Pathogen Detection And Analysis In Patients With Sepsis Complicated With New-onset Atrial Fibrillation:A Retrospective Observational Study

Background Patients with sepsis are prone to complications such as cardiac damage and arrhythmia,of which atrial fibrillation(AF)is the most common.Although a previous study found that gram-positive bacteria and fungal infection were independent risk factors for newonset atrial fibrillation(NOAF)in sepsis patients,no study has conducted a detailed and comprehensive analysis of the pathogens associated with NOAF in sepsis patients.Objective The objectives of our study were mainly to detect and analyze the pathogens in patients with sepsis complicated with NOAF to provide a new scientific basis for the diagnosis,treatment and prevention of sepsis complicated with NOAF and to contribute to improving the mortality and disability rate of sepsis patients.Methods This retrospective observational study examined 2123 patients diagnosed with sepsis in Yichang Central People’s Hospital from August 1,2016,to August 20,2021.We selected 123 septic patients with AF as the case group and 2000 septic patients without AF as the control group.The sociodemographic characteristics,clinical features,laboratory test results,hospital clinical process and outcome of the two groups were compared.Moreover,we analyzed the types of pathogens(bacteria,viruses,fungi),common pathogenic strains,Gram staining characteristics(gram positive/negative)of bacteria,infection sites and infection routes(community infection/hospital infection)of patients with sepsis complicated with NOAF.We used logistic regression to determine the risk factors for NOAF in sepsis patients.Results In the adjusted multivariable analysis,we found that sepsis patients with NOAF are significantly more likely to have older age(OR 2.725;95% CI 1.775-4.184),coronary heart disease(OR 2.124;95% CI 1.300-3.471),heart failure(OR 2.289;95% CI 1.462-3.585),severe inflammation(OR 4.012;95% CI 2.654-6.064),septic shock(OR 2.297;95% CI 1.532-3.445),Pseudomonas aeruginosa infection(OR 4.163;95% CI 2.199-7.880),Streptococcus pneumoniae infection(OR 5.729;95% CI 1.666-19.706)and central venous catheter infection(OR 3.954;95% CI 1.651-9.470).Moreover,sepsis patients with NOAF might have a significantly higher risk of all-cause mortality(p=0.000),higher hospitalization expenses(p=0.000),a higher likelihood of admission to the intensive care unit(ICU)(p=0.000),and a higher likelihood of using mechanical ventilation than those without NOAF(p=0.000).Conclusion In addition to traditional risk factors(such as older age,coronary heart disease,heart failure,severe inflammation and septic shock),Pseudomonas aeruginosa infection,Streptococcus pneumoniae infection and central venous catheter infection also contributed to the risk of NOAF in sepsis patients.Furthermore,NOAF conferred an increased risk for inhospital mortality,hospitalization expenses,admission to the ICU and use of mechanical ventilation in sepsis patients.