Bacterial skin colonization and systemic antibiotic treatment in patients with cutaneous T-cell lymphoma

Bacterial colonization, particularly by Staphylococcus aureus (SA), is prevalent on the skin of patients with primary cutaneous T-cell lymphoma (CTCL). This study aimed to investigate risk factors for cutaneous bacterial and Staphylococcus aureus colonization and to evaluate their impact, together with systemic antibiotic use, on the prognosis of patients with CTCL.

This retrospective study included 113 CTCL patients who underwent skin swab testing at Peking University First Hospital from 2010 to 2024.

Eighty-five patients (75.2%) tested positive for bacterial skin colonization (SA, 60.2%). Ulcerated lesions significantly increased the likelihood of a positive result in bacterial/SA skin cultures (multivariate analysis). Additionally, advanced stages, the presence of tumors, erythroderma, lymphopenia, and eosinophilia were associated with an increased risk of positive skin cultures (Univariate analysis). Cox regression analysis indicated that skin bacterial/SA colonization and antibiotic intervention, were not correlated with overall survival (p > 0.05).

This retrospective study presents data on the prevalence of bacterial skin colonization in Asian CTCL patients. Ulcerated lesions emerged as the most significant risk factor associated with cutaneous bacterial/SA colonization. In Asian patients with CTCL, neither bacterial or Staphylococcus aureus skin colonization was associated with a poorer prognosis, nor did short-term systemic antibiotic therapy improve outcomes.