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. Two thousand people (1200 adults and 800 children) from a single NHS general practice in Southampton UK were randomly selected from a GP age sex register, stratified by age and sex, and invited to undertake nasal self-swabbing in their own home. Overall, 362 (32.5%) adult and 168 (22%) child swabs were returned. Responses were greater for adults, increased age, female gender and decreasing socio-economic deprivation. The overall estimated practice carriage rate of S. aureus directly standardised for age sex was 28% (95% CI 26.1% to 30.2%). Carriage of meticillin-susceptible S. aureus was 27% (95% CI 26.1% to 30.2%) whilst that of meticillin resistant S. aureus was 1.9% (95% CI 0.7% to 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.