P118 Paediatric surveillance self-sampling model in NCFB and PCD – a year on: what have we learnt

<h3>Background</h3> International guidance recommends airway microbiology testing in paediatric outpatients with bronchiectasis (NCFB) every 6–12 months,¹ and every 3 months in Primary Ciliary Dyskinesia (PCD)² to identify new pathogens early, and guide antibiotic therapy. Previous audits of our caseload showed sporadic microbiology testing for these patient groups. To enable guideline-driven care, a model for surveillance self-sampling (SS-Sa) was created to meet these targets without increasing appointment burden or health miles. <h3>Objectives</h3> Evaluate participation by patients and their families/carers in SS-Sa Evaluate the impact of increased microbiology data on decision making <h3>Methods</h3> Participation was offered to all children and young people (CYP) with NCFB and PCD &lt;15 years old on the 2022 caseload. Sputum samples were preferred and throat swabs when unable to expectorate; an additional nasal swab or nasal rinse sample was collected in PCD. Samples were taken at surveillance timepoints, during clinic reviews if clinically indicated, and at home during an exacerbation through the acute service. If families could be independent, they were encouraged to self-sample using labelled posted-out kits. Data on sample results, changes to clinical management, and patterns of collection were collected prospectively from March 2020. <h3>Results</h3> 18/20 identified patients participated from March 2022-June 2023: Total number of samples n=130. 15/130 were unsupervised SS-Sa from 11 CYP. 67/130 were positive cultures, and antibiotics were prescribed for 32/74. Those with PCD had a greater variety of pathogens identified, with two CYP isolating Pseudomonas Aeruginosa asymptomatically. Recurrent pathogens were identified through surveillance and guided antibiotic prophylaxis. <h3>Conclusions</h3> • Surveillance sampling identified PsA early and guided empirical and prophylactic prescribing. • Pre-clinic sampling enabled more streamlined services and were considered advantageous by the families and Respiratory Team. • Despite training, majority of samples were supervised or taken by a clinician due to delays, exacerbations, non-compliance and clinical needs. Low SS-Sa rates need further investigation to refine this surveillance model. <h3>References</h3> Chang AB, <i>et al. Eur Respir J</i>. 2021;<b>58</b>(2). Marthin JK, <i>et al. ERJ Open Res</i>. 2021.