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The role of Acanthamoeba spp. in biofilm communities: a systematic review
Larissa Fagundes Pinto1, Brenda Nazaré Gomes Andriolo2, Ana Luisa Hofling-Lima1
1Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, São Paulo Hospital, Federal University of São Paulo, UNIFESP, Rua Pedro de Toledo, 669 - Vila Clementino, São Paulo, SP, 04039-032, Brazil.
Abstract:
Acanthamoeba spp. have always caused disease in immunosuppressed patients, but since 1986, they have become a worldwide public health issue by causing infection in healthy contact lens wearers. Amoebae of the Acanthamoeba genus are broadly distributed in nature, living either freely or as parasites, and are frequently associated with biofilms throughout the environment. These biofilms provide the parasite with protection against external aggression, thus favoring its increased pathogeny. This review aims to assess observational studies on the association between Acanthamoeba spp. and biofilms, opening potential lines of research on this severe ocular infection. A systematic literature search was conducted in May 2020 in the following databases: PubMed Central®/Medline, LILACS, The Cochrane Library, and EMBASE®. The studies were selected following the inclusion and exclusion criteria specifically defined for this review. Electronic research recovered 353 publications in the literature. However, none of the studies met the inclusion criterion of biofilm-producing Acanthamoeba spp., inferring that the parasite does not produce biofilms. Nonetheless, 78 studies were classified as potentially included regarding any association of Acanthamoeba spp. and biofilms. These studies were allocated across six different locations (hospital, aquatic, ophthalmic and dental environments, biofilms produced by bacteria, and other places). Acanthamoeba species use biofilms produced by other microorganisms for their benefit, in addition to them providing protection to and facilitating the dissemination of pathogens residing in them.
Insights
Acanthamoeba species do not produce biofilms but utilize existing microbial biofilms for protection and dissemination. This review highlights their association with various environmental biofilms, impacting public health, especially in contact lens wearers.
Area of Science:
- Microbiology
- Parasitology
- Ophthalmology
Background:
- Acanthamoeba species are ubiquitous microorganisms causing disease, particularly in immunosuppressed individuals and contact lens wearers.
- Biofilms offer protection to microorganisms, potentially increasing pathogen virulence.
- The association between Acanthamoeba and biofilms is critical for understanding severe ocular infections.
Purpose of the Study:
- To systematically review observational studies on the association between Acanthamoeba species and biofilms.
- To explore potential research avenues concerning Acanthamoeba-associated biofilms and ocular infections.
Main Methods:
- A systematic literature search was performed in May 2020 across PubMed Central/Medline, LILACS, The Cochrane Library, and EMBASE.
- Studies were selected based on predefined inclusion and exclusion criteria.
- 353 publications were initially recovered, with 78 studies ultimately classified as relevant to Acanthamoeba and biofilm associations.
Main Results:
- No studies met the inclusion criteria for Acanthamoeba species producing biofilms, indicating they do not produce their own biofilms.
- 78 studies demonstrated an association between Acanthamoeba species and biofilms in diverse environments (hospital, aquatic, ophthalmic, dental, bacterial, etc.).
- Acanthamoeba utilizes biofilms formed by other microorganisms for protection and dissemination.
Conclusions:
- Acanthamoeba species do not appear to produce biofilms but exploit existing microbial biofilms.
- These external biofilms are crucial for Acanthamoeba survival, protection, and spread, contributing to their pathogenicity.
- Further research into Acanthamoeba's interaction with environmental biofilms is warranted to combat associated infections.
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