Comparison of the ocular microbiome on ocular surface between chronic Stevens-Johnson syndrome patients and healthy subjects

Abstract

Background: Stevens-Johnson syndrome (SJS) usually causes ocular surface disease. 35% of these patients develop chronic ocular sequelae including symblepharon, limbal stem cell deficiency, etc. The sequelae from SJS may also affect the alteration of ocular microbiome. Subjects: 20 chronic SJS patients and 20 healthy subjects were enrolled for specimen collection from inferior conjunctiva for microbiome analysis by using conventional culture and next-generation sequencing(NGS) methods Methods: Prospective, age and sex matched analytical study Results: A significant higher proportion of culture-positive specimen was demonstrated in SJS group (SJS group 60%, healthy 10%, p-value=0.001). In SJS group, we found significantly higher severity score in culture-positive group comparing with culture-negative group (p-value=0.016). In addition, NGS has demonstrated greater diversity of microbial species and higher proportion of pathogenic microorganisms including Pseudomonas spp., Staphylococcus spp., Streptococcus spp., Acinetobacter spp. in SJS group. The obvious difference between 2 bacterial communities was displayed by principle coordinate analysis (PCoA). Conclusions: Ocular surface in SJS is occupied by more diversed microorganisms with increased proportion of opportunistic pathogens. These alterations may cause chronic inflammation and opportunistic infections. Because the marked changes of ocular surface in SJS may cause atypical infection and inflammation, the clinicians should carefully consider appropriate treatment for these patients.