Introduction: Acanthamoeba is an ubiquitous free-living protozoa which causes serious ocular problems. Acanthamoeba keratitis is becoming more prevalent amongst contact lens wearers. The disease can cause loss of vision and blindness if not treated properly. The objective of this research is to study the sensitivity of six Acanthamoeba spp. isolates, of which three were from the clinical isolates (HKL 95, HTH 40 and HS 6) and the remaining three from environmental isolates (TTT 9, TL 3 and SMAL 8) to antimicrobial agents. Methods: The antimicrobial agents chosen for this purpose were polyhexamethylene biguanide (PHMB) and chlorhexidine. Serial dilutions were perfomed for polyhexamethylene biguanide and chlorhexidine. Cyst suspensions from the chosen isolates were exposed to PHMB and chlorhexidine respectively. After 48 hours incubation time at 30°C, each mixture was filtered and filtration membrane was put onto non-nutrient agar laid with Escherichia coli. The agar plates were incubated for three days at 30°C and examined daily until day 14 to detect the presence of Acanthamoeba trophozoites under the inverted microscope. The presence of trophozoites indicated the ineffectiveness of the antimicrobial agents. Results: Both of the antimicrobial agents tested were found to be effective against Acanthamoeba cysts from all the test strains. Polyhexamethylene biguanide gave a minimum cysticidal concentration (MCC) mean value of 2.848 μg/mL while chlorhexidine showed
MCC mean value at a concentration of 3.988 μg/mL. Conlusion: It can be concluded that the Acanthamoeba cysts were sensitive to polyhexamethylene biguanide and chlorhexidine.
Acanthamoeba spp. merupakan ameba hidup bebas yang biasa ditemui
di persekitaran. Ia merupakan agen penyebab keratitis Acanthamoeba (AK)
dan ensefalitis ameba bergranuloma (GAE). Ameba ini juga mampu menjadi
perumah kepada pelbagai bakteria termasuklah yang bersifat patogenik seperti
Mycobacterium, Legionella dan Staphylococcus aureus rintang metisilin (MRSA).
Berdasarkan maklumat ini, satu kajian dijalankan untuk mengesan kehadiran tiga
bakteria endosimbion berkepentingan perubatan di dalam Acanthamoeba spp. yang
telah dipencilkan dari bolong penghawa dingin yang terdapat di wad and dewan
bedah di Pusat Perubatan Universiti Kebangsaan Malaysia. Kehadiran bakteria
endosimbion ini disaring menggunakan pasangan primer khusus bagi setiap genus
menggunakan reaksi rantai polimerase (PCR) konvensional dan disahkan dengan
analisis penjujukan. Dua puluh sembilan (80.56%) pencilan Acanthamoeba spp.
didapati mengandungi bakteria endosimbion patogenik yang disasarkan dengan
sekurang-kurangnya satu genus bakteria bagi setiap pencilan. Mycobacterium
(82.76 %) adalah bakteria yang paling banyak dikesan, diikuti dengan Legionella sp.
(65.52 %) dan Pseudomonas spp. (62.07 %). Tiada bakteria MRSA dikesan daripada
mana-mana pencilan dalam kajian ini. Dua endosimbion Mycobacterium yang
dikenalpasti telah dikelompokkan ke dalam strain Mycobacterium tuberculosis.
Kami membuat kesimpulan bahawa, kebanyakan Acanthamoeba berpotensi untuk
menjadi perumah bagi pelbagai bakteria patogenik, namun implikasi interaksi ini
terhadap patogenisiti kedua-dua organisma masih kurang jelas dan memerlukan
penyelidikan yang lebih lanjut.
Acanthamoeba is a free-living amoeba and opportunistic protozoa that causes infection to humans. One of its primary infections is Acanthamoeba keratitis that occurs mostly amongst contact lens users. There are some difficulties in providing effective treatment to the patients as the cysts of Acanthamoeba spp. are very resistant towards most of the antimicrobial agents. Thus, study was conducted to determine the effectiveness of antimicrobial agents comprising 0.1% propamidine isethionate (Brolene®) and 0.3% ciprofloxacin (Ciloxan®) towards two clinical isolates of Acanthamoeba spp. (HUKM 74 and HS 72). Besides that, the minimum cysticidal concentration (MCC) of the tested antimicrobial agents were also determined. Propamidine isethionate and ciprofloxacin showed cysticidal activities at therapeutic dosage against both Acanthamoeba spp. isolates. The minimum cysticidal concentration for propamidine isethionate was between 62.5-125 µg/ml while for ciprofloxacin was 375 µg/ml. Both the clinical isolates of Acanthamoeba belonged to group II (Polyphagids).
Is Acanthamoeba sp. normally found in the eyes? A study was carried out to establish the possibility of Acanthamoeba sp. as a part of the normal conjunctival flora. Conjunctiva swabbing were carried out in 286 healthy Orang Asli school children using sterile cotton swab. The swab was then inoculated onto non-nutrient agar (NN-A). Heat killed Escherichia coli that was used as food source for the growth of the amoebae was pipetted onto and away from the smear. The plates were incubated at 30 degrees C and examined daily using an inverted microscope for 14 days. Morphology of the trophozoites and cysts of the amoebae were used as the taxonomic criteria for identification. Positive-controls and negative-controls were done to check for the consistency of the technique used and monitoring of contamination respectively. None of the conjunctiva swab cultured was positive for Acanthamoeba sp. This finding may indicate that Acanthamoeba sp. is not part of normal conjunctival flora or conjunctiva swab is an insensitive technique to isolate the organism. However, a more extensive research is needed to investigate these possibilities.