Abstract
Our objectives were to investigate whether the conjunctival microbiota is altered by contact lens wear and/or bacterial keratitis and to explore the hypothesis that commensals of conjunctival microbiota contribute to bacterial keratitis. Swab samples from both eyes were collected separately from the inferior fornix of the conjunctiva of non-contact-lens users (nparticipants = 28) and contact lens users (nparticipants = 26) and from patients with contact-lens-associated bacterial keratitis (nparticipants = 9). DNA from conjunctival swab samples was analyzed with 16S rRNA gene amplicon sequencing. Pathogens from the corneal infiltrates were identified by cultivation. In total, we identified 19 phyla and 283 genera; the four most abundant genera were Pseudomonas, Enhydrobacter, Staphylococcus, and Cutibacterium. Several pathogens related to bacterial keratitis were identified in the conjunctival microbiota of the whole study population, and the same bacteria were identified by both methods in the conjunctiva and cornea for four patients with contact-lens-associated bacterial keratitis. The overall conjunctival microbiota profile was not altered by contact lens wear or bacterial keratitis; thus, it does not appear to contribute to the development of bacterial keratitis in contact lens users. However, in some individuals, conjunctival microbiota may harbor opportunistic pathogens causing contact-lens-associated bacterial keratitis.
Highlights
Microbial keratitis is caused by microorganisms, such as bacteria and fungi, and is a sight-threatening condition globally affecting up to 2 million people per year [1]
No previous studies have investigated the potential alterations of the conjunctival microbiota profile in contact-lens-associated bacterial keratitis (CLABK) using molecular techniques
Conjunctival microbiota has been described for fungal keratitis by Ge et al [9], who reported that the conjunctival microbiota profile was altered with lower bacterial diversity and with differences in the relative abundances for some bacteria such as Corynebacterium, Staphylococcus and Pseudomonas
Summary
Microbial keratitis is caused by microorganisms, such as bacteria and fungi, and is a sight-threatening condition globally affecting up to 2 million people per year [1]. It is feasible to assume that the reported alterations to ocular surface microbiota through contact lens wear [6,7] may contribute to the development of microbial keratitis [8]. Shin et al [6] demonstrated a more skinlike microbiota in contact lens users with higher relative abundances of Methylobacterium, Lactobacillus, Acinetobacter, and Pseudomonas and lower abundances of Haemophilus, Streptococcus, Staphylococcus, and Corynebacterium. No previous studies have investigated the potential alterations of the conjunctival microbiota profile in contact-lens-associated bacterial keratitis (CLABK) using molecular techniques. Conjunctival microbiota has been described for fungal keratitis by Ge et al [9], who reported that the conjunctival microbiota profile was altered with lower bacterial diversity and with differences in the relative abundances for some bacteria such as Corynebacterium, Staphylococcus and Pseudomonas
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