Self-sampling is appropriate for detection of Staphylococcus aureus: a validation study

Cleef, Brigitte Agl van; Rijen, Miranda van; Ferket, Marianne; Kluytmans, Jan

doi:10.1186/2047-2994-1-34

Cited by 19 publications

(22 citation statements)

References 11 publications

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“…This is however believed to be a minor bias. A recent pilot study has shown high degree of agreement between self-samples and investigator samples (93% agreement, κ 0.85 for nasal swabs and 83% agreement, κ 0.60 for throat swabs) 35. Another limitation is the previously described underestimation of MSSA presence but this is of negligible impact in the results because detection of MRSA and S aureus remains unaffected.…”

Section: Discussionmentioning

confidence: 96%

Risk factors for persistence of livestock-associated MRSA and environmental exposure in veal calf farmers and their family members: an observational longitudinal study

et al. 2013

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ObjectivesLivestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) emergence is a major public health concern. This study was aimed at assessing risk factors for persistently carrying MRSA in veal calf farmers and their family members. We also evaluate the dynamics of MRSA environmental load during the veal-calf production cycle.DesignObservational, longitudinal, repeated cross-sectional study.Setting52 veal calf farms in the Netherlands.ParticipantsFrom the end of 2010 to the end of 2011, a total of 211 farmers, family members and employees were included in the study.Primary outcome and secondary outcome measuresNasal swabs were taken from participants on days 0, 4, 7 and week 12. A persistent MRSA carrier was defined as a person positive for MRSA on days 0, 4 and 7. Participants filled in an extensive questionnaire to identify potential risk factors and confounders. For estimation of MRSA prevalence in calves and environmental contamination, animal nasal swabs and Electrostatic Dust Collectors were taken on day 0 and week 12.ResultsThe presence of potential animal reservoirs (free-ranging farm cats and sheep) and the level of contact with veal calves was positively associated with persistent MRSA carriage. Interestingly, at the end of the study (week 12), there was a twofold rise in animal prevalence and a significantly higher MRSA environmental load in the stables was found on farms with MRSA carriers.ConclusionsThis study supports the hypothesis that environmental contamination with MRSA plays a role in the acquisition of MRSA in farmers and their household members and suggests that other animal species should also be targeted to implement effective control strategies.

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Section: Discussionmentioning

confidence: 96%

Risk factors for persistence of livestock-associated MRSA and environmental exposure in veal calf farmers and their family members: an observational longitudinal study

et al. 2013

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“…Firstly, participants were swabbed only in the nares, which likely missed some carriage even at the timepoints assayed 30,31 ; a recent study suggests that this may have particularly underestimated carriage in younger people 32 . However, swabbing of the nares enabled participant self-swabbing, which was vital for our study and was recently shown to have reasonable accuracy 33 . Secondly, the bi-monthly sampling interval may have missed some transient carriage.…”

Section: Discussionmentioning

confidence: 98%

Dynamics of acquisition and loss of carriage of Staphylococcus aureus strains in the community: The effect of clonal complex

Miller

Walker

Godwin

et al. 2014

Journal of Infection

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SummaryBackgroundStaphylococcus aureus nasal carriage increases infection risk. However, few studies have investigated S. aureus acquisition/loss over >1 year, and fewer still used molecular typing.Methods1123 adults attending five Oxfordshire general practices had nasal swabs taken. 571 were re-swabbed after one month then every two months for median two years. All S. aureus isolates were spa-typed. Risk factors were collected from interviews and medical records.Results32% carried S. aureus at recruitment (<1% MRSA). Rates of spa-type acquisition were similar in participants S. aureus positive (1.4%/month) and negative (1.8%/month, P = 0.13) at recruitment. Rates were faster in those carrying clonal complex (CC)15 (adjusted (a)P = 0.03) or CC8 (including USA300) (aP = 0.001) at recruitment versus other CCs. 157/274 (57%) participants S. aureus positive at recruitment returning ≥12 swabs carried S. aureus consistently, of whom 135 carried the same spa-type. CC22 (including EMRSA-15) was more prevalent in long-term than intermittent spa-type carriers (aP = 0.03). Antibiotics transiently reduced carriage, but no other modifiable risk factors were found.ConclusionsBoth transient and longer-term carriage exist; however, the approximately constant rates of S. aureus gain and loss suggest that ‘never’ or truly ‘persistent’ carriage are rare. Long-term carriage varies by strain, offering new explanations for the success of certain S. aureus clones.

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“…There is growing evidence from large studies that self-swabbing is acceptable to study participants, but there is limited data on the accuracy of self-swabbing by patients 19, 20. One study compared investigator to participant swabs, but these study participants were nursing personnel, and may not have represented patients who are not healthcare professionals 21 . Further, it is unclear how accurately samples taken weeks before admission predict carriage at admission 17 …”

Section: Introductionmentioning

confidence: 99%

Multi-site and nasal swabbing for carriage of Staphylococcus aureus : what does a single nose swab predict?

Young

Votintseva

Foster

et al. 2017

Journal of Hospital Infection

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SummaryBackgroundCarriage of Staphylococcus aureus is a risk for infections. Targeted decolonization reduces postoperative infections but depends on accurate screening.AimTo compare detection of S. aureus carriage in healthy individuals between anatomical sites and nurse- versus self-swabbing; also to determine whether a single nasal swab predicted carriage over four weeks.MethodsHealthy individuals were recruited via general practices. After consent, nurses performed multi-site swabbing (nose, throat, and axilla). Participants performed nasal swabbing twice-weekly for four weeks. Swabs were returned by mail and cultured for S. aureus. All S. aureus isolates underwent spa typing. Persistent carriage in individuals returning more than three self-swabs was defined as culture of S. aureus from all or all but one self-swabs.FindingsIn all, 102 individuals underwent multi-site swabbing; S. aureus carriage was detected from at least one site from 40 individuals (39%). There was no difference between nose (29/102, 28%) and throat (28/102, 27%) isolation rates: the combination increased total detection rate by 10%. Ninety-nine patients returned any self-swab, and 96 returned more than three. Nasal carriage detection was not significantly different on nurse or self-swab [28/99 (74%) vs 26/99 (72%); χ2: P = 0.75]. Twenty-two out of 25 participants with first self-swab positive were persistent carriers and 69/71 with first self-swab negative were not, giving high positive predictive value (88%), and very high negative predictive value (97%).ConclusionNasal swabs detected the majority of carriage; throat swabs increased detection by 10%. Self-taken nasal swabs were equivalent to nurse-taken swabs and predicted persistent nasal carriage over four weeks.

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Self-sampling is appropriate for detection of Staphylococcus aureus: a validation study

Cited by 19 publications

References 11 publications

Risk factors for persistence of livestock-associated MRSA and environmental exposure in veal calf farmers and their family members: an observational longitudinal study

Risk factors for persistence of livestock-associated MRSA and environmental exposure in veal calf farmers and their family members: an observational longitudinal study

Dynamics of acquisition and loss of carriage of Staphylococcus aureus strains in the community: The effect of clonal complex

Multi-site and nasal swabbing for carriage of Staphylococcus aureus : what does a single nose swab predict?

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