Bacterial Colonization in Patients with Chronic Lymphocytic Leukemia and Factors Associated with Infections and Colonization

Abstract

Patients with chronic lymphocytic leukemia (CLL) have defects in both humoral and cellular immunity as a result of their underlying malignancy, as well as chemotherapy-related immune suppression. Upper respiratory tract (URT) colonization can be regarded as a major contributor to infection, so the relationship between carriage rates, disease incidence, or antibiotic resistance should be monitored. This prospective study included 50 newly diagnosed, previously untreated patients with CLL and 38 healthy volunteers. A total of 264 samples obtained from anterior nares and oropharynx were microbiologically examined. A significantly higher frequency of S. aureus and Gram-negative bacilli (GNB) colonization in CLL patients was observed in comparison to healthy volunteers. Information regarding baseline characteristics; the Rai staging system; hematological tests results; immunophenotype of basic lymphocyte subsets, including the expression of programmed cell death-1 protein (PD-1) and its ligand (PD-L1); as well as Epstein-Barr virus (EBV) status were determined to analyze risk factors for infections and bacterial colonization. The data represent the basic information for identification of further risk factors of infection and bacterial oropharyngeal colonization in CLL patients. The rate of disease progression within the time from the CLL diagnosis was significantly higher in patients colonized by GNB. This study highlights EBV infection and frequencies of PD-1 positive T CD3+ cells and B cells as risk factors in CLL patients.