a, 16S rRNA sequencing of faecal samples from controls (n = 14), patients with alcohol-use disorder (n = 43), or alcoholic hepatitis (n = 75). The graph demonstrates the relative abundance of sequence reads in each genus. b, Bacterial diversity (Shannon index and Simpson index) and richness (Chao richness) was calculated in controls (n = 14), patients with alcohol-use disorder (n = 43) or alcoholic hepatitis (n = 75). c, E. faecalis in faecal samples from controls (n = 25), patients with alcohol-use disorder (n = 38) or alcoholic hepatitis (n = 82), assessed by qPCR. d, Percentage of faecal samples positive for E. faecalis in controls (n = 25), patients with alcohol-use disorder (n = 38) or alcoholic hepatitis (n = 82), assessed by qPCR. E. faecalis was detected in faeces from 80% of patients with alcoholic hepatitis, versus 36% of controls (P < 0.001). There was also a significant difference between patients with alcohol-use disorder and patients with alcoholic hepatitis (P < 0.01). e, Receiver operating characteristic curves and area under the curve (AUC) for the comparison of 90-day mortality and cytolysin positivity (red; n = 57), MELD score (blue; n = 56), ABIC score (yellow; n = 57) and discriminant function (green; n = 42) in patients with alcoholic hepatitis. f, E. faecalis in faecal samples from patients with alcoholic hepatitis whose faecal samples were cytolysin-positive (n = 25) or cytolysin-negative (n = 54), assessed by qPCR (P = 0.8174). g, 16S rRNA sequencing of faecal samples from patients with alcoholic hepatitis from different centres (France, n = 9; Mexico, n = 6; Spain, n = 5; UK, n = 11; USA (east), n = 16; USA (Midwest), n = 12; USA (west), n = 16 patients). We used PCoA based on Jaccard dissimilarity matrices to show β-diversity among groups at the genus level. The composition of faecal microbiota was significantly different between patients from different regions (P < 0.01). h, Percentage of faecal samples that were positive for cylL L and cylL S DNA sequences (cytolysin-positive), in patients with alcoholic hepatitis from different centres (France, n = 16; Mexico, n = 6; Spain, n = 6; UK, n = 10; USA (east), n = 16; USA (Midwest), n = 13; USA (west), n = 15 patients), assessed by qPCR (P = 0.6094). i, E. faecalis in faecal samples from patients with alcoholic hepatitis from different centres, assessed by qPCR (P = 0.5648). j, Percentage of faecal samples that were positive for E. faecalis in patients with alcoholic hepatitis from different centres (France, n = 16; Mexico, n = 6; Spain, n = 6; UK, n = 10; USA (east), n = 16; USA (Midwest), n = 13; USA (west), n = 15 patients), assessed by qPCR (P = 0.0529). k, Percentage of subjects with faecal samples that were positive for cylL L and cylL S DNA sequences (cytolysin-positive), in patients with alcoholic hepatitis and with (n = 30) or without (n = 18) cirrhosis, assessed by qPCR (P = 0.3431). l, E. faecalis in faecal samples from patients with alcoholic hepatitis and with (n = 30) or without (n = 18) cirrhosis, assessed by qPCR (P = 0.5736). m, Percentage of faecal samples that were positive for E. faecalis in patients with alcoholic hepatitis and with (n = 30) or without (n = 18) cirrhosis, assessed by qPCR (P = 0.2878). Results are expressed as mean ± s.e.m. (c, f, i, l). For the box and whisker plots in b, the box extends from the 25th to 75th percentiles, and the centre line represents the median; for all three groups, the bottom whiskers show the minimum values; for the control group (black), the top whisker shows the maximum value; for the other two groups, the top whiskers represent the 75th percentile plus 1.5× the inter-quartile distance (the distance between the 25th and 75th percentiles); all values greater than this are plotted as individual dots. P values were determined by Kruskal–Wallis test (i) with Dunn’s post hoc test (b, c), two-sided Fisher’s exact test (h, j, k, m) followed by FDR procedures (d), two-sided Mann–Whitney Wilcoxon rank-sum test (f, l) or PERMANOVA (g). The exact group size (n) and P values for each comparison are listed in Supplementary Table 10. *P < 0.05, **P < 0.01, ***P < 0.001, ****P < 0.0001.