Study of nasopharyngeal microflora of persons suffering from chronic lymphocytic leukemia, their antibiotic and phagosusceptibility.

The literature provides limited data on bacterial pathogens responsible for infections in patients with chronic lymphocytic leukemia (CLL). Similarly, information on the antibiotic susceptibility of these pathogens in CLL patients is sparse. Given the close association between infectious complications and mortality rates in CLL, there is significant interest in these pathogenic agents. This study aims to identify microorganisms isolated from the nasopharynx of CLL patients and to explore effective treatments to neutralize them. In Georgia, data on the effects of phage therapy on pathogenic microorganisms isolated from CLL patients are nonexistent. This study aims to analyze the microflora of the upper respiratory tract of CLL patients to explore the possibility of replacing chemotherapy with alternative treatment options. For this purpose, within the frame of our research, we studied the nasopharyngeal microflora of 22 CLL patients (average age 65 years) and 7 healthy volunteers of the corresponding age group by determining their antibiotic and phage sensitivity. As a result of the study, it was found that 51% of the nasopharyngeal microflora in CLL patients are pathogenic microorganisms, compared to 33% in the healthy control group. Additionally, CLL patients not only exhibit an increased presence of pathogenic flora but also greater diversity. In these patients, pathogenic cocci, rods (E. coli), and bacilli are present, along with fungal strains such as Aspergillus and Candida, which are not observed in the upper respiratory tracts of healthy individuals, whose flora is very uniform. Linezolid and moxifloxacin were identified as the most effective antibiotics for therapeutic purposes. The highest microbial resistance was detected against vancomycin and tobramycin. Five different commercial bacteriophages were used to determine the phage sensitivity of the microflora identified in both healthy individuals and CLL patients. None of the commercial phages were active against the isolated strains, whether from the nasopharyngeal swabs of healthy individuals or those with CLL. Based on our research, we can conclude that antibiotic therapy, specifically drugs from the fluoroquinolone and oxazolidinone groups, remains the most effective treatment approach given the high rate of pathogenic flora in the upper respiratory tract of people with CLL. Alternative treatments in the form of commercial bacteriophages cannot replace chemical drugs.