AUTHOR=Zhu Xiangjia , Wei Ling , Rong Xianfang , Zhang Yinglei , Zhang Qian , Wen Xiaofeng , He Wenwen , Zhang Keke , Chen Feng , Wei Lai , Lu Yi 

TITLE=Conjunctival Microbiota in Patients With Type 2 Diabetes Mellitus and Influences of Perioperative Use of Topical Levofloxacin in Ocular Surgery

JOURNAL=Frontiers in Medicine

VOLUME=8

YEAR=2021

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2021.605639

DOI=10.3389/fmed.2021.605639

ISSN=2296-858X

ABSTRACT=<p><bold>Background:</bold> 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.</p><p><bold>Methods:</bold> 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.</p><p><bold>Results:</bold> The α-diversity of the conjunctival microbiota was significantly higher in T2DM patients than in controls (<italic>P</italic> &lt; 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 <italic>Bacteroidetes</italic> and <italic>Fusobacteria</italic>, genus <italic>Pseudomonas, Haemophilus</italic>, and <italic>Empedobacter</italic> were enriched, while genus <italic>Streptococcus</italic> 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 <italic>Staphylococcus</italic> 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.</p><p><bold>Conclusions:</bold> The conjunctival microbiome of T2DM patients was more complex and may respond differently to topical antibiotics.</p>