Abstract
Background: Patients with type 2 diabetes mellitus (T2DM) are prone to ocular surface infections. We therefore characterized the conjunctival microbiome of T2DM patients and the influence of topical levofloxacin to investigate whether a dysbiosis is associated with this phenomenon.Methods: Conjunctival microbiome of 79 T2DM patients and 113 non-diabetic controls was profiled using the 16S rDNA sequencing approach. Furthermore, 21 T2DM and 14 non-diabetic patients who underwent cataract surgeries were followed up perioperatively and the influence of pre- and post-operative levofloxacin on the conjunctival microbiome was further investigated prospectively and compared longitudinally.Results: The α-diversity of the conjunctival microbiota was significantly higher in T2DM patients than in controls (P < 0.05). Significant differences in both composition and function of the conjunctival microbiome were identified on the ocular surface of T2DM patients as compared to non-diabetic controls. Particularly, phylum Bacteroidetes and Fusobacteria, genus Pseudomonas, Haemophilus, and Empedobacter were enriched, while genus Streptococcus was reduced on the T2DM ocular surface. Microbial genes functioning of bacterial chemotaxis was elevated in the conjunctival microbiome of T2DM patients. Furthermore, compared to the initial status, several genera including Staphylococcus were more abundant in the conjunctival microbiome of T2DM patients after 3-days use of preoperative levofloxacin topically, while no genus was more abundant in the non-diabetic follow-up group. No difference was observed between initial status and 7 days after ceasing all postoperative medications in both diabetic and non-diabetic follow-up groups.Conclusions: The conjunctival microbiome of T2DM patients was more complex and may respond differently to topical antibiotics.
Highlights
It’s estimated 700 million people may suffer from diabetes mellitus by the year 2045 [1]
Significant differences in both composition and function of the conjunctival microbiome were identified on the ocular surface of Type 2 diabetes mellitus (T2DM) patients as compared to non-diabetic controls
Microbial genes functioning of bacterial chemotaxis was elevated in the conjunctival microbiome of T2DM patients
Summary
It’s estimated 700 million people may suffer from diabetes mellitus by the year 2045 [1]. Diabetic patients are known to be vulnerable to infections throughout the whole body [3], with higher positive rates of bacterial isolation from various tissues [4,5,6]. They are prone to the ocular infections in lids, conjunctiva, and cornea [7, 8], as well as more complications after ocular surgeries [9], leading to worse visual prognosis [10, 11]. Patients with type 2 diabetes mellitus (T2DM) are prone to ocular surface infections. We characterized the conjunctival microbiome of T2DM patients and the influence of topical levofloxacin to investigate whether a dysbiosis is associated with this phenomenon
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