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Evaluation of swabbing methods for estimating the prevalence of bacterial carriage in the upper respiratory tract: a cross sectional study

Evaluation of swabbing methods for estimating the prevalence of bacterial carriage in the upper respiratory tract: a cross sectional study
Evaluation of swabbing methods for estimating the prevalence of bacterial carriage in the upper respiratory tract: a cross sectional study
Objectives Bacterial carriage in the upper respiratory tract is usually asymptomatic but can lead to respiratory tract infection (RTI), meningitis and septicaemia. We aimed to provide a baseline measure of Streptococcus pneumoniae, Moraxella catarrhalis, Pseudomonas aeruginosa, Staphylococcus aureus, Haemophilus influenzae and Neisseria meningitidis carriage within the community. Self-swabbing and healthcare professional (HCP) swabbing were compared.

Design Cross-sectional study.

Setting Individuals registered at 20 general practitioner practices within the Wessex Primary Care Research Network South West, UK.

Participants 10?448 individuals were invited to participate; 5394 within a self-swabbing group and 5054 within a HCP swabbing group. Self-swabbing invitees included 2405 individuals aged 0–4?years and 3349 individuals aged ?5?years. HCP swabbing invitees included 1908 individuals aged 0–4?years and 3146 individuals aged ?5?years.

Results 1574 (15.1%) individuals participated, 1260 (23.4%, 95% CI 22.3% to 24.5%) undertaking self-swabbing and 314 (6.2%, 95% CI 5.5% to 6.9%) undertaking HCP-led swabbing. Participation was lower in young children and more deprived practice locations. Swab positivity rates were 34.8% (95% CI 32.2% to 37.4%) for self-taken nose swabs (NS), 19% (95% CI 16.8% to 21.2%) for self-taken whole mouth swabs (WMS), 25.2% (95% CI 20.4% to 30%) for nasopharyngeal swabs (NPS) and 33.4% (95% CI 28.2% to 38.6%) for HCP-taken WMS. Carriage rates of S. aureus were highest in NS (21.3%). S. pneumoniae carriage was highest in NS (11%) and NPS (7.4%). M. catarrhalis carriage was highest in HCP-taken WMS (28.8%). H. influenzae and P. aeruginosa carriage were similar between swab types. N. meningitidis was not detected in any swab. Age and recent RTI affected carriage of S. pneumoniae and H. influenzae. Participant costs were lower for self-swabbing (£41.21) versus HCP swabbing (£69.66).

Conclusions Higher participation and lower costs of self-swabbing as well as sensitivity of self-swabbing favour this method for use in large population-based respiratory carriage studies.
e005341-[11pp]
Coughtrie, A.L.
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Whittaker, R.N.
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Begum, N.
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Anderson, Rebecca
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Tuck, A.
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Faust, S.N.
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Jefferies, Johanna M.C.
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Yuen, Ho Ming
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Roderick, P.J.
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Mullee, M.A.
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Moore, M.V.
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Clarke, S.C.
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Coughtrie, A.L.
38635fa8-f3de-49e8-9906-54a787177c55
Whittaker, R.N.
0b3a113a-d44c-4a47-befe-8b346488e4c3
Begum, N.
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Anderson, Rebecca
3b1eb108-4d0d-4fd6-a1a6-50f2cc03a533
Tuck, A.
90d0a731-080b-4872-8fc0-45cd71db1e2c
Faust, S.N.
f97df780-9f9b-418e-b349-7adf63e150c1
Jefferies, Johanna M.C.
9468e292-0b41-412d-9470-944e257c7bcf
Yuen, Ho Ming
b1df4c57-0c2a-44ac-ab40-22b88e8effe8
Roderick, P.J.
dbb3cd11-4c51-4844-982b-0eb30ad5085a
Mullee, M.A.
fd3f91c3-5e95-4f56-8d73-260824eeb362
Moore, M.V.
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Clarke, S.C.
f7d7f7a2-4b1f-4b36-883a-0f967e73fb17

Coughtrie, A.L., Whittaker, R.N., Begum, N., Anderson, Rebecca, Tuck, A., Faust, S.N., Jefferies, Johanna M.C., Yuen, Ho Ming, Roderick, P.J., Mullee, M.A., Moore, M.V. and Clarke, S.C. (2014) Evaluation of swabbing methods for estimating the prevalence of bacterial carriage in the upper respiratory tract: a cross sectional study. BMJ Open, 4 (10), e005341-[11pp]. (doi:10.1136/bmjopen-2014-005341). (PMID:25358677)

Record type: Article

Abstract

Objectives Bacterial carriage in the upper respiratory tract is usually asymptomatic but can lead to respiratory tract infection (RTI), meningitis and septicaemia. We aimed to provide a baseline measure of Streptococcus pneumoniae, Moraxella catarrhalis, Pseudomonas aeruginosa, Staphylococcus aureus, Haemophilus influenzae and Neisseria meningitidis carriage within the community. Self-swabbing and healthcare professional (HCP) swabbing were compared.

Design Cross-sectional study.

Setting Individuals registered at 20 general practitioner practices within the Wessex Primary Care Research Network South West, UK.

Participants 10?448 individuals were invited to participate; 5394 within a self-swabbing group and 5054 within a HCP swabbing group. Self-swabbing invitees included 2405 individuals aged 0–4?years and 3349 individuals aged ?5?years. HCP swabbing invitees included 1908 individuals aged 0–4?years and 3146 individuals aged ?5?years.

Results 1574 (15.1%) individuals participated, 1260 (23.4%, 95% CI 22.3% to 24.5%) undertaking self-swabbing and 314 (6.2%, 95% CI 5.5% to 6.9%) undertaking HCP-led swabbing. Participation was lower in young children and more deprived practice locations. Swab positivity rates were 34.8% (95% CI 32.2% to 37.4%) for self-taken nose swabs (NS), 19% (95% CI 16.8% to 21.2%) for self-taken whole mouth swabs (WMS), 25.2% (95% CI 20.4% to 30%) for nasopharyngeal swabs (NPS) and 33.4% (95% CI 28.2% to 38.6%) for HCP-taken WMS. Carriage rates of S. aureus were highest in NS (21.3%). S. pneumoniae carriage was highest in NS (11%) and NPS (7.4%). M. catarrhalis carriage was highest in HCP-taken WMS (28.8%). H. influenzae and P. aeruginosa carriage were similar between swab types. N. meningitidis was not detected in any swab. Age and recent RTI affected carriage of S. pneumoniae and H. influenzae. Participant costs were lower for self-swabbing (£41.21) versus HCP swabbing (£69.66).

Conclusions Higher participation and lower costs of self-swabbing as well as sensitivity of self-swabbing favour this method for use in large population-based respiratory carriage studies.

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Published date: 30 October 2014
Organisations: Faculty of Medicine, Primary Care & Population Sciences

Identifiers

Local EPrints ID: 370691
URI: https://eprints.soton.ac.uk/id/eprint/370691
PURE UUID: 2d77360f-96b1-4877-b9b7-35c075cba39c
ORCID for S.N. Faust: ORCID iD orcid.org/0000-0003-3410-7642
ORCID for P.J. Roderick: ORCID iD orcid.org/0000-0001-9475-6850
ORCID for M.V. Moore: ORCID iD orcid.org/0000-0002-5127-4509
ORCID for S.C. Clarke: ORCID iD orcid.org/0000-0002-7009-1548

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Date deposited: 04 Nov 2014 11:02
Last modified: 15 Oct 2019 00:53

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