A new device to prevent contamination of nasal swabs by Staphylococcus aureus in acute rhinosinutitis

Background: There is a risk of bacterial contamination of nasal swabs during passage of the narrow nasal vestibule in patients carrying Staphylococcus aureus in their nares. We aimed to test if a newly developed contamination-free bacterial swab (CFS) device for swab introduction could reduce the risk of contamination with Staphylococcus aureus from the nasal vestibule in patients with acute upper respiratory tract infections. Methodology: A single-blinded non-randomized controlled trial that included 64 participants with acute upper respiratory tract infections. The left and right nasal cavities were swabbed using the present-day technique and the CFS device, respectively. Primary outcome was frequency of Staphylococcus aureus positive cultures; secondary outcome was growth of other bacteria. Results: We found a significantly higher frequency of Staphylococcus aureus in cultures taken with the present-day technique (23%) when compared to the new device (8%, p=0.008). Growth of other bacteria did not differ markedly between sample techniques. Conclusions: The newly developed device reduces contamination with Staphylococcus aureus significantly. It has the potential to increase diagnostic accuracy in acute upper respiratory tract infections, decrease the overall use of antibiotics and thereby counteract overuse of antibiotics and emerging antibiotic resistance.