Ocular surface microbiome alterations are found in both eyes of individualswith unilateral infectious keratitis

Abstract

Purpose: To analyze the ocular surfacemicrobiome (OSM) profile in both eyes of individuals with unilateral keratitis. Methods: In this prospective, cross-sectional study, the conjunctival OSM of adults (>18 years old) presenting to an ophthalmic emergency department with acute unilateral keratitis and controls without an acute infectious process was sampled. Samples underwent DNA amplification and 16S sequencing using Illumina MiSeq 250 and were analyzed using Qiime. Statistical analysis was performed using a two-sided Student ttest, diversity indices, and principal coordinate analysis. The main outcome measures included relative abundance and α and β diversity. Results: Bacterial DNA was recovered from all 34 eyes of 17 individuals with keratitis (mean age, 49.3 ± 17.5 years) and 16 eyes of controls (mean age, 56.6 ± 17.0 years). In the two culture-positive eyes, 16S aligned with culture results. Significant differences in α diversities were noted when comparing both eyes of individuals with keratitis to control eyes (all P < 0.05), but no significant differences between the eyes of an individualwith keratitis. Principal coordinate analysis plots confirmed this finding, demonstrating separation between either eye of patientswith keratitis and controls (both P<0.01), however not between eyes in patients with unilateral keratitis. Both eyes of individuals with keratitis had greater abundance of Pseudomonas compared with controls both on compositional analysis and linear discriminant analysis. Conclusions: Alterations in theOSMprofile are detected in both eyes of individualswith unilateral keratitis compared with controls. Beyond the causative organism, a greater abundance of potential pathogens and lesser abundance of commensal organismswere found. Translational Relevance: The OSM profile is altered in both eyes of individuals with unilateral keratitis, whichmay lend insight into the role of themicrobiome in the pathophysiology of disease.