Impact of volatile phenols and their precursors on wine quality and control measures of Brettanomyces/Dekkera yeasts

Volatile phenols are aromatic compounds and one of the key molecules responsible for olfactory defects in wine. The yeast genus Brettanomyces is the only major microorganism that has the ability to covert hydroxycinnamic acids into important levels of these compounds, especially 4-ethylphenol and 4-ethylguaiacol, in red wine. When 4-ethylphenols reach concentrations greater than the sensory threshold, all wine’s organoleptic characteristics might be influenced or damaged. The aim of this literature review is to provide a better understanding of the physicochemical, biochemical, and metabolic factors that are related to the levels of p-coumaric acid and volatile phenols in wine. Then, this work summarizes the different methods used for controlling the presence of Brettanomyces in wine and the production of ethylphenols

Genetic variation in RYR1 is associated with heart failure progression and mortality in a diverse patient population

IntroductionHeart failure (HF) is a highly prevalent disease affecting roughly 7 million Americans. A transcriptome-wide analysis revealed RYR1 upregulation in HF patients with severe pulmonary hypertension. Therefore, we aimed to further characterize the role of RYR1 in HF progression and mortality.MethodsIn a mouse model of HF, expression of Ryr1 was compared in cardiac pulmonary, and vascular tissue between HF and control mice. Candidate single nucleotide polymorphisms (SNPs) in the RYR1 gene region were identified, including variants affecting RYR1 expression in relevant tissue types. A Cox proportional hazard model was used to analyze genetic associations of candidate SNPs with all-cause mortality in HF patients. An exploratory analysis assessed significantly associated SNPs with risk of HF and arrhythmia development.ResultsIn the preclinical HF model, left ventricular expression of Ryr1 was increased compared to control (fold change = 2.08; P = 0.01). In 327 HF patients, decreased mortality risk was associated with two RYR1 SNPs: rs12974674 (HR: 0.59; 95% CI: 0.40–0.87; P = 0.007) and rs2915950 (HR: 0.62, 95% CI: 0.43–0.88; P = 0.008). Based on eQTL data, these SNPs were associated with decreased RYR1 expression in vascular tissue. Two missense variants, in linkage disequilibrium with rs2915950 (rs2915952 and rs2071089) were significantly associated with decreased mortality risk (P = 0.03) and decreased risk of atrial fibrillation/flutter (OR: 0.66, 95% CI: 0.44–0.96; P = 0.03 and OR: 0.67, 95% CI: 0.45–0.98; P = 0.04, respectively). Survival associations with these SNPs were replicated in HF patients self-identifying as Black in the UK Biobank, and the arrhythmia associations were replicated in the overall UK Biobank population.ConclusionIncreased RYR1 expression may contribute to HF progression, potentially through the mechanisms associated with calcium handling and arrhythmia development. Our findings suggest that RYR1 should be further studied as a potential therapeutic target for reducing HF-related mortality

Evaluation of prophylactic dosages of Enoxaparin in non-surgical elderly patients with renal impairment

Background: Thromboprophylaxis dosing strategies using enoxaparin in elderly patients with renal disease are limited, while dose adjustments or monitoring of anti-Xa levels are recommended. We sought to evaluate the efficacy and safety of enoxaparin 20 mg versus 30 mg subcutaneously daily by comparing anti-Xa levels, thrombosis and bleeding. Methods: We conducted a prospective, single-blinded, single-center randomized clinical trial including non-surgical patients, 70 years of age or older, with renal disease requiring thromboprophylaxis. Patients were randomized to receive either 20 mg or 30 mg of enoxaparin. The primary endpoint was peak anti-Xa levels on day 3. Secondary endpoints included trough anti-Xa levels on day 3, achievement of within range prophylactic target peak anti-Xa levels and the occurrence of hemorrhage, thrombosis, thrombocytopenia or hyperkalemia during hospitalization. Results: Thirty-two patients were recruited and sixteen patients were randomized to each arm. Mean peak anti-Xa level was significantly higher in 30 mg arm (n = 13) compared to the 20 mg arm (n = 11) 0.26 ± 0.11, 95%CI (0.18-0.34), versus 0.14 ± 0.09, 95CI (0.08-0.19) UI/ml, respectively; p = 0.004. Mean trough anti-Xa level was higher in 30 mg arm (n = 10) compared to the 20 mg arm (n = 16), 0.06 ± 0.03, 95CI (0.04-0.08) versus 0.03 ± 0.03, 95CI (0.01-0.05) UI/ml, respectively; p = 0.044. Bleeding events reported in the 30 mg arm were one retroperitoneal bleed requiring multiple transfusions, and in the 20 mg arm one hematuria. No thrombotic events were reported. Conclusion: Peak anti-Xa levels provided by enoxaparin 20 mg were lower than the desired range for thromboprophylaxis in comparison to enoxaparin 30 mg. Trial registration: The trial was retrospectively registered on ClinicalTrials.gov identifier: NCT03158792. Registered: May 18, 2017. © 2019 The Author(s)

Rates of Multidrug-Resistant Gram-Negative Bacterial Infections in Hospitalized Non-Immunocompromised Pediatric Patients: A 9-Year Retrospective Study at a Lebanese Tertiary Medical Center

Ramia Zakhour,1,2,* Sarah Khafaja,1,2,* Rawan Korman,1,* Celina F Boutros,1 Zeinab El Zein,1– 3 Ahmad Chmaisse,1 Magda Haj,1 Amani Haddara,1 Zeina El-Houry,1 Malak Jbahi,1 Sarah Chamseddine,1 Samer Bou Karroum,1 Dana Al Oweini,1 Yolla Salama Youssef,1 Nour Youssef,1,2 Mayse Nasser,1 Danielle Fayad,1 Farida Abi Farraj,1 Clara El Nakib,1 Imad Isaac,1 Mireille Lteif,1 George F Araj,1,4 Ghassan S Dbaibo1– 3 1Center for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon; 2Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon; 3Division of Pediatric Infectious Diseases, Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon; 4Clinical Microbiology Laboratory, Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon*These authors contributed equally to this workCorrespondence: Ghassan S Dbaibo, Center for Infectious Diseases Research (CIDR), Division of Pediatric Infectious Diseases, Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, 1107, Lebanon, Email [email protected]: Multidrug resistant (MDR) Gram-negative bacterial infections are considered a major public health threat. The objectives of this study were to describe the epidemiology, potential contributing factors, and antimicrobial resistance patterns associated with infections caused by MDR Gram-negative bacteria (GNB) in non-immunocompromised children and adolescents.Methods: This was a retrospective observational study conducted at the American University of Beirut Medical Center (AUBMC) from 2009 to 2017. The study included non-immunocompromised patients 18 years of age or younger with infections caused by GNB isolated from a sterile site or nonsterile site in the setting of clinical infection.Results: A total of 810 episodes of infection with GNB in 674 pediatric patients were identified. The most common pathogens were Enterobacterales followed by Pseudomonas. MDR GNB infections represented 47.8% of the episodes, with alarming MDR rates among Escherichia coli (64.3%), Klebsiella pneumoniae (59.1%) and Acinetobacter species (70.6%). Previous infection with the same organism during the previous 12 months, urinary catheter or cardiac catheterization in the past 30 days had high percentages of infections with MDR GNB. The carbapenem resistance rates were 1.7% in Enterobacterales, 19.8% in Pseudomonas species and 64.7% in Acinetobacter species.Conclusion: High prevalence of infections with MDR GNB was detected in non-immunocompromised pediatric patients in Lebanon. This poses a significant threat to the pediatric population and underscores the importance of implementing antimicrobial stewardship programs and infection control policies, which are crucial to cope with the burden of these infections, especially in the presence of other ongoing challenges such as the current economic collapse and ongoing war leading to severe antimicrobial shortages.Keywords: adolescents, antimicrobial resistance, children, gram-negative bacteria, multidrug resistanc

The impact of vaccination on the burden of invasive pneumococcal disease from a nationwide surveillance program in Lebanon: an unexpected increase in mortality driven by non-vaccine serotypes

Background: The impact of pneumococcal conjugate vaccines (PCVs) on the burden of invasive pneumococcal disease (IPD) and serotype distribution was examined across age groups from data collected by the Lebanese Inter-Hospital Pneumococcal Surveillance Program. Methods: Between 2005 and 2020, 593 invasive Streptococcus pneumoniae isolates were collected from 79 hospitals throughout Lebanon. Serotypes and antimicrobial resistance (AMR) profiles were identified, and trends compared over 3 eras: PCV7, post-PCV7/ pre-PCV13, and PCV13 eras. Results: The prevalence of PCV7 serotypes decreased significantly from 43.6% in the PCV7 era to 17.8% during the PCV13 era (p<0.001). PCV13-only serotypes remained stable in the PCV13 compared to the post-PCV7 eras, especially serotypes 1 and 3, whereas non-vaccine types (NVT) increased throughout the study period, especially 24 and 16F. The mortality rate increased substantially from 12.5% (PCV7 era) to 24.8% (PCV13 era). A significant decrease in AMR was observed across the three study eras. Conclusion: PCVs substantially impacted IPD and AMR in vaccinated and unvaccinated populations despite an increase in mortality driven by NVT. Broadening the recommendation of vaccination to include older age-groups, using higher valency vaccines, and implementing stringent antimicrobial stewardship are likely to further impact the burden of IPD. © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group