Patient-derived pathogenic microbe deposition enhances exposure risk in pediatric clinics.

Healthcare-associated infections (HAIs) pose significant risks to pediatric patients in outpatient settings. To prevent HAIs, understanding the sources and transmission routes of pathogenic microorganisms is crucial. This study aimed to identify the sources of opportunistic bacterial pathogens (OBPs) in pediatric outpatient settings and determine their transmission routes. Furthermore, assessing the public health risks associated with the core OBPs is important. We collected 310 samples from various sites in pediatric outpatient areas and quantified the bacteria using qPCR and CFU counting. We also performed 16S rRNA gene and single-bacterial whole-genome sequencing to profile the transmission routes and antibiotic resistance characteristics of OBPs. We observed significant variations in microbial diversity and composition among sampling sites in pediatric outpatient settings, with active communication of the microbiota between linked areas. We found that the primary source of OBPs in multi-person contact areas was the hand surface, particularly in pediatric patients. Five core OBPs, Staphylococcus epidermidis, Acinetobacter baumannii, Pseudomonas aeruginosa, Streptococcus mitis, and Streptococcus oralis, were mainly derived from pediatric patients and spread into the environment. These OBPs accumulated at multi-person contact sites, resulting in high microbial diversity in these areas. Transmission tests confirmed the challenging spread of these pathogens, with S. epidermidis transferring from the patient's hand to the environment, leading to an increased abundance and emergence of related strains. More importantly, S. epidermidis isolated from pediatric patients carried more antibiotic-resistance genes. In addition, two strains of multidrug-resistant A. baumannii were isolated from both a child and a parent, confirming the transmission of the five core OBPs centered around pediatric patients and multi-person contact areas. Our results demonstrate that pediatric patients serve as a significant source of OBPs in pediatric outpatient settings. OBPs carried by pediatric patients pose a high public health risk. To effectively control HAIs, increasing hand hygiene measures in pediatric patients and enhancing the frequency of disinfection in multi-person contact areas remains crucial. By targeting these preventive measures, the spread of OBPs can be reduced, thereby mitigating the risk of HAIs in pediatric outpatient settings.

Analysis of factors influencing parents' willingness to accept the quadrivalent influenza vaccine for school-aged children in the Nanhai District, China.

Recently, China has attached great importance to promoting immunization, prompting the media, scholars, and public to focus on its coverage and efficacy. This study aimed to understand the factors influencing parental willingness to have their school-aged children vaccinated with quadrivalent influenza vaccines (QIVs). A cross-sectional study through face-to-face interviews was conducted between September and December 2018. Forty-four kindergartens and primary and junior high schools were randomly selected via stratified three-stage cluster sampling. Of 4,430 participants, 24.6% reported having heard of QIV and 24.2% reported having previously received information on QIV. Of these, 42.8% expressed willingness to obtain the QIV for their children. A junior college degree (adjusted odds ratio [aOR] = 1.447; 95% confidence interval [95% CI]: 1.202-1.742), higher influenza knowledge level (medium level, aOR = 1.150, 95% CI, 1.006-1.314; high level, aOR = 1.332, 95% CI, 1.045-1.697), and previous influenza information (aOR = 2.241; 95% CI, 1.604-3.130) were positively correlated with vaccination willingness. In contrast, no previous QIV-related information (aOR = 0.490; 95% CI, 0.418-0.575), no perceived susceptibility of children to influenza (aOR = 0.576; 95% CI, 0.489-0.680), fear of side effects (aOR = 0.599; 95% CI, 0.488-0.735), concern that vaccines need to be carefully administered (aOR = 0.728; 95% CI, 0.593-0.894), and mistrust of new vaccines (aOR = 0.730; 95% CI, 0.628-0.849) were pivotal barriers hindering parents from having their children vaccinated. This study provides baseline information for future immunization programs and delivery, with the ultimate goal of increasing vaccine uptake and minimizing school-wide influenza outbreaks.