Remodeling of gut bacteriome and virome in acute retinal necrosis: expansion of Enterobacteriaceae-related taxa.

BACKGROUND

This study was designed to examine the alterations in the gut bacteriome and virome of patients with acute retinal necrosis (ARN), and to explore potential cross-kingdom microbial associations.

METHODS

The gut virome and bacteriome of 10 patients with new-onset ARN and 10 age- and sex-matched healthy individuals (N) were profiled using viral metagenomics and 16S rRNA sequencing, respectively.

RESULTS

The gut bacteriome in ARN patients was significantly altered, with Enterobacteriaceae_A increased at the family level. Genus-level analysis further described higher relative abundances of opportunistic pathogens, such as Escherichia and Klebsiella, alongside lower relative abundances of commensal anaerobes, including Fusicatenibacter and Anaerobutyricum. Exploratory clinical association analysis suggested a positive association between Klebsiella and intraocular pressure, while Fusicatenibacter tended to be further reduced in patients with vasculitis involving the major retinal arteries. Predicted bacterial functional profiling indicated an enrichment in enterobactin biosynthesis and related metabolic pathways. In contrast, differences in the gut eukaryotic virome were limited, and no significant enrichment of fecal Herpesviridae was detected. Virome perturbations predominantly occurred at the bacteriophage level, featuring shifts in predicted bacterial host assignment from commensal bacteria toward opportunistic pathogen-associated taxa and an increased inferred proportion of temperate phages. Exploratory cross-kingdom analysis suggested associations involving Escherichia and three related phage features.

CONCLUSION

Gut dysbiosis in ARN was associated with Enterobacteriaceae-related bacterial remodeling and phage alterations. These findings highlight an ARN-associated bacteriome-phage alteration pattern that warrants validation in larger independent cohorts.