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Background: Coronavirus disease 2019 (COVID-19) has now spread to most countries and regions of the world. Risk factors associated with multi-drug resistant organism (MDRO) infections in patients with COVID-19 have not been well studied yet. In the present study, we aimed to identify the risk factors associated with the MDRO infections and their impact on in-hospital mortality of COVID-19 patients. Methods: This retrospective cohort study was conducted between December 2019 and April 2020 at two tertiary hospitals in Wuhan, China. Data of cases were collected through electronic medical records system. This study was focused on cases with bacterial culture records. Risk factors and outcomes associated with MDRO infections were analyzed using logistic regression model. Results: Of the 2891 patients, 370 patients have bacterial culture results, and MDROs were isolated in 38 patients. Respiratory tract infections (67.3%) were the most common hospital acquired infections. Variables independently associated with MDRO infections were dyspnea at admission (odds ratio (OR) 4.74; 95% confidence interval (CI) 2.06-10.88; P < 0.001), intensive care unit (ICU) admission (OR 5.02; 95% CI 1.99-12.63; P < 0.01), and invasive mechanical ventilation (OR 5.13; 95% CI 2.15-12.27; P < 0.001), adjusted for age and gender. MDROs infection was also a significant risk factor of death for the patients, adjusted for age, gender, severity of illness, ICU admission and mechanical ventilation (OR 1.12, 95% CI: 0.43-2.96, P = 0.817). Conclusion: In our study, dyspnea at admission, ICU admission and invasive mechanical ventilation were associated with the presence of MDRO infections, and clinicians should be alert in MDRO infections in COVID-19 hospitalized patients. [ABSTRACT FROM AUTHOR]

Background: Thoracic ossification of ligamentum flavum (TOLF) is a progressively disabling disease. Isolated or continuous TOLF has been frequently reported in literature, however there are very few reports of multilevel or non-continuous TOLF. The purpose of the study was to discuss the surgical strategy of multilevel TOLF and evaluate safety and efficacy of a two-stage operation regimen. Methods: From October 2007 to May 2014, eleven patients (4 males, 7 females) that underwent two-stage surgery for multilevel spinal stenosis were retrospectively reviewed. The follow-up period lasted at least 12 months. Demographic data, radiological findings as well as operative data were collected. Postoperative functional outcomes evaluated by the modified Japanese Orthopedic Association score (mJOA) and complications were analyzed. Results: The patients ranged in age from 30 to 65 years (average, 50.2 ± 11.8 years), and comprised 4 men and 7 women. All patients exhibited significant improvements in neurological deficits. The mJOA score improved from a mean of 3.5 ± 2.2 preoperatively to 4.6 ± 2.3 before second-stage surgery and to 7.5 ± 2.2 at final follow-up. The improvement was statistically significant in the average mJOA improvement rate at final follow-up. No staging-related complications were noted in this study. Conclusions: Staged surgery can effectively achieve neurological functional recovery in patients with multi-segment spinal stenosis in thoracic and lumbar regions, with favorable efficacy and safety. Yet, slight neurological deterioration was observed during the intervals of these two index surgeries. [ABSTRACT FROM AUTHOR]