Investigating Domestic Shower Settings as a Risk Factor for <i>Acanthamoeba</i> Keratitis
Binod Rayamajhee | Dinesh Subedi | Seoyoung Won | Jamie (Jung Yun) Kim | Ajay Vijay | Jacqueline Tan | Fiona L. Henriquez | Mark Willcox | Nicole A. Carnt
<i>Acanthamoeba</i> keratitis (AK) is a sight-threatening infection of the cornea, which is caused by soil and the waterborne protist <i>Acanthamoeba</i> spp. AK most commonly occurs during contact lens (CL) wear. Risk factors for AK have been linked to non-optimal lens hygiene practices and <i>Acanthamoeba</i> contamination of domestic water. This study investigated the prevalence of<i> Acanthamoeba</i> species in domestic showers in the greater Sydney region, as well as the perception of water contamination of CL as being a risk factor for AK among previous AK patients and their family and friends. Samples from four locations of 13 participants’ shower areas were cultured and <i>Acanthamoeba </i>18S rRNA was amplified by PCR, followed by sequencing. Twenty-six responses were received to the online questionnaire. Fifteen water samples (29%, 15/52) contained amoeba that were morphologically classified as <i>Acanthamoeba</i> spp. PCR amplification confirmed the presence of <i>Acanthamoeba </i>spp. in four samples (8%, 4/52). Three isolates belonged to the T4, and one isolate to the T3 genotype. On the questionnaire survey, 96% (25/26) of respondents believed that water contamination was likely to be a risk factor for <i>Acanthamoeba</i> keratitis and 58% rated showering with CL as ‘extremely likely’ to be a risk factor for AK. <i>Acanthamoeba </i>pathogenic genotypes (T3 and T4) in the domestic bathroom water suggest that clinicians should remain vigilant in educating CL wearers about avoiding domestic water contamination of CL.
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