Skip to main content

The role of Acanthamoeba spp. in biofilm communities: a systematic review


Acanthamoeba spp. have always caused disease in immunosuppressed patients, but since 1986, they have become a worldwide public health issue by causing infection in healthy contact lens wearers. Amoebae of the Acanthamoeba genus are broadly distributed in nature, living either freely or as parasites, and are frequently associated with biofilms throughout the environment. These biofilms provide the parasite with protection against external aggression, thus favoring its increased pathogeny. This review aims to assess observational studies on the association between Acanthamoeba spp. and biofilms, opening potential lines of research on this severe ocular infection. A systematic literature search was conducted in May 2020 in the following databases: PubMed Central®/Medline, LILACS, The Cochrane Library, and EMBASE®. The studies were selected following the inclusion and exclusion criteria specifically defined for this review. Electronic research recovered 353 publications in the literature. However, none of the studies met the inclusion criterion of biofilm-producing Acanthamoeba spp., inferring that the parasite does not produce biofilms. Nonetheless, 78 studies were classified as potentially included regarding any association of Acanthamoeba spp. and biofilms. These studies were allocated across six different locations (hospital, aquatic, ophthalmic and dental environments, biofilms produced by bacteria, and other places). Acanthamoeba species use biofilms produced by other microorganisms for their benefit, in addition to them providing protection to and facilitating the dissemination of pathogens residing in them.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2

Data availability

All data extracted from the reviewed papers during this study are described in this article.


Download references


This work was supported by the Coordination for the Improvement of Higher Education Personnel – CAPES, Ministry of Education, Brazil.

Author information

Authors and Affiliations



L.F.P. wrote the paper and supplementary materials, designed the figures, and analyzed the data; B.N.G.A. designed the review, analyzed the data, and critically reviewed the paper; D.F. analyzed the data and critically reviewed the paper; A.L.H.L. critically reviewed the paper.

Corresponding author

Correspondence to Denise Freitas.

Ethics declarations

Ethics approval

This is a systematic review, and no ethical approval is required.

Consent to participate

Not applicable.

Consent for publication

The authors affirm that patients provided informed consent for the publication of the images in Fig. 1.

Competing interests

The authors declare no competing interests.

Additional information

Handling Editor: Julia Walochnik

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Pinto, L.F., Andriolo, B.N.G., Hofling-Lima, A.L. et al. The role of Acanthamoeba spp. in biofilm communities: a systematic review. Parasitol Res 120, 2717–2729 (2021).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:


  • Acanthamoeba
  • Amoeba
  • Biofilm
  • Infection
  • Pathogens
  • Protozoa