Observed Effectiveness of Palivizumab for 29-36-Week Gestation Infants.

BACKGROUND: Respiratory syncytial virus (RSV) is a common reason for hospitalization of infants. In clinical trials, palivizumab reduced RSV hospitalization rates for premature infants. The 2014 American Academy of Pediatrics clinical practice guideline advised against use of palivizumab for otherwise healthy infants ≥29 weeks' gestation. The aim of this study was to determine the effect of palivizumab administration on hospitalization rates for RSV and bronchiolitis without RSV diagnosis among infants 29 to 36 weeks' gestation who do not have chronic illness. METHODS: Claims data were extracted from databases of 9 Texas Medicaid managed care programs. Eligible infants were 29 to 36 weeks' gestation, without claims suggesting chronic illness, and who were born between April 1 and December 31 of 2012, 2013, and 2014. RESULTS: A total of 2031 eligible infants of 29 to 32 weeks' gestation and 12 066 infants of 33 to 36 weeks' gestation were identified; 41.5% of the infants 29 to 32 weeks' gestation and 3.7% of the infants 33 to 36 weeks' gestation had paid claims for dispensing of ≥1 palivizumab doses. Among the infants of 29 to 32 weeks' gestation, palivizumab dispensing was associated with reduced RSV hospitalization rates (3.1% vs 5.0%, P = .04) but increased hospitalizations for bronchiolitis without RSV diagnosis (3.3% vs 1.9%, P = .05). There were no significant differences by palivizumab administration status for the infants of 33 to 36 weeks' gestation. CONCLUSIONS: Among infants 29 to 32 weeks' gestation without chronic illness, palivizumab use was associated with reduced RSV hospitalizations but increased hospitalizations for bronchiolitis without RSV diagnosis.

Growth and Survival of Clostridium perfringens in Rare Beef Prepared in a Water Bath.

The low-temperature, long-time cooking of beef, using either a water bath or a conventional oven, resulted in partial inactivation of Clostridium perfringens vegetative cells. Beef roasts were cooked in a water bath for process times calculated to inactivate low and high levels of C. perfringens vegetative cells. Cooking beef in a water bath to an internal temperature of 60 C and holding for at least 12 min, as required by the USDA, reduced a population of C. perfringens by approximately 3 log cycles. To decrease the risk of subsequent outgrowth of C. perfringens , roasts (⩽ 1.5 kg) may be subjected to a process calculated for a 12-log reduction in population, which would include holding times of 2.3 h or longer at an internal temperature of 60 C. Recommendations are given for cooking and cooling roasts to minimize microbiological problems.