Occurrence and molecular characterization of Acanthamoeba, Naegleria fowleri and Blastocystis in water samples from various sources in Egypt.

PCR-testing coupled to isolate sequencing was conducted to detect prevalence and various genotypes/subtypes of 3 neglected waterborne protists (Acanthamoeba, Naegleria fowleri and Blastocystis) in water samples from various sources in Dakahlia governorate, Egypt. Out of 62 protozoan-suspected samples by microscopy, Acanthamoeba was molecularly confirmed in 24 (38.7%) samples from various sources including tap water. Twenty Acanthamoeba isolates were successfully-sequenced; 18 were designated as the genotype T3 and 2 as T4. Naegleria spp. were detected in 6 (9.6%) samples from the Nile, of them 2 (3.2%) were identified as N. fowleri. Blastocystis spp. were found in 4 (6.4%) samples from waste water and ground water. Blastocystis subtype 2 was found in a sample from waste water, which may reflect human infection with this subtype and constitutes a public health hazard because waste water is occasionally discharged in the Nile with minimal treatments. Findings of the present study were analyzed in combination with those of earlier surveys from the other Egyptian governorates to evaluate the whole situation of the 3 protists in water from Egypt. Results of this analysis showed that Acanthamoeba had a high mean prevalence (43.03%) throughout Egypt, with insignificant variations among various water sources. Various Acanthamoeba genotypes were detected, and the highly pathogenic T4 was the most significantly identified type. A common T4 haplotype circulated in water from Egypt and 3 other countries (Tanzania, Rwanda, Uganda) located on the Nile basin, and included isolates from keratitis-infected patients, which confirms the potential role of water in the epidemiology of Acanthamoeba keratitis infecting humans in these countries. The estimated mean prevalence for Naegleria spp. was 23.79%, being the highest in the Nile water. In the present study, occurrence of 3 potentially pathogenic protists has been confirmed in water from Egypt, which should alert the authorities to revise the procedures for controlling these pathogens in water.