecular analyses. Korean J Parasitol 2005;43:7–13.
32. Lee JS,Hahn TW,Choi SH,Yu HS,Lee JE. Acanthamoeba keratitis related to cosmetic contact lenses. Clin Experiment Ophthalmol 2007;35:775–777.
33. Lee JE,Hahn TW,Oum BS,Choi HY,Yu HS,Lee JS. Acanthamoeba keratitis related to orthokeratology. Int Ophthalmol 2007;27:45–49.
34. Ibrahim YW,Boase DL,Cree IA. Factors affecting the epidemiology of Acanthamoeba keratitis. Ophthalmic Epidemiol 2007;14:53–60.