Improvement of Must Fermentation from Late Harvest cv. Tempranillo Grapes Treated with Pulsed Light.

Pulsed light irradiation is a nonthermal technology currently used for the elimination of pathogens from a diverse range of food products. In the last two decades, the results obtained using PL at laboratory scale are encouraging wine experts to use it in the winemaking industry. PL can reduce native yeast counts significantly, which facilitates the use of starter cultures, reducing SO2 requirements at the same time. In this experimental set up, Tempranillo grapes were subjected to pulsed light treatment, and the fermentative performance of non-Saccharomyces yeasts belonging to the species Schizosaccharomyces pombe, Lachancea thermotolerans, Torulaspora delbrueckii, Metschnikowia pulcherrima and Hanseniaspora vineae was monitored in sequential fermentations against spontaneous fermentation and pure culture fermentation with the species Saccharomyces cerevisiae. The experimental analyses comprised the determination of anthocyanin (High performance liquid chromatography with photodiode array detector-HPLC-DAD), polyphenol index and colour (Ultraviolet-visible spectroscopy-UV-Vis spectrophotometer), fermentation-derived volatiles (Gas chromatography with flame ionization detector-GC-FID), oenological parameters (Fourier transform Infrared spectroscopy-FT-IR) and structural damage of the skin (atomic force microscopy-AFM). The results showed a decrease of 1.2 log CFU/mL yeast counts after pulsed light treatment and more rapid and controlled fermentation kinetics in musts from treated grapes than in untreated samples. The fermentations done with treated grapes allowed starter cultures to better implant in the must, although a larger anthocyanin loss (up to 93%) and an increase in hue values (1 unit) towards more yellow hues were observed for treated grapes. The development of biomass was larger in musts from treated grapes. The profile of volatile compounds and oenological parameters reveals that fermentations carried out with untreated grapes are prone to deviations from native microbiota (e.g., production of lactic acid). Finally, no severe damage on the skin was observed with the AFM on treated grapes.

The Impact of Hanseniaspora vineae Fermentation and Ageing on Lees on the Terpenic Aromatic Profile of White Wines of the Albillo Variety.

Hanseniaspora vineae is a non-Saccharomyces yeast that has a powerful impact on the sensory profile of wines. Its effect on the aromatic profile of non-aromatic grape varieties, such as Albillo Mayor (Vitis vinifera, L), during vinification is a useful biotechnology to improve sensory complexity. Fermentation in steel barrels using Hanseniaspora vineae and sequential inoculation with Saccharomyces cerevisiae have been used to study the formation of terpenes and cell lysis in the production of Albillo white wines. The GC-MS analysis profile shows a significant effect of H. vineae fermentation on the contents of terpenes (≈×3), mainly in linalool (>×3), ß-citronellol (>×4), geraniol (>×2) and α-terpineol (≈×2). The contents of several polyoxygenated terpenes and some volatile phenols with a spicy aroma were increased during fermentation. In summary, Hanseniaspora vineae releases a large number of cell wall polysaccharides during fermentation that affect wine palatability and structure. Hanseniaspora vineae is a powerful bio-tool to enhance the fruitiness, floral notes and freshness in non-aromatic white varieties.

White wine processing by UHPH without SO2. Elimination of microbial populations and effect in oxidative enzymes, colloidal stability and sensory quality.

The use of UHPH sterilization in the absence of SO2 has been used to eliminate wild microorganisms and inactivate oxidative enzymes. A white must of the Muscat of Alexandria grape variety was continuously processed by UHPH at 300 MPa (inlet temperature: 23-25 °C). The initial microbial load of the settled must was 4-log CFU/mL for both yeast and moulds, and slightly lower for bacteria. After UHPH processing, no microorganisms were detected in 1 mL. UHPH musts remain without fermentative activity for more than 60 days. Concentrations of the thermal markers indicated the absence of thermal damage in the UHPH-treated musts, since 5-hydroxymethylfurfural was not detected. In addition, the must treated by UHPH keeps terpene concentrations similar to those of the untreated controls. A strong inactivation of the oxidative enzymes was observed, with no browning at room temperature for more than 3 days. The antioxidant value of the UHPH-treated must was 156% higher than the control.

Evolution of the Phenolic Fraction and Aromatic Profile of Red Wines Aged in Oak Barrels.

Various changes occur in red wine during aging in oak barrels. Among these, the variation of the polyphenolic fraction and the transfer of aromatic compounds to the wine from oak wood are of great importance. The aim of the present work is to compare the chemical composition of wines aged in different new oak barrels with similar commercial denominations. During 8 months, the total polyphenol index (TPI), color parameters, anthocyanins and pyranoanthocyanins, and wood aromatic compounds were periodically evaluated. The measurement of the TPI and color parameters was similar in all wines, but significant differences were found in total anthocyanin and vitisin content and in certain aromatic compounds belonging to volatile phenols, furanic compounds, and phenolic aldehydes. The results obtained indicate the need for the winemaker to carry out preliminary tests in order to be able to choose the wood that best suits the sensorial profile of the wine.

Clinical and prognostic differences between methicillin-resistant and methicillin-susceptible Staphylococcus aureus infective endocarditis.

BACKGROUND: S. aureus (SA) infective endocarditis (IE) has a very high mortality, attributed to the age and comorbidities of patients, inadequate or delayed antibiotic treatment, and methicillin resistance, among other causes. The main study objective was to analyze epidemiological and clinical differences between IE by methicillin-resistant versus methicillin-susceptible SA (MRSA vs. MSSA) and to examine prognostic factors for SA endocarditis, including methicillin resistance and vancomycin minimum inhibitory concentration (MIC) values > 1 µg/mL to MRSA. METHODS: Patients with SA endocarditis were consecutively and prospectively recruited from the Andalusia endocarditis cohort between 1984 and January 2017. RESULTS: We studied 437 patients with SA endocarditis, which was MRSA in 13.5% of cases. A greater likelihood of history of COPD (OR 3.19; 95% CI 1.41-7.23), invasive procedures, or recognized infection focus in the 3 months before IE onset (OR 2.9; 95% CI 1.14-7.65) and of diagnostic delay (OR 3.94; 95% CI 1.64-9.5) was observed in patients with MRSA versus MSSA endocarditis. The one-year mortality rate due to SA endocarditis was 44.3% and associated with decade of endocarditis onset (1985-1999) (OR 8.391; 95% CI (2.82-24.9); 2000-2009 (OR 6.4; 95% CI 2.92-14.06); active neoplasm (OR 6.63; 95% CI 1.7-25.5) and sepsis (OR 2.28; 95% CI 1.053-4.9). Methicillin resistance was not associated with higher IE-related mortality (49.7 vs. 43.1%; p = 0.32). CONCLUSION: MRSA IE is associated with COPD, previous invasive procedure or recognized infection focus, and nosocomial or healthcare-related origin. Methicillin resistance does not appear to be a decisive prognostic factor for SA IE.

Clinical impact of an educational antimicrobial stewardship program associated with infectious diseases consultation targeting patients with cancer: Results of a 9-year quasi-experimental study with an interrupted time-series analysis.

OBJECTIVES: Antibiotic stewardship programs (ASP) have already demonstrated clinical benefits. However, their effectiveness or safety in immunocompromised hosts needs to be proved. METHODS: An ecologic quasi-experimental study was performed from January 2009 to June 2017 in the Oncology department of a tertiary-care hospital. A stable program of Infectious Diseases consultation (IDC) already existed at this unit, and an educational ASP was added in 2011. Its main intervention consisted of face-to-face educational interviews. Antibiotic consumption was assessed through quarterly Defined Daily Doses (DDD) per 100 occupied bed-days. Mortality was evaluated in patients with bloodstream infections through the quarterly incidence density per 1000 admissions, and the annual mortality rates at 7 and 30-days. Time-trends were analysed through segmented-regression analysis, and the impact of the ASP was assessed through before-after interrupted time-series analysis. RESULTS: Mortality significantly decreased throughout the study period (-13.3% annual reduction for 7-day mortality rate, p < 0.01; -8.1% annual reduction for 30-day mortality, p = 0.03), parallel to a reduction in antibiotic consumption (quarterly reduction -0.4%, p = 0.01), especially for broader-spectrum antibiotics. The before-after study settled a significant inflexion point on the ASP implementation for the reduction of antibiotic consumption (change in level 0.95 DDD, p = 0.71; change in slope -1.98 DDD per quarter, p < 0.01). The decreasing trend for mortality before the ASP also continued after its implementation. CONCLUSIONS: The combination of an ASP with IDC improved antibiotic use among patients with cancer, and was accompanied by a reduction of mortality of bacteraemic infections. Implementation of the ASP was necessary to effectively change antibiotic use.

Sonication of Yeast Biomasses to Improve the Ageing on Lees Technique in Red Wines.

Ageing on Lees (AOL) is a technique to improve the aromatic and gustatory complexity of wine, mainly by improving its body and reducing its astringency. However, the autolytic process is slow, resulting in high production costs. This work evaluated the effect of adding sonicated lees and combining it with oak chips, as a new technique to accelerate the AOL process and improve the aromatic quality of aged red wine. Cell disruption due to sonication was verified by optical microscopy. Volatile acidity, total polyphenol index, color intensity, tonality, dissolved oxygen, anthocyanins, and fermentative volatiles were monitored throughout the ageing of the wines. Sensory analysis was performed at the end of the ageing process. Polysaccharides released from the cell walls and the oxygen consumption, was quantified using a hydroalcoholic solution. The results indicated a 20% increase of the polysaccharide content and suggested an increase in the antioxidant capacity of the lees. No significant changes were observed in the fermentative volatile compounds and the total polyphenol index (TPI), except for those wines in contact with wood. The sonication of lees had some protective effect on the total anthocyanins content, however, color intensity was significantly lower in the sonicated treatments. The sonication of the lees did not cause any defect at the sensory level. Therefore, sonication could allow a reduction in the SO2 addition to wine, as well as a shortening of the ageing times.

Application of ultrasound to improve lees ageing processes in red wines.

Ageing on lees (AOL) is a technique that increases volatile compounds, promotes colour stability, improves mouthfeel and reduces astringency in red wines. The main drawback is that it is a slow process. Several months are necessary to obtain perceptible effects in wines. Different authors have studied the application of new techniques to accelerate the AOL process. Ultrasound (US) has been used to improve different food industry processes; it could be interesting to accelerate the yeast autolysis during AOL. This work evaluates the use of the US technique together with AOL and oak chips for this purpose studying the effects of different oenological parameters of red wines. The results obtained indicate an increase of polysaccharides content when US is applied in wine AOL. In addition, total polyphenol index (TPI) and volatile acidity were not affected. However, this treatment increases the dissolved oxygen affecting the volatile compounds and total anthocyanins.

Formation of polymeric pigments in red wines through sequential fermentation of flavanol-enriched musts with non-Saccharomyces yeasts.

Non-Saccharomyces yeasts may contribute to enrich wine aroma while promoting the formation of stable pigments. Yeast metabolites such as acetaldehyde and pyruvate participate in the formation of stable pigments during fermentation and wine aging. This work evaluated the formation of polymeric pigments in red musts added with (+)-Catechin, ProcyanidinB2 and ProcyanidinC1. The non-Saccharomyces yeasts used were Lachancea thermotolerans, Metschnikowia pulcherrima and Torulaspora delbrueckii in sequential fermentation with Saccharomyces cerevisiae and Schizosaccharomyces pombe. Use of Lachancea thermotolerans led to larger amounts of polymeric pigments in sequential fermentation. (+)-Catechin is the flavanol prone to forming such pigments. The species Metschnikowia pulcherrima produced higher concentration of esters and total volatile compounds. The sensory analysis pointed out differences in fruitiness and aroma quality. The results obtained strengthen the fact that metabolites from non-Saccharomyces yeasts may contribute to form stable polymeric pigments while also influencing wine complexity.

Prognostic factors of infective endocarditis in patients on hemodialysis: A case series from a National Multicenter Registry.

BACKGROUND: Infective endocarditis (IE) is a severe complication associated with high mortality. OBJECTIVES: To examine the clinical characteristics of IE in hemodialysis (HD) patients and to determine prognostic factors related to HD. METHODS: From January 2008 to April 2015, 2488 consecutive patients with definite IE were included. Clinical characteristics of IE patients on HD were compared with those of IE patients who were not on HD. RESULTS: A total of 126 patients (63% male, median age: 66years; IQR: 54-74years) with IE (5.1%) were on HD. Fifty-two patients died during hospitalization (41%) and 17 additional patients (14%) died during the first year. The rate of patients who underwent surgery during hospitalization was lower in HD patients (38 patients, 30%) than in non-HD patients (1177 patients, 50%; p<0.001). Age >70years (OR: 4.1, 95% CI: 1.7-10), heart failure (OR: 3.3, 95% CI: 1.4-7-6), central nervous system (CNS) vascular events (OR: 6.7, 95% CI: 2.1-22) and septic shock (OR: 4.1, 95% CI: 1.4-12.1) were independently associated with fatal outcome in HD patients. Of the 38 patients who underwent surgery, 15 (39.5%) died during hospitalization. CONCLUSIONS: HD patients with IE present a high mortality. Advanced age and complications, such as heart failure, CNS stroke or septic shock, are associated with mortality.

Yeast influence on the formation of stable pigments in red winemaking.

The anthocyanin profile of a wine greatly varies over time depending on many factors. In addition to color modifications due to changes in the chemical composition of wine, there may be some influence of the yeast strain used in fermentation. The main aim of this study is to identify and quantify the different ways in which yeast may influence on wine color and its stability, during red winemaking. Hydroxycinnamate decarboxylase activity was measured by the ability to transform the p-coumaric acid (HPLC-DAD). Acetaldehyde (GC-FID) and pyruvic acid (Y15 enzymatic autoanalyser) contents were monitored along fermentation. Stable pigments formation, including vitisins, vinylphenolic pyranoanthocyanins and flavanols-anthocyanins adducts, were analyzed by HPLC-DAD/ESI-MS. Moreover, the ability of adsorbing color molecules by yeasts' cell walls was assessed. It could be concluded that the strain used has substantial influence on the formation of stable pigments, and therefore, proper yeast selection is important to ensure the stability of the wine coloring matter.

Characteristics and Outcome of Streptococcus pneumoniae Endocarditis in the XXI Century: A Systematic Review of 111 Cases (2000-2013).

Streptococcus pneumoniae is an infrequent cause of severe infectious endocarditis (IE). The aim of our study was to describe the epidemiology, clinical and microbiological characteristics, and outcome of a series of cases of S. pneumoniae IE diagnosed in Spain and in a series of cases published since 2000 in the medical literature. We prospectively collected all cases of IE diagnosed in a multicenter cohort of patients from 27 Spanish hospitals (n = 2539). We also performed a systematic review of the literature since 2000 and retrieved all cases with complete clinical data using a pre-established protocol. Predictors of mortality were identified using a logistic regression model. We collected 111 cases of pneumococcal IE: 24 patients from the Spanish cohort and 87 cases from the literature review. Median age was 51 years, and 23 patients (20.7%) were under 15 years. Men accounted for 64% of patients, and infection was community-acquired in 96.4% of cases. The most important underlying conditions were liver disease (27.9%) and immunosuppression (10.8%). A predisposing heart condition was present in only 18 patients (16.2%). Pneumococcal IE affected a native valve in 93.7% of patients. Left-sided endocarditis predominated (aortic valve 53.2% and mitral valve 40.5%). The microbiological diagnosis was obtained from blood cultures in 84.7% of cases. In the Spanish cohort, nonsusceptibility to penicillin was detected in 4.2%. The most common clinical manifestations included fever (71.2%), a new heart murmur (55%), pneumonia (45.9%), meningitis (40.5%), and Austrian syndrome (26.1%). Cardiac surgery was performed in 47.7% of patients. The in-hospital mortality rate was 20.7%. The multivariate analysis revealed the independent risk factors for mortality to be meningitis (OR, 4.3; 95% CI, 1.4-12.9; P < 0.01). Valve surgery was protective (OR, 0.1; 95% CI, 0.04-0.4; P < 0.01). Streptococcus pneumoniae IE is a community-acquired disease that mainly affects native aortic valves. Half of the cases in the present study had concomitant pneumonia, and a considerable number developed meningitis. Mortality was high, mainly in patients with central nervous system (CNS) involvement. Surgery was protective.

[Descriptive analysis of diseases associated with Streptococcus bovis bacteremia]. / Análisis descriptivo de las enfermedades asociadas a bacteriemia por Streptococcus bovis.

BACKGROUND AND OBJECTIVE: It is well-known the relationship between Streptococcus bovis (S. bovis) bacteremia and colon cancer, liver cirrhosis and others neoplasms. However, a study protocol to rule out these underlying diseases has not been carried out yet. Our objective was to describe S. bovis bacteremia and associated diseases. PATIENTS AND METHOD: Multicenter, retrospective cohort study. S. bovis bacteremias episodes between 2001 and 2009 were included. Mean variables: colon neoplasm, non-colonic neoplasm or liver cirrhosis. Epidemiologist aspects, bacteremia related variables, personal and familiar history and clinical and analytical data were collected. RESULTS: Ninety three patients were included. One out of four individuals had a colon neoplasm. Fifty seven per cent were concomitant cases with bacteremia and six cases were diagnosed after bacteremia (time bacteremia-diagnosis of neoplasm [months], median [Q1-Q3], 2.6 [1-11]). Fourteen (15%) patients were diagnosed with any non-colonic neoplasm (mainly biliary and pancreatic [6 cases] or esophagus-gastric [3 cases]). There were three patients (21%) with concomitant bacteremia non-colonic neoplasm and two after it (1.2 and 10.4 months). Twenty-one (23%) patients suffered from liver cirrhosis. CONCLUSIONS: Patients with S. bovis bacteremia must undergo a study designed to rule out underlying diseases. We suggest that this study should include: a colonic evaluation, ideally by colonoscopy, a liver evaluation by serum chemistry, an abdominal ultrasound scan or a method of liver fibrosis assessment, a gastroscopy and an evaluation of biliary and pancreatic areas by magnetic resonance imaging.

[Microbiological diagnosis of sexually-transmitted infection (2007)]. / Diagnóstico microbiológico de las infecciones de transmisión sexual (2007).

Sexually transmitted infections (STIs) constitute an important world-wide public health problem. The use of sensitive and specific laboratory methods for diagnosing this condition is crucial to reduce the transmission and sequelae of STI. The present review describes current microbiological methods for the diagnosis of STIs. Neisseria gonorrhoeae and Chlamydia trachomatis are the pathogens most frequently involved in urethral and cervical infection. Culture continues to be the gold standard for diagnosing gonorrhea. Nucleic acid amplification assays are considered the new gold standard for C. trachomatis, although culture is till the most specific technique. Genital ulcers due to Treponema pallidum, Haemophilus ducreyi, or herpes simplex virus have little clinical and bacteriological correlation; therefore, it is essential to establish the microbiological diagnosis. Lesions present in the primary or secondary period of syphilis can be diagnosed by dark field microscopy. Serologic diagnosis for the remaining periods is based on non-treponemal tests associated with confirmatory treponemal tests. Cell culture is considered the gold standard for herpes simplex virus although molecular methods also have a sensitivity and specificity near 100%. Currently, microbiologic diagnosis of H. ducreyi and venereal lymphogranuloma is achieved with the use of molecular methods on samples obtained from the ulceration or lymph adenopathy. The diagnosis of genital warts in immunocompetent patients is based on clinical findings in most cases because the lesions are sufficiently characteristic. Culture is considered the reference method in Trichomonas vaginalis infection.