Presence of SARS-CoV-2 RNA on playground surfaces and water fountains.

The possibility of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission by fomites or environmental surfaces has been suggested. It is unclear if SARS-CoV-2 can be detected in outdoor public areas. The objective of the current study was to assess the presence of SARS-CoV-2 in environmental samples collected at public playgrounds and water fountains, in a country with high disease prevalence. Environmental samples were collected from six cities in central Israel. Samples were collected from drinking fountains and high-touch recreational equipment at playgrounds. Sterile pre-moistened swabs were used to collect the samples, put in viral transfer media and transferred to the laboratory. Viral detection was achieved by real-time reverse transcriptase-polymerase chain reaction, targeting four genes. Forty-three samples were collected from playground equipment and 25 samples from water fountains. Two of the 43 (4.6%) samples from playground equipment and one (4%) sample from a drinking fountain tested positive. It is unclear whether the recovery of viral RNA on outdoor surfaces also indicates the possibility of acquiring the virus. Adherence to environmental and personal hygiene in urban settings seems prudent.

Maternal vaccinations coverage and reasons for non-compliance - a cross-sectional observational study.

BACKGROUND: Maternal influenza and pertussis vaccinations have been proven safe and effective in reducing maternal and infant morbidity and mortality. Though recommended, not all pregnant women receive these important vaccines. We aimed to evaluate the vaccine coverage of maternal immunization in pregnancy for seasonal influenza and acellular pertussis and elucidate the reasons for non-vaccination among pregnant women. The secondary objective was to describe factors that affect vaccine uptake. METHODS: A cross sectional observational study using anonymous questionnaires distributed to women in the maternity ward or pregnant women hospitalized in the high-risk ward, between Nov 2017 and June 2018, In an Israeli tertiary hospital. RESULTS: Of 321 women approached, 313 were eligible, with a total of 290 women completing the questionnaire (92.6%). We found a 75.9% (95% CI 71-81) and 34.5% (95% CI 29-40) vaccination rate for pertussis and influenza vaccines, respectively. The most prominent reason for not receiving the pertussis vaccine was being under-informed (24%). Influenza vaccine was not received mainly due to concerns about vaccine efficacy (28%). Other factors influencing vaccine uptake included education, prior childbirth and vaccine recommendations made by the provider. CONCLUSION: Although maternal vaccination of pertussis and influenza is officially recommended, vaccine uptake is suboptimal. Our study suggests a central role for medical providers in diminishing the concerns about safety and efficacy, and presents novel factors influencing compliance rates, like seasonality and number of prior births.

Electronically Monitored Adherence to Short-Term Antibiotic Therapy in Children.

BACKGROUND: Nonadherence to short-term antibiotic treatment in children can lead to treatment failure and the development of drug-resistant microorganisms. We aimed to provide reliable adherence estimates in this population. METHODS: A prospective, blinded, electronically monitored, observational study between January 2018 and October 2021. Patients aged 2 months to 5 years diagnosed with an acute bacterial infection requiring short-term (5-10 days) oral antibiotic monotherapy, were provided with an electronically monitored medication bottle, recording every manipulation of the cap. Primary outcomes were overall adherence, predefined as administration of >75% of doses relative to the number of doses prescribed, and timing adherence, defined as the administration of >75% of prescribed doses taken within ±20% of the prescribed interval. RESULTS: One hundred infants (49 boys, mean [range] age 1.87 years [0.2-5.1]) were included in the final analysis. Only 11 participants received all the recommended doses. Overall adherence was 62%, whereas timing adherence was 21%. After applying a logistic regression model, the only factor significantly associated with nonadherence was being a single parent (odds ratio = 5.7; 95% confidence interval [1.07-30.3]). Prescribers overestimated adherence, defining 49 of 62 (77.7%) participants as likely adherent. Patients predicted to be adherent were not more likely to be adherent than those predicted to be nonadherent (31/47 actual adherence among those predicted to be adherent vs 6/16, P = .77). CONCLUSIONS: Adherence of children to the short-term antimicrobial treatment of an acute infection is suboptimal. Providers were unable to predict the adherence of their patients. These data are important when considering recommended treatment durations and developing interventional programs to increase adherence.