Moon Jayoon, Lee Yunjin, Yoon Chang Ho, Kim Mee Kum
Laboratory of Ocular Regenerative Medicine and Immunology, Seoul Artificial Eye Center, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea.
Department of Ophthalmology, Saevit Eye Hospital, Goyang, Republic of Korea.
BMC Ophthalmol. 2022 Apr 19;22(1):179. doi: 10.1186/s12886-022-02406-x.
Stevens-Johnson syndrome (SJS) is an abnormal immune-response causing extensive exfoliation of the mucocutaneous tissue including conjunctiva. While several factors are associated with the alteration of conjunctival microbiota, the conjunctiva of SJS patients are found to harbor a different microbiota compared to healthy subjects. We investigated the conjunctival microbiota of Korean SJS patients, and identified factors associated with the conjunctival microbiota and its positive culture.
Medical records were retrospectively reviewed in 30 chronic SJS patients who had undergone conjunctival swab culture sampling. Demographic factors, chronic ocular surface complications score (COCS), tear break-up time (TBUT), tear secretion, tear matrix metalloproteinase 9 (MMP9), and results of conjunctival swab culture were assessed.
Positive culture was seen in 58.1%. Gram positive bacteria was most commonly isolated, among which Coagulase-negative Staphylococci (45.5%) and Corynebacterium species (40.9%) were predominantly observed. Tear MMP9 positivity was observed significantly more in the positive culture group (100%) compared to the negative culture group (70%) (P = 0.041). Topical cyclosporine and corticosteroid were not associated with repetitive positive cultures. No significant differences in COCS, TBUT, and tear secretion were found between culture-positive and culture-negative groups.
Our study suggests that tear MMP9 positivity may be related with the presence of an abnormal ocular surface microbiota in chronic SJS patients.
史蒂文斯 - 约翰逊综合征（SJS）是一种异常免疫反应，可导致包括结膜在内的粘膜皮肤组织广泛剥脱。虽然有几个因素与结膜微生物群的改变有关，但与健康受试者相比，SJS患者的结膜中发现存在不同的微生物群。我们调查了韩国SJS患者的结膜微生物群，并确定了与结膜微生物群及其阳性培养相关的因素。
回顾性分析30例接受结膜拭子培养采样的慢性SJS患者的病历。评估人口统计学因素、慢性眼表并发症评分（COCS）、泪膜破裂时间（TBUT）、泪液分泌、泪液基质金属蛋白酶9（MMP9）以及结膜拭子培养结果。
58.1%的患者培养结果为阳性。革兰氏阳性菌是最常分离出的菌种，其中凝固酶阴性葡萄球菌（45.5%）和棒状杆菌属（40.9%）最为常见。与阴性培养组（70%）相比，阳性培养组中泪液MMP9阳性的观察率显著更高（100%）（P = 0.041）。局部使用环孢素和皮质类固醇与重复阳性培养无关。培养阳性组和培养阴性组在COCS、TBUT和泪液分泌方面没有显著差异。
我们的研究表明，泪液MMP9阳性可能与慢性SJS患者眼表微生物群异常的存在有关。
