Program Schedule

A Pilot Study of the Acceptability and Feasibility of Self-Collected Pre-Operative Staphylococcus aureus Nasal Screening

Session: Poster Abstract Session: MRSA and VRE
Thursday, October 9, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
Background: Routine pre-operative screening of patients for meticillin-resistant Staphylococcus aureus (MRSA) colonisation has been used as a method of reducing post-operative wound infections. As most patients attend pre-operative assessment clinics a number of weeks before their surgical procedure, the results of MRSA screening may not identify recent acquisition.  We piloted an investigation of the feasibility and acceptability of a patient-collected nasal swab posted back to the laboratory for analysis.

Methods: 100 patients in a mixed discipline pre-operative assessment clinic were screened for MRSA as per current hospital infection control protocol. They were then issued with a pack including a charcoal swab and information sheet and were advised to return the swab via a pre-paid return envelope. Each pack included a questionnaire regarding ease of use and acceptability of self-collecting the swab at home. The self-collected samples were processed as per routine culture based laboratory methods for S. aureus (SA) and MRSA. The clinic taken swabs was processed for MRSA only. The results of both self-taken and nurse-collected screens were collated and compared, and questionnaire data analysed.

Results: A total of 77 packs out of 100 (77%) distributed were returned to the laboratory. 78% of returns were aged below 65 years. MRSA was not isolated from any of the pre-operative assessment clinic swabs or self-collected samples. Meticillin-sensitive SA was isolated from 21/77 (27%).  Five returns did not include a questionnaire. 71/72 (99%) of the questionnaire respondents found the instructions easy to understand and all reported that they had managed to collect the samples without difficulty. 97% of patients found the process acceptable and would prefer this to re-attendance to a healthcare facility for further sampling. Informal feedback from pre-operative clinic staff has also been complimentary regarding the scheme.

Conclusion: This preliminary study shows that self-collected nasal screening is acceptable to the majority of patients. The prevalence of MRSA colonisation in our pre-operative population is low, but the detection of MSSA in nearly a third of patients shows that this method may have an acceptable clinical yield. A larger study is required and underway to confirm these findings.

Michelle S. Toleman and O. Martin Williams, Public Health England - Bristol Public Health Laboratory, Bristol, United Kingdom


M. S. Toleman, None

O. M. Williams, None

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