Dataset Information

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

ABSTRACT:

Background

Carriage of Staphylococcus aureus is a risk for infections. Targeted decolonization reduces postoperative infections but depends on accurate screening.

Aim

To 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.

Methods

Healthy 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.

Findings

In 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%).

Conclusion

Nasal 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.

SUBMITTER: Young BC

PROVIDER: S-EPMC5490851 | biostudies-literature | 2017 Jul

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

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

Young B C BC Votintseva A A AA Foster D D Godwin H H Miller R R RR Anson L W LW Walker A S AS Peto T E A TEA Peto T E A TEA Crook D W DW Knox K K

The Journal of hospital infection 20170130 3

<h4>Background</h4>Carriage of Staphylococcus aureus is a risk for infections. Targeted decolonization reduces postoperative infections but depends on accurate screening.<h4>Aim</h4>To 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.<h4>Methods</h4>Healthy individuals were recruited via general practices. After consent, nurses performed multi-s ...[more]

PMID: 28246002

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Project description:Industrial hog operation (IHO) workers can be occupationally exposed to Staphylococcus aureus and may carry the bacteria in their nares. Workers may persistently carry S. aureus or transition between different states of nasal carriage over time: no nasal carriage, nasal carriage of a human-associated strain, and nasal carriage of a livestock-associated strain. We developed a mathematical model to predict the proportion of IHO workers in each nasal carriage state over time, accounting for IHO worker mask use. We also examined data sufficiency requirements to inform development of models that produce reliable predictions. We used nasal carriage data from a cohort of 101 IHO workers in North Carolina, sampled every 2 weeks for 4 months, to develop a three-state Markov model that describes the transition dynamics of IHO worker nasal carriage status over the study period and at steady state. We also stratified models by mask use to examine their impact on worker transition dynamics. If conditions remain the same, our models predicted that 49.1% of workers will have no nasal carriage of S. aureus, 28.2% will carry livestock-associated S. aureus, and 22.7% will carry human-associated S. aureus at steady state. In stratified models, at steady state, workers who reported only occasional mask (<80% of the time) use had a higher predicted proportion of individuals with livestock-associated S. aureus nasal carriage (39.2%) compared to workers who consistently (≥80% of the time) wore a mask (15.5%). We evaluated the amount of longitudinal data that is sufficient to create a Markov model that accurately predicts future nasal carriage states by creating multiple models that withheld portions of the collected data and compared the model predictions to observed data. Our data sufficiency analysis indicated that models created with a small subset of the dataset (approximately 1/3 of observed data) perform similarly to models created using all observed data points. Markov models may have utility in predicting worker health status over time, even when limited longitudinal data are available.

Dataset Information

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

Background

Aim

Methods

Findings

Conclusion

Publications

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

Similar Datasets

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