title: Nasal self-swabbing for estimating the prevalence of Staphylococcus aureus in the community.
abstract: Staphylococcus aureus remains a significant cause of morbidity and mortality and, therefore, a burden on healthcare systems. Our aim was to estimate the current rate of nasal S. aureus carriage in the general population and to determine the feasibility of nasal self-swabbing as a means of detection. Two thousand people (1200 adults and 800 children) from a single NHS general practice in Southampton, UK, were randomly selected from a general practice age sex register, stratified by age and sex, and invited to undertake nasal self-swabbing in their own home. Overall, 362 (32.5%) swabs from adults and 168 (22%) from children were returned. Responses were greater for adults and those of increased age, female gender and decreasing socio-economic deprivation. The overall estimated practice carriage rate of S. aureus directly standardized for age sex was 28% [95% confidence interval (CI) 26.1-30.2%]. Carriage of meticillin-susceptible S. aureus was 27% (95% CI 26.1-30.2%), whilst that of meticillin-resistant S. aureus was 1.9% (95% CI 0.7-3.1%). Although nasal self-swabbing rates were relatively low, they are comparable to other studies and may allow large population-based carriage studies to be undertaken at relatively low cost. Importantly, this study updates prevalence data for S. aureus carriage in the community.
authors.affiliation: Health Protection Agency, Hampshire and Isle of Wight Health Protection Unit, Unit 8, Fulcrum 2, Solent Way, Whiteley, Hampshire PO15 7FN, UK.
authors.forename: Jenny
authors.initials: J
authors.lastname: Gamblin
authors.affiliation: Academic Unit of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, University Hospital Southampton Foundation NHS Trust, South Academic Block, Southampton SO16 6YD, UK.
authors.forename: Johanna M
authors.initials: JM
authors.lastname: Jefferies
authors.affiliation: Academic Unit of Primary and Population Sciences, Faculty of Medicine, University of Southampton, University Hospital Southampton Foundation NHS Trust, South Academic Block, Southampton SO16 6YD, UK.
authors.forename: Scott
authors.initials: S
authors.lastname: Harris
authors.affiliation: HPA Public Health Laboratory, Southampton Laboratory Level B, South Pathology Block, University Hospital Southampton Foundation NHS Trust, Southampton SO16 6YD, UK.
authors.forename: Nusreen
authors.initials: N
authors.lastname: Ahmad
authors.affiliation: HPA Public Health Laboratory, Southampton Laboratory Level B, South Pathology Block, University Hospital Southampton Foundation NHS Trust, Southampton SO16 6YD, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Marsh
authors.affiliation: NIHR Respiratory Biomedical Research Unit, University Hospital Southampton Foundation NHS Trust, Southampton SO16 6YD, UK.|NIHR Wellcome Trust Clinical Research Facility, University Hospital Southampton Foundation NHS Trust, Southampton SO16 6YD, UK.|Academic Unit of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, University Hospital Southampton Foundation NHS Trust, South Academic Block, Southampton SO16 6YD, UK.
authors.forename: Saul N
authors.initials: SN
authors.lastname: Faust
authors.affiliation: Grove Medical Practice, Shirley Health Centre, Grove Road, Southampton SO15 3UA, UK.
authors.forename: Simon
authors.initials: S
authors.lastname: Fraser
authors.affiliation: Academic Unit of Primary and Population Sciences, Faculty of Medicine, University of Southampton, University Hospital Southampton Foundation NHS Trust, South Academic Block, Southampton SO16 6YD, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: Moore
authors.affiliation: Academic Unit of Primary and Population Sciences, Faculty of Medicine, University of Southampton, University Hospital Southampton Foundation NHS Trust, South Academic Block, Southampton SO16 6YD, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Roderick
authors.affiliation: Institute of Public Health, College of Medicine & Health Sciences, UAE University, PO Box 17666, Al Ain, United Arab Emirates.
authors.forename: Iain
authors.initials: I
authors.lastname: Blair
authors.affiliation: NIHR Respiratory Biomedical Research Unit, University Hospital Southampton Foundation NHS Trust, Southampton SO16 6YD, UK.|HPA Public Health Laboratory, Southampton Laboratory Level B, South Pathology Block, University Hospital Southampton Foundation NHS Trust, Southampton SO16 6YD, UK.|Academic Unit of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, University Hospital Southampton Foundation NHS Trust, South Academic Block, Southampton SO16 6YD, UK.
authors.forename: Stuart C
authors.initials: SC
authors.lastname: Clarke
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002353:Carrier State / Q000453:epidemiology / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009666:Nose / Q000382:microbiology*; D011159:Population Surveillance; D015995:Prevalence; D012648:Self Care; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000302:isolation & purification*; D055815:Young Adult