Mehmet Aykur1,2, Derya Dirim Erdogan3, Nur Selvi Gunel4, Ayse Guler5, Cigir Biray Avci4, Nese Celebisoy5, Cumhur Gunduz4, Hande Dagci3. 1. Department of Parasitology, Faculty of Medicine, Ege University, Bornova/İzmir, Turkey. mehmetaykur@gmail.com. 2. Department of Parasitology, Faculty of Medicine, Tokat Gaziosmanpaşa University, PO Box 60030, Tokat, Turkey. mehmetaykur@gmail.com. 3. Department of Parasitology, Faculty of Medicine, Ege University, Bornova/İzmir, Turkey. 4. Department of Medical Biology, Faculty of Medicine, Ege University, Bornova/İzmir, Turkey. 5. Department of Neurology, Faculty of Medicine, Ege University, Bornova/İzmir, Turkey.
Abstract
PURPOSE: This study was aimed to investigate the presence of pathogenic free-living amoebae (FLA) in suspected cases of meningoencephalitis with unknown causes of death in Turkey. METHOD: A total of 92 patients, who were diagnosed as meningoencephalitis, were enrolled. All cerebrospinal fluid (CSF) samples were directly microscopically examined and cultured. Acanthamoeba, N. fowleri and B. mandrillaris were further investigated using molecular diagnostic tools including real-time PCR, sequencing, and phylogenetic analyses. RESULTS: The examined CSF samples were not found positive for the presence of FLA by microscopic examination and culture method. However, two CSF samples were detected positive by real-time PCR assay. Of the positive CSF samples, one was identified as Acanthamoeba genotype T4 and the second positive sample was identified as N. fowleri belonging to genotype II. Furthermore, the pathogens diagnoses was verified through Sanger sequencing. CONCLUSION: This study was significant to report the presence of Acanthamoeba genotype T4 and N. fowleri genotype II in CSF samples by real-time PCR assay. The present study shows the significance of primary amoebic meningoencephalitis (PAM) and granulomatous amoebic encephalitis (GAE) as one of the differential diagnoses to be considered by clinicians during the evaluation of suspected meningoencephalitis or cases of unknown cause in Turkey. Using real-time PCR, this has made the rapid detection, in a short time-frame, of Acanthamoeba and N. fowleri in CSF samples from patients. The problems with qPCR is that it is not available in every laboratory, reagents are expensive, and it requires skilled and expert personnel to set up these assays.
PURPOSE: This study was aimed to investigate the presence of pathogenic free-living amoebae (FLA) in suspected cases of meningoencephalitis with unknown causes of death in Turkey. METHOD: A total of 92 patients, who were diagnosed as meningoencephalitis, were enrolled. All cerebrospinal fluid (CSF) samples were directly microscopically examined and cultured. Acanthamoeba, N. fowleri and B. mandrillaris were further investigated using molecular diagnostic tools including real-time PCR, sequencing, and phylogenetic analyses. RESULTS: The examined CSF samples were not found positive for the presence of FLA by microscopic examination and culture method. However, two CSF samples were detected positive by real-time PCR assay. Of the positive CSF samples, one was identified as Acanthamoeba genotype T4 and the second positive sample was identified as N. fowleri belonging to genotype II. Furthermore, the pathogens diagnoses was verified through Sanger sequencing. CONCLUSION: This study was significant to report the presence of Acanthamoeba genotype T4 and N. fowleri genotype II in CSF samples by real-time PCR assay. The present study shows the significance of primary amoebic meningoencephalitis (PAM) and granulomatous amoebic encephalitis (GAE) as one of the differential diagnoses to be considered by clinicians during the evaluation of suspected meningoencephalitis or cases of unknown cause in Turkey. Using real-time PCR, this has made the rapid detection, in a short time-frame, of Acanthamoeba and N. fowleri in CSF samples from patients. The problems with qPCR is that it is not available in every laboratory, reagents are expensive, and it requires skilled and expert personnel to set up these assays.
Authors: Jacob Lorenzo-Morales; Alfonso Martín Cabello-Vílchez; Carmen M Martín-Navarro; Enrique Martínez-Carretero; José E Piñero; Basilio Valladares Journal: Trends Parasitol Date: 2013-08-26
Authors: Muhammet Karakavuk; Mehmet Aykur; Esra Atalay Şahar; Mehmet Karakuş; Duygu Aldemir; Ömer Döndüren; Hüseyin Gökhan Özdemir; Hüseyin Can; Adnan Yüksel Gürüz; Hande Dağcı; Mert Döşkaya Journal: Exp Parasitol Date: 2017-08-12 Impact factor: 2.011