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The present study aims to both identify and quantify trans-sinapoylquinic acid (SiQA) regioisomers in green coffee by combined UHPLC-ESI-QqTOF-MS/MS and UHPLC-ESI-QqQ-MS/MS methods. Among the various mono-acyl chlorogenic acids found in green coffee, SiQA regioisomers are the least studied despite having been indicated as unique phytochemical markers of Coffea canephora (known as Robusta). The lack of commercially available authentic standards has been bypassed by resorting to the advantages offered by high-resolution LC-MS as far as the identification is concerned. SiQA regioisomers have been identified in several samples of Robusta and Coffea arabica (known as Arabica) commercial lots from different geographical origin and, for the first time, in different samples of coffee wild species (Coffea liberica and Coffea pseudozanguebariae). Quantification (total SiQA ranging from 3 to 5 mg/100 g) let to reconsider these chlorogenic acids as unique phytochemical markers of Robusta being present in the same quantity and distribution in C. liberica as well. Gardeniae Fructus samples (fruits of Gardenia jasminoides) have additionally been characterized as this matrix is recognized as one of the few naturally occurring SiQA sources. The SiQA regioisomer content (total SiQA about 80 mg/100 mg) fully supports the proposal to use this matrix as a surrogate standard for further studies., (© 2023 John Wiley & Sons Ltd.)

The aim of this study was to describe the proportion of multidrug-resistant microorganisms (MDROs) involved in ventilator-associated pneumonia (VAP) as the first hospital-acquired infection in 536 adults with restricted risk factors for MDRO-related infection. We found a significant decrease in the percentage of MDROs involved in VAP between 2003 and 2016 and this percentage increased when VAP occurred after day 10., (Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)

Introduction: A new respiratory virus, SARS-CoV-2, has emerged and spread worldwide since late 2019. This study aims at analysing clinical presentation on admission and the determinants associated with admission in intensive care units (ICUs) in hospitalized COVID-19 patients., Patients and Methods: In this prospective hospital-based study, socio-demographic, clinical and biological characteristics, on admission, of adult COVID-19 hospitalized patients presenting from the community for their first admission were prospectively collected and analysed. Characteristics of patients hospitalized in medical ward to those admitted in ICU were compared using Mann-Whitney and Chi-square or Fisher exact test when appropriate. Univariate logistic regression was first used to identify variables on admission that were associated with the outcome i.e. admission to an ICU versus total hospital stay in a medical ward. Forward selection was then applied beginning with sex, age and temperature in the multivariable logistic regression model., Results: Of the 412 patients included, 325 were discharged and 87 died in hospital. Multivariable regression showed increasing odds of ICU hospitalization with temperature (OR, 1.56 [95% CI, 1.06-2.28] per degree Celsius increase), oxygen saturation <90% (OR, 12.45 [95% CI, 5.27-29.4]), abnormal lung auscultation on admission (OR, 3.58 [95% CI, 1.58-8.11]), elevated level of CRP (OR, 2.7 [95% CI, 1.29-5.66for CRP>100mg/L vs CRP<10mg/L). and monocytopenia (OR, 3.28 [95% CI, 1.4-7.68]) were also associated with increasing odds of ICU hospitalization. Older patients were less likely to be hospitalized in ICU (OR, 0.17 [95%CI, 0.05-0.51]., Conclusions: Age and delay between onset of symptoms and hospital admission were associated with the risk of hospitalisation in ICU. Age being a fixed variable, interventions that shorten this delay would improve the prognosis of Covid-19 patients., Competing Interests: The authors have read the journal’s policy and have the following competing interests: PV received grants and fees from Anios, Pfizer, Astellas, MSD, Gilead and Sanofi. These grants and fees were not related to this present manuscript. This does not alter our adherence to PLOS ONE policies on sharing data and materials. There are no patents, products in development or marketed products associated with this research to declare. All other authors have no competing interest to declare.

The enzyme CYP1A2 is responsible for the metabolism of numerous antioxidants in the body, including caffeine, which is transformed into paraxanthine, its main primary metabolite. Both molecules are known for their antioxidant and pro-oxidant characteristics, and the paraxanthine-to-caffeine molar ratio is a widely accepted metric for CYP1A2 phenotyping, to optimize dose-response effects in individual patients. We developed a simple, cheap and fast electrochemical based method for the simultaneous quantification of paraxanthine and caffeine in human saliva, by differential pulse voltammetry, using an anodically pretreated glassy carbon electrode. Cyclic voltammetry experiments revealed for the first time that the oxidation of paraxanthine is diffusion controlled with an irreversible peak at ca. +1.24 V (vs. Ag/AgCl) in a 0.1 M H 2 SO 4 solution, and that the mechanism occurs via the transfer of two electrons and two protons. The simultaneous quantification of paraxanthine and caffeine was demonstrated in 0.1 M H 2 SO 4 and spiked human saliva samples. In the latter case, limits of detection of 2.89 μM for paraxanthine and 5.80 μM for caffeine were obtained, respectively. The sensor is reliable, providing a relative standard deviation within 7% ( n = 6). Potential applicability of the sensing platform was demonstrated by running a small scale trial on five healthy volunteers, with simultaneous quantification by differential pulse voltammetry (DPV) of paraxanthine and caffeine in saliva samples collected at 1, 3 and 6 h postdose administration. The results were validated by ultra-high pressure liquid chromatography and shown to have a high correlation factor (r = 0.994).

Coffee diterpenes are the main constituents of the coffee oil unsaponifiable fraction. The three most important diterpenes are cafestol, kahweol, and 16-O-methylcafestol (16-OMC), and they are produced, except for cafestol, only by plants of the Coffea genus. Recently, in addition to these three major diterpenes, another 16-O-methylated diterpene (16-O-methylkahweol: 16-OMK) has been identified and quantified, for the first time, in Robusta coffee. For many years, 16-OMC has been considered present exclusively in Robusta, and so it has been reputed an excellent authenticity marker for the presence of Robusta in coffee products. For its quantification, nuclear magnetic resonance (NMR) has proved very useful when compared with other methods. Quite recently, the detection of very low levels of the two 16-O-methylated diterpenes (16-OMD) 16-OMC and 16-OMK in roasted Arabica was reported. This finding makes the use of NMR methods in 16-OMD quantification in Arabica coffee particularly challenging in view of both the trace amounts of 16-OMD and the impossibility to discriminate between 16-OMC and 16-OMK. The ultra-high performance liquid chromatography mass spectrometry (UHPLC-MS) method, already used to detect 16-OMC and 16-OMK in Arabica roasted coffee, is then more suitable for quantitative analyses. Up to now however, no quantification of coffee 16-OMD via ultra-high performance liquid chromatography tandem mass spectrometry (UHPLC-MS/MS) has been carried out; this largely stimulated the present study. For the first time, a simple procedure for the quantitative detection of 16-OMD in Arabica coffee has been developed, and as far as 16-OMC is concerned, fully validated in terms of specificity, linearity, concentration range, limit of detection (LOD), limit of quantification (LOQ), and repeatability following the criteria specified in the EU Commission Decision 2002/675/EC. This method proved to be very specific and sensitive. In order to avoid the chemical complexity generated by the roasting process, the method was optimized and validated on several green Arabica samples from different geographical origins., (© 2020 John Wiley & Sons, Ltd.)

Chlorogenic acids (CGAs) are a large class of esters formed between quinic acid and hydroxycinnamic acids. They are present in coffee as a complex mixture of positional and geometric isomers, where caffeoylquinic acids (CQAs) are the most abundant, followed by dicaffeoylquinic acids (diCQAs), feruloylquinic acids (FQAs), and p-coumaroylquinic acids (p-CoQAs). The aim of this work is to develop a new reliable and fast liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for simultaneous identification and quantification of total amount of 11 CGAs in roasted coffee. Regarding sample preparation step, aqueous methanol and 100% aqueous ultrasonic extractions were evaluated. For the filtration Step 4, different membranes were tested, in order to fill the void of complete evaluation of extractables recovery when using different membranes, highlighting an incomplete recovery when using nylon filters. An LC/electrospray ionization (ESI)-MS/MS method was developed and validated following the European rules in terms of specificity, linearity, concentration range, limit of detection (LOD) and limit of quantification (LOQ), precision, and trueness, in order to obtain a useful quality control tool for roasted coffee. The method was applied for quantification of CGAs of a roasted coffee sample previously characterized by an interlaboratory circuit (LVU), and results were compared with the quantitation of CGAs via UHPLC-DAD. The quantitative results were expressed as 5-CQA equivalents, and the validation of this approach opens the way to reliable, cheap, and environmental-friendly tools for quality control purposes., (© 2020 John Wiley & Sons, Ltd.)

The synthesis of five hydroxycinnamoyl amides (HCAs) was accomplished and their identification and quantification in the green coffee bean samples of Coffea arabica , Coffea canephora , and Coffea liberica was performed. The HCAs p -coumaroyl- N -tyrosine 1b , caffeoyl- N -phenylalanine 2b , caffeoyl- N -tyrosine 3b , and p -coumaroyl- N -tryptophan 4b were characteristic of the C. canephora species while caffeoyl- N -tryptophan 5b was present in both C. canephora and C. arabica , but with higher content in C. canephora . The HCAs presence was also analyzed in C. liberica for the first time and none of the targeted compounds was found, indicating that this species is very similar to C. arabica species. Between C. canephora samples from various origins, significant differences were observed regarding the presence of all the HCAs, with C. canephora from Tanzania containing all five derivatives.

Natural polyphenols are important dietary antioxidants that significantly benefit human health. Coffee and tea have been shown to largely contribute to the dietary intake of these antioxidants in several populations. More recently, the use of coffee leaves to produce tea has become a potential commercial target, therefore prompting studies on the quantification of polyphenols in coffee leaves. In this study a variety of coffee leaf species, at different development stages, were analyzed using ultra-high pressure liquid chromatography. The results demonstrate that both the botanical origin of the samples and their maturity influence significantly the concentration of the antioxidants; for total chlorogenic acids a two-fold difference was found between different species and up to a three-fold variation was observed between young and mature leaves. Furthermore, the range of concentrations of chlorogenic acids in young leaves (35.7-80.8 mg/g of dry matter) were found to be comparable to the one reported for green coffee beans. The results provide important data from which potential new commercial products can be developed.

Quantitative analyses of mono-p-coumaroylquinic acids (pCoQAs) and total chlorogenic acids (CGAs) in green coffee commercial lots of C. arabica, C. canephora and C. liberica from different geographical origins and eight wild Coffea species were carried out. Among the commercial lots, pCoQAs average content of C. arabica (0.67 mg/g) is higher than that of C. canephora (0.40 mg/g) being C. liberica intermediate (0.58 mg/g). As far as the analyzed wild Coffea species is concerned, C. pseudozanguebariae is characterized by the lower pCoQAs content (0.12 mg/g) whereas C. sessiliflora is by far the richest source of pCoQAs (2.18 mg/g). Effect of the roasting process on the mono-p-coumaroylquinic acids profile was evaluated for the economically exploited species C. arabica and C. canephora. For the first time distribution of mono-p-coumaroylquinic acid isomers in wild coffee species by fast and accurate UHPLC-DAD analyses using authentic standards previously synthetized, is reported., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Identification of both hydroxycinnamic and chlorogenic acids present in aqueous extracts of walnut leaves (Juglans regia L.) were carried out by using, for the first time, standard compounds not commercially available for qualitative identification. In particular, in addition to caffeic, ferulic, p-coumaric and sinapic acids, cis and trans mono-caffeoylquinic, dicaffeoylquinic, mono-feruloylquinic and cis and trans mono-p-coumaroylquinic acid isomers were detected and quantified by Ultra High Pressure Liquid Chromatography and the seasonal variations of these secondary metabolites were investigated.

Chlorogenic acids are relevant coffee quality markers, taste, and aroma precursors as well as important bioactive compounds. A number of mono-acyl, di-acyl, and tri-acyl quinic acid isomers were found in green coffee beans, being mono-caffeoyl, mono-feruloyl, mono-p-coumaroyl, and di-caffeoylquinic acid isomers considered as quantitatively major compounds. Roasting process increases the chemical complexity of coffee by inducing the formation of a number of lactones (quinides), shikimates, and other chlorogenic acids derivatives. So far, little attention has been paid in characterizing minor chlorogenic acids and derivatives in roasted Coffea arabica, also known as Arabica. In the present work, roasted C. arabica samples from different geographical origins (Brazil, Colombia, Costa Rica, Ethiopia, Guatemala, and India) were characterized by UHPLC-ESI-QqTOF-MS/MS. Several minor chlorogenic acid isomers were identified. In particular, HR-MS/MS provided putative identification of four dimethoxycinnamoyl-quinic acid derivatives, such as 4-dimethoxycinnamoylquinic acid, 4-dimethoxycinnamoyl-3-caffeoylquinic acid, 3-dimethoxycinnamoyl-4-feruloylquinic acid, 4-dimethoxycinnamoyl-5-feruloylquinic acid, and two caffeoyl, feruloyl quinic acid derivatives (3-caffeoyl-4-feruloylquinic acid and 3-feruloyl-4-caffeoylquinic acid). To our knowledge, these compounds were found in roasted Arabica coffee for the first time, and their presence is independent on the different geographical origins examined., (© 2018 John Wiley & Sons, Ltd.)

Objectives: The objective of the study was to estimate the length of stay of patients with hospital-acquired infections hospitalized in ICUs using a multistate model., Design: Active prospective surveillance of hospital-acquired infection from January 1, 1995, to December 31, 2012., Setting: Twelve ICUs at the University of Lyon hospital (France)., Patients: Adult patients age greater than or equal to 18 years old and hospitalized greater than or equal to 2 days were included in the surveillance. All hospital-acquired infections (pneumonia, bacteremia, and urinary tract infection) occurring during ICU stay were collected., Interventions: None., Measurements and Main Results: The competitive risks of in-hospital death, transfer, or discharge were considered in estimating the change in length of stay due to infection(s), using a multistate model, time of infection onset. Thirty-three thousand four-hundred forty-nine patients were involved, with an overall hospital-acquired infection attack rate of 15.5% (n = 5,176). Mean length of stay was 27.4 (± 18.3) days in patients with hospital-acquired infection and 7.3 (± 7.6) days in patients without hospital-acquired infection. A multistate model-estimated mean found an increase in length of stay by 5.0 days (95% CI, 4.6-5.4 d). The extra length of stay increased with the number of infected site and was higher for patients discharged alive from ICU. No increased length of stay was found for patients presenting late-onset hospital-acquired infection, more than the 25th day after admission., Conclusions: An increase length of stay of 5 days attributable to hospital-acquired infection in the ICU was estimated using a multistate model in a prospective surveillance study in France. The dose-response relationship between the number of hospitalacquired infection and length of stay and the impact of early-stage hospital-acquired infection may strengthen attention for clinicians to focus interventions on early preventions of hospital-acquired infection in ICU.

OBJECTIVES We aimed to ascertain the factors associated with lack of isolation precautions (IP) in patients infected or colonized by third-generation cephalosporin-resistant Enterobacteriaceae (3GCR-E) and methicillin-resistant Staphylococcus aureus (MRSA) in hospital settings. DESIGN Prospective surveillance and audit of practices. SETTING The study included 4 university hospitals in Lyon, France. PARTICIPANTS All patients hospitalized between April and June in 2013 and 2015 were included. Case patients had ≥1 clinical sample positive for MRSA and/or 3GCR-E. METHODS Factors associated with the lack of IP implementation were identified using multivariate logistic regression. The incidence of MDRO infections was expressed per 10,000 patient days. RESULTS Overall, 57,222 patients accounting for 192,234 patient days of hospitalization were included, and 635 (1.1%) MDRO cases were identified. MRSA incidence was 2.5 per 10,000 patient days (95% confidence interval [95% CI], 2.1-3.0) and 3GCR-E incidence was 10.1 per 10,000 patient days (95% CI, 9.2-11.0), with no crude difference between 2013 and 2015 (P=.15 and P=.11, respectively). Among 3GCR-E, the main species were Escherichia coli (43.8%) and Klebsiella pneumoniae (31.0%). Isolation precautions were implemented in 78.5% of cases. Lack of IP implementation was independently associated with patient age, year, specialty, hospital, colonization compared with infection, and lack of medical prescription for IPs (adjusted odds ratio, 17.4; 95% CI, 8.5-35.8; P<.001). CONCLUSIONS MRSA and 3GCR-E infections and/or colonizations are frequent in healthcare settings, and IPs are implemented in most cases. When IPs are lacking, the main factor is the absence of medical prescription for IPs, underscoring the need for alerts to physicians by the microbiological laboratory and/or the infection control team. Infect Control Hosp Epidemiol 2017;38:1188-1195.

Background: Hospital-acquired infections (HAIs) in intensive care units (ICUs) are associated with increased length of stay (LOS). The objective of this study was to graphically describe by heat mapping LOS of patients hospitalized in ICUs related to the occurrence of HAI and severity at admission measured by the Simplified Acute Physiological Score II (SAPSII)., Methods: Adult patients hospitalized in ICUs of Lyon University Hospitals (France) were included in an active standardized surveillance study of HAI from January 1, 1995-December 31, 2012. Surveillance included adult patients aged ≥18 years hospitalized ≥2 days. Patient follow-up ended at ICU discharge or death. LOS was calculated in days from differences between dates of entry and discharge from ICUs. HAIs recorded were pneumonia, bacteremia, and urinary tract infection. The heat map was designed with a spreadsheet software., Results: A total of 34,694 patients were analyzed. Among infected patients, 72.3% had 1 infected site (IS), 23% had 2 ISs, and 4.7% had 3 ISs. Median LOS was 24 days in infected patients (20.4 days among patients with 1 IS, 34.2 days among patients with 2 ISs, and 45.3 days among patients with 3 ISs) and 5 days in noninfected patients (P < .001). Two groups of multi-infected patients with long LOSs were identified with the heat map., Conclusions: The heat map facilitated easy-to-implement semi-quantitative visualization of increasing LOS through the SAPSIIs and number of ISs., (Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.)