HBR patients present complex situations in routine practise. Balance between thrombotic and hemorragic risk is difficult to deal. Cobra PzF offer a rapid reendothelialization as short as 7 days that offer a simplification of antithrombotic therapy. To report procedural and 1-year outcomes following COBRA PzF NCS implantation in a routine daily setting for HBR patients treated with clopidogrel as mono antiplatelet therapy (MAPT) at discharge. This is a prospective, consecutive, observational study in HBR patients who underwent PCI with COBRA PzF NCS and treated with clopidogrel alone at discharge. The primary endpoint was definite stent thrombosis at one month. The secondary endpoint was MACE [cardiac death, myocardial infarction (MI), target lesion revascularization (TLR)] at 12 months. Two hundred patients with 301 lesions were enrolled and treated. Mean age was 79.3 ± 8.9 years, 70% men and 33% presented an ACS. Patients included had at least 1.9 inclusion LEADERS FREE criteria. Angiographic success was achieved in all cases. The primary endpoint occurred in 0%, no stent thrombosis was observed. MACE at 12-months was 4% including cardiac death 0%, MI 0% and TLR 4%. No severe bleeding events (BARC3-5) or stroke or late stent thrombosis were noted. Clopidogrel as MAPT after COBRA PzF NCS implantation in HBR patients is feasible and an attractive option. One-year follow-up was associated with good clinical outcomes and compared favourably with all previous studies.

Aims: To report procedural and 1-year outcomes following COBRA PzF NCS implantation in a routine daily setting with high bleeding risk (HBR) patients treated with clopidogrel as mono antiplatelet therapy (MAPT). Methods: This is a prospective, consecutive, observational study in HBR patients who underwent PCI with COBRA PzF NCS and treated with clopidogrel alone at discharge. The primary endpoint was definite stent thrombosis at one month. The secondary endpoint was MACE (Cardiac Death, myocardial infarction (MI), target lesion revascularization (TLR)) at 12 months. Results: From October 2015 to December 2018, 77 patients with 120 lesions were enrolled and treated. Mean age was 78.7 +/- 8.89 years, 58.5% men and 18.2% had ACS. Patients included had a minimum of 2.0 inclusion LEADERS FREE criteria. Angiographic success was achieved in all cases. The primary endpoint occurred in 0%, no stent thrombosis was occurred. MACE at 12-months (available for 52 patients) was 3.8% including cardiac death 0%, MI 0% and TLR 3.8%. No severe bleeding events (BARC3-5) or stroke or late stent thrombosis were noted. Conclusion: Clopidogrel as MAPT after COBRA PzF NCS implantation in HBR patients is feasible and an attractive option. One-year follow-up was associated with excellent clinical outcomes and should be confirmed with large randomised study. Condensed abstract: This is prospective registry of high bleeding risk patients treated with the COBRA PzF NCS and MAPT at discharge. The primary end point demonstrated no stent thrombosis. The rate of major cardiac adverse events (a composite of cardiovascular death, myocardial infarction and target lesion revascularisation) at 1 year was 3.8%. No severe bleeding events, stroke or late stent thrombosis were noted. One-year follow-up was associated with good clinical outcomes and compared favorably with current devices. (c) 2019 Elsevier Inc. All rights reserved.

BACKGROUND Femoral access is the gold standard for transcatheter aortic valve replacement (TAVR). Guidelines recommend reconsidering surgery when this access is not feasible. However, alternative peripheral accesses exist, although they have not been accurately compared with femoral access. OBJECTIVES This study compared nonfemoral peripheral (n-FP) TAVR with femoral TAVR. METHODS Using the data from the national prospective French registry (FRANCE TAVI [French Transcatheter Aortic Valve Implantation]), this study compared the characteristics and outcomes of TAVR procedures according to whether they were performed through a femoral or a n-FP access, using a pre-specified propensity score-based matching between groups. Subanalysis during 2 study periods (2013 to 2015 and 2016 to 2017) and among low/intermediate-low and intermediate-high/high volume centers were performed. RESULTS Among 21,611 patients, 19,995 (92.5%) underwent femoral TAVR and 1,616 (7.5%) underwent n-FP TAVR (transcarotid, n = 914 or trans-subclavian, n = 702). Patients in the n-FP access group had more severe disease (mean logistic EuroSCORE 19.95 vs. 16.95; p < 0.001), with a higher rate of peripheral vascular disease, known coronary artery disease, chronic pulmonary disease, and renal failure. After matching, there was no difference in the rate of post-procedural death and complications according to access site, except for a 2-fold lower rate of major vascular complications (odds ratio: 0.45; 95% confidence interval: 0.21 to 0.93; p = 0.032) and unplanned vascular repairs (odds ratio: 0.41; 95% confidence interval: 0.29 to 0.59; p < 0.001) in those who underwent n-FP access. The comparison of outcomes provided similar results during the second study period and in intermediate-high/high volume centers. CONCLUSIONS n-FP TAVR is associated with similar outcomes compared with femoral peripheral TAVR, except for a 2-fold lower rate of major vascular complications and unplanned vascular repairs. n-FP TAVR may be favored over surgery in patients who are deemed ineligible for femoral TAVR and may be a safe alternative when femoral access risk is considered too high. (C) 2019 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation.

According to PARTNER 2 (2016), Transcatheter Aortic Valve Replacement (TAVR) is non inferior to surgery in intermediate risk patient. Furthermore, TAVR through a transfemoral access might be superior to surgery (second cohort, not designed for superiority) while TAVR through other access sites,

Background. - The COBRA PzF coronary stent, which has a unique nano-coating of Polyzene-F, was developed to reduce the risk of stent thrombosis. Aims. To report procedural and 1-year clinical outcomes following COBRA PzF coronary stent implantation in a real-world percutaneous coronary intervention (PCI) registry. Methods. - All patients assigned to treatment with the COBRA PzF in the GCS Axium Rambot Center, Aix-en-Provence, France between February 2013 to June 2014 were prospectively enrolled. Results. - Among 100 patients (71% men, mean +/- standard error age 71.4 +/- 11.0 years), 38% had acute coronary syndromes. The population was consistent with real-world experience and included patients with multiple co-morbidities and 26% with diffuse multivessel disease. A total of 151 lesions were treated with 166 stents, including 26% of lesions with a type B2 or C classification. Pre- and post-procedural quantitative coronary angiography analyses showed a mean acute gain of 2.2 +/- 0.2 mm. Angiographic success was achieved in all cases. One-year follow-up was available for all patients and the target vessel failure (composite of all-cause mortality, myocardial infarction or target vessel revascularization) rate was 12%, including 2% mortality (end-stage cardiomyopathy), 5% myocardial infarction (five periprocedural myocardial infarctions with isolated troponin elevation without chest pain or Q waves) and 5% target lesion revascularization. There were no cases of definite stent thrombosis. Conclusion The COBRA PzF stent was safe and effective in routine practice. One-year follow-up was associated with excellent clinical outcomes and compared favourably with current devices. These results are very promising in a real-world population of complex patients, and further study is warranted. (C) 2017 Published by Elsevier Masson SAS.

The complete genome sequences of three Listeria monocytogenes serotype 1/2a strains, Lm 3136, Lm 3163, and Lm N1546, which were responsible for listeriosis outbreaks in 2005 and 2011 in Switzerland, are presented here.

Stenting options for patients at high risk of bleeding (elderly, AF, ACS) are sub-optimal. BMS are not as effective as DES in reducing restenosis but DES require long term DAPT, which increases bleeding risk. Recent animal studies have demonstrated that the nano PzF surface modified stent (Cobra PzF, CeloNova) is thrombo-resistant, and is associated with a rapid reendothelialization. 100 patients (71 men) with mean age 71.4±2 year old of all comer patients were prospectively included to evaluate the safety and the efficacy of the Cobra PzF stent. Patients presented with multiple co-morbidities including 22% DM, 10% AF, 17% EF<40%, 10% VKA, 28% ACS, 10% STEMI and 26% diffused and multivessel diseases. 166 Cobra PzF stents were implanted in 151 lesions (74% B1 lesions) via a radial route (72%) with a 6F-guiding catheter. 1.66 stent/pt was implanted for a mean stent length of 18.7± 0.5mm and a mean diameter of 3.1±0.3mm. Target lesions in left main (2%), LAD Diag (43%), CxMg (23%), RCA (32%), including bifurcated kissed lesions (12%) were treated with 50% direct stenting. The device was successfully implanted in 100% of targeted lesions to achieve a complete revascularization in all cases. In-hospital, there were no adverse events (Death, MI, TLR, cerebral events, stent thrombosis) or incidence of major bleeding complications or transfusions. At one month, no events were reported. 6-month results showed 4% of MACE (terminal cardiac insufficiency and 3 restenosis successfully treated). Those Results are very promising in real world and complex patients (Diabetes, AF, Acute MI, Unstable Angina, Bifurcation, VKA). The COBRA PzF stent is safe and effective in routine practice. These preliminary data and the rapid reendothelialization observed in preclinical will serve as an impetus for a multi-center randomized study of short DAPT.

ABSTRACT The complete genome sequence of Listeria monocytogenes LL195, a serotype 4b clinical strain isolated during the 1983–1987 listeriosis epidemic in Switzerland, is presented.

In Burkina Faso, a Western African country, reports on pneumococci carriage, resistance patterns and serotypes are inconsistent. The present study was conducted in order to evaluate these parameters. Thus 860 nasopharyngeal swabs were collected from children attending vaccination centers for pneumococci isolation, identification and serotype determination. The susceptibility to 16 antibiotics was assayed as recommended by the National Committee for Clinical Laboratory Standard (NCCLS). The results revealed that the majority of children were of 2 to 24 months age and 73.4% of children were well vaccinated. A carriage rate of 50.6% was recoded among the children. The main serotypes were: 6 (22.22%); 23 (16.67%); 7 and 9 (3.70%); 4, 11, 14, 15, 20 and 24 (1.85%). Serotypesl9, 23, 6, 7 and 18 were linked to penicillin resistance. Globally, high resistance rates to: amikacin, tetracyclin, pefloxacin, cotrimoxazol and penicillins (resistance rates greater than 25%) were recorded; however the following antibiotics remained active on the strains: rifampicin, ceftriaxone, erythromycin, spectinomycin, chloramphenicol, vancomycin, lincomycin and ciprofloxacin.

Since 1986, 68% of the Listeria monocytogenes isolates from human cases of invasive listeriosis in Sweden are available for retrospective studies. The aim of the present study was to characterize 601 human invasive isolates of L. monocytogenes in Sweden from 1986 to 2007 by using serotyping and pulsed-field gel electrophoresis. Since 1996, serovar 4b was permanently reduced to the second or third most common serovar in human cases in Sweden. During the latter period, 2000-2007, only 13% belonged to serovar 4b and 71% to 1/2a. The dendrogram, based on pulsovars, reveals two clusters with different serovars. Cluster 1 exhibits serovars 4b and 1/2b, whereas cluster 2 consists of serovar 1/2a. Serovar 1/2a seems to be more heterogeneous than serovar 4b.

Interpretive reading analyses the complete resistance profiles of bacteria to multiple antibiotics and infers the resistance mechanisms present; it aids therapeutic choice and enhances surveillance data. We evaluated the Advanced Expert System (AES), which interprets MICs generated by the VITEK 2. Ten European laboratories tested 42 reference strains and 76-106 of their own strains, representing important resistance genotypes. Interpretive reading by the VITEK 2 AES achieved full agreement with genotype data for 88-89% of strains, with the correct mechanism identified as one of two possibilities for a further 5-6%. Mechanisms inferred with 90% agreement with reference data included methicillin resistance in staphylococci, glycopeptide resistance in enterococci, quinolone resistance in staphylococci and Enterobacteriaceae, AAC(6')-APH(2")-mediated aminoglycoside resistance in Gram-positive cocci, erm-mediated macrolide resistance in pneumococci, extended-spectrum beta-lactamases (ESBLs) in Enterobacteriaceae and Pseudomonas aeruginosa, and acquired penicillinases in Enterobacteriaceae. VanA, VanB and VanC phenotypes of enterococci were distinguished reliably, and ESBL production was accurately inferred in AmpC-inducible species as well as Escherichia coli and Klebsiella spp. Mechanisms identified, but only as possibilities among several, included IRT-type beta-lactamases and individual aminoglycoside-modifying enzymes in Enterobacteriaceae. Most disagreements with reference data concerned pneumococci found to have high-level penicillin resistance by the VITEK 2 AES but previously determined, phenotypically, to have intermediate resistance. When ESBL production was inferred in E. coli and klebsiellae, the VITEK 2 AES edited susceptible results for cephalosporins (except cefoxitin) to resistant; when an acquired penicillinase was inferred in Enterobacteriaceae, piperacillin results were edited to resistant; and when staphylococci were found methicillin resistant, resistance was reported for all beta-lactams. Further editing may be desirable (e.g. of cephalosporin results for salmonellas inferred to have ESBLs).

Since a long time a public garden in Basle is known as a site for overnight accomodation and assembly of starlings. The birds cause an immense faecal contamination of the park and the neighbouring district. A nursery and a primary school are directly affected. To evaluate the health risk coming from the starlings droppings for the population, particularly for the children and to assess the role of starling sin the transmission of diseases to humans and in the epidemiology of human diseases the presence of human bacterial pathogens in the faeces of starlings was determined. Some of the isolated strains were further typed and compared to strains of human origin. C. jejuni, L. monocytogenes and C. psittaci were most often found. The typisation of some C. jejuni and L. monocytogenes isolates showed a great variety of geno-, sero- respectively phage types that did not belong to the strains most often found in isolates of human origin. Starlings can harbour human pathogens and therefore a potential risk of infection comes from their droppings. It seems however rather improbable, that these birds present a constant direct source of infection for human beings.

The antenatal diagnosis of congenital toxoplasmosis represents today an important application of molecular diagnostic methods such as PCR. Done directly in amniotic fluid, the PCR for T. gondii is able to detect in utero infected foetus with high probability. Doing so, it precludes to obtain foetal blood and to use more cumbersome and lengthy procedures such as inoculation to cell lines or to mice. Although it is use today in many centres, the molecular diagnosis of T. gondii by PCR is neither commercialized nor standardised. The objective of this report is to present the methodology used in our institution and to establish its degree of validation.