“Presence of free-living amoebae (FLA) in Northern Chile, an emerging challenge for public health”

Abstract

FLA are amphizoic protozoa found in natural and artificial environments, such as recreational waters, water systems, and soils. Their ability to form cysts and their tolerance to disinfectants and extreme conditions make them an emerging challenge for public health. In the Atacama Desert, Acanthamoeba spp. has been found, demonstrating its adaptation to extreme conditions and its potential as reservoirs of pathogens. Significant species include Naegleria fowleri, Balamuthia mandrillaris, and Acanthamoeba spp., responsible for severe infections such as amoebic meningitis and encephalitis. In Chile, FLA has been documented in 15 regions, highlighting the T4 genotype of Acanthamoeba associated with severe cases. The lack of routine surveillance and diagnosis, along with the initial clinical nonspecificity and limited training of healthcare personnel, favors underdiagnosis and reduces early treatment. In northern Chile, geographic and climatic factors increase exposure. Research in chlorinated pools and natural waters of the highlands confirms the risk to the population. It is necessary to implement preventive measures, strengthen epidemiological surveillance, train healthcare personnel, and use appropriate techniques for their identification. The COVID-19 pandemic has demonstrated the danger of natural microorganisms, underscoring the importance of research and prevention under the One Health approach.