Risk factors for Gram-negative bacterial infection of cardiovascular implantable electronic devices: multicenter observational study (CarDINe Study).

Infections of cardiovascular implantable electronic devices (CIED) are mainly due to gram-positive bacteria (GPB). Data about gram negative bacteria CIED (GNB-CIED) infections are limited. Aims of our work are to investigate risk factors, clinical and diagnostic characteristics, and outcome of patients with GNB-CIED. Multicenter, international, retrospective, case-control-control study on patients undergoing CIED implantation from 2015 to 2019 in 17 centers across Europe. For each patient diagnosed with GNB-CIED, one matching control with GPB-CIED infection and two matching controls without infection were selected. 236 patients were enrolled: 59 with GNB-CIED infection, 59 with GPB-CIED infection and 118 without infection. No differences regarding clinical presentation, diagnostic and therapeutic managements were found between the groups. A trend toward higher rate of FDG PET/CT positivity was observed among patients with GN than in those with GPB-CIED infection (85.7% vs. 66.7%, p=0.208). Risk factors for GNB-CIED infection were Charlson Comorbidity Index Score (RRR=1.211, P= 0.011), obesity (RRR: 5.122, P=0.008), ventricular-pacing ventricular-sensing inhibited-response pacemaker (PM-VVI) implantation (RRR: 3,027, P=0.006) and the right subclavian vein site of implantation (RRR: 5.014, P=0.004). At 180-day survival analysis GNB-CIED infection was associated with increased mortality risk (HR=1.842, P=0.067). Obesity, high number of comorbidities, and right subclavian vein implantation site are associated with increased risk of GNB-CIED infection. A prompt therapeutic intervention that may be guided by the use of FDG PET/CT is suggested in patients with GNB-CIED infection considering the poorer outcome observed in this group

Observation of Gravitational Waves from the Coalescence of a 2.5−4.5 M⊙2.5-4.5~M_\odot Compact Object and a Neutron Star

International audienceWe report the observation of a coalescing compact binary with component masses $2.5-4.5~M_\odot$ and $1.2-2.0~M_\odot$ (all measurements quoted at the 90% credible level). The gravitational-wave signal GW230529_181500 was observed during the fourth observing run of the LIGO-Virgo-KAGRA detector network on 2023 May 29 by the LIGO Livingston Observatory. The primary component of the source has a mass less than $5~M_\odot$ at 99% credibility. We cannot definitively determine from gravitational-wave data alone whether either component of the source is a neutron star or a black hole. However, given existing estimates of the maximum neutron star mass, we find the most probable interpretation of the source to be the coalescence of a neutron star with a black hole that has a mass between the most massive neutron stars and the least massive black holes observed in the Galaxy. We estimate a merger rate density of $55^{+127}_{-47}~\text{Gpc}^{-3}\,\text{yr}^{-1}$ for compact binary coalescences with properties similar to the source of GW230529_181500; assuming that the source is a neutron star-black hole merger, GW230529_181500-like sources constitute about 60% of the total merger rate inferred for neutron star-black hole coalescences. The discovery of this system implies an increase in the expected rate of neutron star-black hole mergers with electromagnetic counterparts and provides further evidence for compact objects existing within the purported lower mass gap