Family Research of Microbes Linked to Respiratory Infections (FAMILY Micro) observational study: Assessing the use of minimally invasive self-sampling methodologies at home for long-term monitoring of the oral, nasal and hand microbiota of adults and children within UK families

Background: Monitoring the presence of commensal and pathogenic microorganisms in the human oral, nasal and hand niches as determinants for respiratory tract infections is of critical global relevance as was evident during the COVID-19 pandemic. However, community-based surveillance is difficult because current sampling methods are not optimal for a wide age range of participants, particularly young children. We designed a platform of minimally invasive self-sampling at home and assessed its use for longitudinal monitoring of the oral, nasal and hand microbiota of adults and children within families. Methods: Healthy families with two adults and up to three children, living in and near Liverpool, United Kingdom, self-collected saliva, nasal lining fluid using synthetic absorptive matrices and hand swabs at home every two weeks for six months. Questionnaires were used to collect demographic and epidemiological data and assess feasibility and acceptability. At the end of the study, participants were invited to take part in an interview. Results: Thirty-three families completed the study. Sample collection using our approach was acceptable to 25/33 (76%) families, as sampling was fast (76%), easy (76%) and painless (60%). Saliva and hand sampling was acceptable to all participants of any age, whereas nasal sampling was accepted mostly by adults and children older than 5 years. Conclusion: Multi-niche self-sampling at home can be used by adults and children for longitudinal microbial surveillance, providing key data for monitoring respiratory infections. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement The study was funded by the Liverpool School of Tropical Medicine's Director's Catalyst Fund 2020 awarded to Dr Nikolaou and the UKRI Strength in Places Fund awarded to Prof Ferreira. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The North West - Greater Manchester West Research Ethics Committee of the NHS Health Research Authority gave ethical approval for this work (20/NW/0304). I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors