Isolation and Identification of Acanthamoeba Strains From the Oral Cavity of Patients Undergoing Hemodialysis in Shahrekord County, the Southwest of Iran in 2018

Acanthamoeba spp. as opportunistic microorganisms are widespread in a wide range of environmental sources in the world and may cause severe diseases in immune-deficient patients. The aim of this study was to determine the prevalence and genotypes of Acanthamoeba spp. in hemodialysis patients in Shahrekord county of Chaharmahal and Bakhtiari province.   In this cross-sectional study, 79 oral swabs were collected from the mouth of patients with chronic renal disorder undergoing hemodialysis from June to October 2018. The samples were then cultured on non-nutrient agar and examined by Giemsa staining, polymerase chain reaction (PCR), sequencing, and tolerance testing methods.   Morphological investigations indicated that 30.4% (24/79) of the subjects were infected with some free-living amoebae (FLA), and the PCR showed that only 3 samples contained Acanthamoeba spp. The sequencing of the latter samples demonstrated that these isolates belonged to T2 and T4 genotypes. After performing the assay tolerance test, 2 of these 3 isolates were related to T4 genotypes representing a high pathogenic potance.   The infection of hemodialysis patients with some of Acanthamoeba spp. particularly, the T4 genotype should be considered important for these patients. Therefore, it is recommended that dialysis machines and dialysis units in hospitals be checked and disinfected periodically.