Purva Mathur

All India Institute of Medical Sciences, New Dilli, NCT, India

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Publications (113)138.12 Total impact


  • No preview · Article · Sep 2015 · Intensive Care Medicine
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    ABSTRACT: Elizabethkingia meningoseptica is an infrequent cause of hospital-acquired infections. The clinical and microbiological profiles of infections due to E. meningoseptica over a seven-year period at a Level I trauma centre are reported in this study. Medical records of patients from whose clinical samples E. meningoseptica was isolated on at least two occasions were reviewed. A total of 21 cases were observed during the study, 16 (76.2%) of which exhibited multidrug resistance. The observed in-hospital mortality rate was 47.6%. A high index of clinical suspicion and effective detection of E. meningoseptica in clinical samples are requisite for improved clinical outcome.
    No preview · Article · Aug 2015 · Journal of Hospital Infection
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    ABSTRACT: Background: Occupational exposure to sharps and splashes pose a major hazard among health care workers (HCWs); so knowledge and awareness regarding sharps/splashes by blood and potentially infectious body fluids (BBF) is a must. Hence, the study was done to assess the extent of knowledge of the staff and using awareness classes and hands on practice as a model to increase awareness as well as prevention. Materials and Methods: This prospective interventional cohort study, using before – after trial, was conducted in a Level I trauma care centre. All cadres of HCWs were enrolled randomly into 5 different groups of 15 each. This study was conducted in 2 phases – interactive classes and hands on practice (Phase I) and questionnaire assessment and work area observation (phase II). This was repeated twice and the final outcome was analysed. A systematic level of grading was used to assess the improvement. Results: It was observed that Group 1 (doctors) and group 2 (nurses) had the maximum knowledge about such exposures and its prevention compared to the other groups (groups 3, 4 and 5) during the initial assessment (Phase I). The remaining groups showed a major improvement after the 2nd assessment, though their knowledge was poor in the beginning. Groups 1and 2 showed 32% and remaining groups showed a 25% improvement in voluntary reporting after the second assessment (Phase II). Conclusion: Awareness classes and hands on practice are indeed useful in generating knowledge about sharps/ splashes. Certain incentives given at right time can improve it further.
    No preview · Article · Jul 2015 · Journal of Clinical and Diagnostic Research
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    ABSTRACT: Wound is a disruption of normal anatomic structure and function of the skin, and any infection in this constitutes wound infection. Wound infection delays wound healing, and it causes wound breakdown, leading to increased hospital stay, morbidity and mortality. Most of the published data available focus on surgical site infections. In the developing countries, however, wound infection is an important cause of hospital mortality and morbidity. No data are available on the microbial profile of the wounds presenting at our hospital.
    No preview · Article · Jul 2015
  • N Rajkumari · P Mathur · K Farooque · V Sharma

    No preview · Article · Jul 2015 · Indian journal of medical microbiology
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    ABSTRACT: Trauma is one of the leading causes of mortality worldwide with infections as important causes of death in such patients. Bacterial infections cause activation of monocytes with excessive synthesis of pro-inflammatory cytokines. Hence, this prospective study was conducted to assess the activity of monocytes in traumatized sepsis patients using flow cytometry and to assess if they have any prognostic potential. A total of 16 consecutive trauma patients with sepsis and having positive blood culture were enrolled, along with four healthy controls during the period of March 2013 to July 2013. Blood from septic patients were collected on the same day when blood culture was positive and on days 2 and 5 thereafter. Surface staining for monocytes with CD14 and intracellular staining for interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) was done and results were analyzed by flow cytometer. Procalcitonin (PCT) assay was done using MiniVidas. Complete clinical follow-up was done for the patients. Of the 16 patients, four died due to infections by various microorganisms. Isolated abdominal trauma (25%) was the most common injury among the enrolled patients of sepsis. Levels of TNF-α were significantly decreased when stimulated with lipopolysaccharide in the fatal patients as compared to the healthy controls. Patients having sepsis who survived had an increased level of TNF-α during the follow-up periods. This study showed that activity of monocytes to produce TNF-α and IL-6 were reduced in severe sepsis. Early identification of such immune-paralysis can help in earlier intervention to salvage this vulnerable trauma population.
    No preview · Article · May 2015 · Journal of laboratory physicians
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    ABSTRACT: Bloodstream infection (BSI) and bacteremias due to Enterococcus spp. are increasing worldwide with the current need to understand its causes among hospitalized trauma patients. Hence, the study was conducted. A 3-year retrospective laboratory cum clinical based study was performed at a level I trauma center in India. Patients with health care associated enterococcal bacteremia were identified using the hospital database, their episodes of BSI/bacteremia calculated and their clinical records and treatment were noted. A total of 104 nonrepetitive Enterococcus spp. was isolated of which Enterococcus faecium was the most common (52%). High-level resistance to gentamicin high-level aminoglycoside resistance was seen in all the Enterococcus spp. causing bacteremia, whereas a low resistance to vancomycin and teichoplanin was observed. Overall mortality was more in patients infected with vancomycin-resistant Enterococcus (5/11, 46%) compared to those with vancomycin sensitive Enterococcus (9/93, 10%); though no significant association of mortality with Enterococcus spp. bacteremia (P > 0.05) was seen. The rate of bacteremia due to Enterococcus spp. was 25.4 episodes/1,000 admissions (104/4,094) during the study period. Enterococcal bacteremia is much prevalent in trauma care facilities. Here, a microbiologist can act as a sentinel and help in preventing such infections.
    No preview · Article · May 2015 · Journal of laboratory physicians
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    ABSTRACT: Maxillofacial trauma is an apt example of a difficult airway. The anesthesiologist faces challenges in their management at every step from airway access to maintenance of anesthesia and extubation and postoperative care. A retrospective study was done of 288 patients undergoing surgery for maxillofacial trauma over a period of five years. Demographic data, detailed airway assessment and the method of airway access were noted. Trauma scores, mechanism of injury, duration of hospital stay, requirement of ventilator support were also recorded. Complications encountered during perioperative anaesthetic management were noted. 259 (89.93%) of the patients were male and 188 (62.85%) were in the 21-40 year range. 97.57% of the cases were operated electively. 206 (71.53%) patients were injured in motor vehicular accidents. 175 (60.76%) had other associated injuries. Mean Glasgow coma scale score (GCS), injury severity score (ISS) and revised trauma score (RTS) were 14.18, 14.8 and 12, respectively. Surgery was performed almost nine days following injury. The mean duration of hospitalization was 16 days. ICU admission was required in 22 patients with mean duration of ICU stay being two days. Majority of patients had difficult airway. 240 (83.33%) patients were intubated in the operating room and fibreoptic guided intubation was done in 159 (55.21%) patients. Submental intubation was done in 45 (14.93%) cases. Maxillofacial injuries present a complex challenge to the anaesthesiologist. The fibreoptic bronchoscope is the main weapon available in our arsenal. The submental technique scores over the time-honored tracheostomy. Communication between the anaesthesiologist and the surgeon must be given paramount importance.
    No preview · Article · Apr 2015
  • Purva Mathur
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    ABSTRACT: HealthCare Associated Infections (HCAIs) are increasingly considered to be preventable adverse events, which require prioritized global attention. In the face of increasing antimicrobial resistance, prevention remains the best method to curb these infections. Surveillance of HCAIs and antimicrobial resistance using standard methods is becoming a model for prevention. Surveillance identifies the rates of HCAIs, the areas for intervention and improvement, as well as the impact of those preventive interventions. Objectivized definitions, algorithmic diagnosis and electronic databases have made surveillance systems more user-friendly and effective over time. The scope of surveillance is ever-widening with increasing need for post-discharge surveillance, day-care and home-based treatment and the technology revolution. This review provides an overview of the global health care associated infection surveillance systems and recent innovations therein.
    No preview · Article · Apr 2015
  • Purva Mathur

    No preview · Article · Mar 2015
  • S. Lalwani · N. Rajkumari · P. Mathur · V. Sharma · V. Trikha
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    ABSTRACT: Sir,Health Care Associated Infections (HCAIs) increase the morbidity and mortality in patients coming for trauma care. Trauma is a silently growing epidemic, which takes its toll mostly in young adults. Patients with pelvic injuries form a specific cohort who often has multiple accompanying injuries because they are commonly caused by high-energy trauma [1] and their overall mortality varies from 5 to 30 % [2-4]. Although many studies have been done on the risk factors, causes and treatment of the pelvic trauma [1, 5], specific studies on infections and fatality in pelvic trauma cases are scarce.This retrospective study reports the profile of infections in fatal cases of primary pelvic trauma from 2010 to 2012 at a level-1 Indian trauma centre. The patient’s demographic data, duration of survival, type of pelvic injury and any associated injuries, if any, were noted and analysed. The profile of infections developing in these patients was recorded and analysed as per the predisposing fa ...
    No preview · Article · Feb 2015 · European Journal of Trauma and Emergency Surgery

  • No preview · Article · Feb 2015 · Journal of laboratory physicians
  • P Punia · N Bhardwaj · P Mathur · G Gupta · M C Misra
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    ABSTRACT: Streptococcus pyogenes causes mild to acutely life-threatening diseases. Herein, we report our experience with five cases of fatal bacteraemia due to various groups of Streptococci, three of them due to Group G Streptococcus and one case each due to Group A Streptococcus and Group F Streptococcus. The peculiarity of all these cases was the rapidity of deaths occurring in these patients despite all the strains being sensitive to Penicillin. Hence, timely intervention in all suspected cases is strongly advocated. All isolates of beta-haemolytic Streptococci should be identified up till the species level and antimicrobial susceptibility be performed so that proper and early management can be done.
    No preview · Article · Jan 2015 · Indian Journal of Medical Microbiology
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    ABSTRACT: Device-associated infections constitute the majority of health care-associated infections (HAIs) in ICUs. Trauma patients are predisposed to acquire such infections due to various trauma-related factors. The prevalence of HAIs is underreported from developing nations due to a lack of systematic surveillance. This study reports the impact of an intensive surveillance on the rates and outcome of device-associated infections in trauma patients from a developing country and compares the rates with a previous pilot observation. The study was conducted at a level-1 trauma centre of India. Surveillance for ventilator-associated pneumonia (VAP), central line-associated blood stream infections (CLA-BSIs) and catheter-associated urinary tract infections (CA-UTIs) was done based on centre for disease control-National Healthcare Safety Network (CDC-NHSN) definitions. The impact of an intensive surveillance, education and awareness drive on the rates of infections over the study period, and compliance to preventive bundles and hand hygiene was assessed. A total of 15,462 ventilator days, 12,207 central line days and 17,740 urinary catheter days were recorded in the study population. The overall rates of VAP, CLA-BSI and CA-UTI were respectively 17, 7.2 and 15.5/1000 device days. There was a significant correlation between device days and the propensity to develop infections. Infections were the cause of death in 36.6% of fatal trauma cases. A significantly higher rate of VAP, CLA-BSI and CA-UTIs was noted in fatal cases. The compliance to ventilator bundle, central line bundle, bladder bundle and hand hygiene were 74.5%, 86%, 79.3% and 64.6%, respectively. A high rate of multi-drug-resistance was observed in all pathogens. A gross reduction in the rates of all infections was observed over time during the study due to implementation of a stringent surveillance system, feedbacks and education. The compliance to hand hygiene and preventive bundles also increased over time. The automated surveillance was easy and useful for data entry and analysis. Surveillance had a significant impact on reduction of HAIs and mortality in trauma patients.
    No preview · Article · Jan 2015 · Indian Journal of Medical Microbiology
  • S. Sagar · P. Mathur · A. Sharma
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    ABSTRACT: Object-oriented programming is not enough influential to handle the changing requirements. Component-based software development is a paradigm, which develops software systems that are integrated with the existing software component as plug-ins, which can be reused again and again. Hence, reusability of a component is more important than other quality factors of a software system. Selection of the most reusable software component is one of the critical activity for developing a quality system. Reusability has few types of sub-quality factors, which have considerable impact on reusability either directly or indirectly. In this paper Fuzzy-Analytic Hierarchy Process (Fuzzy-AHP) model is proposed for component selection using reusability as an important quality factor of a software component. Proposed model selects components with concurrent consideration of multiple criteria and ranks the components according to their reusability values. An empirical analysis has also been carried out on six industrial components, which are used for cleaning the system or improving system performance. A code is developed in Java for the proposed model, which successfully assigns the rank to each component based on overall performance index value. The result shows that the proposed approach is suitable for identifying the best software component in efficient and simple manner.
    No preview · Article · Jan 2015 · International journal of innovative computing, information & control: IJICIC

  • No preview · Article · Jan 2015
  • Priyam Batra · Purva Mathur · M.C. Misra

    No preview · Article · Dec 2014 · Journal of Infection
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    ABSTRACT: Background: Soft tissue and wound infections due to Enterococcus spp. are increasing worldwide with current need to understand the epidemiology of the Enterococcal infections of wounds and its prevalent antibiotic resistance pattern among hospitalized patients more so in trauma patients. Aim: Hence, we have looked into the distribution of Enterococcus spp. responsible for causing wound and soft tissue infections among trauma patients, its antibiotic resistance pattern and how it affects the length of hospital stay and mortality. Methodology: A laboratory cum clinical based study was performed over a period of 3 years at a level I trauma centre in New Delhi, India. Patients with Enterococcal wound and soft tissue infections were identified using the hospital data base, their incidence of soft tissue/ wound infections calculated, drug resistance pattern and their possible risk factors as well as outcomes analysed. Results: A total of 86 non-repetitive Enterococcus spp. was isolated of which E. faecium was maximally isolated 48 (56%). High level of resistance was seen to gentamicin HLAR in all the species of enterococcus causing infections whereas a low level resistance to vancomycin and teichoplanin was observed among the isolates. Longer hospital stay, repeated surgical procedure, prior antibiotic therapy and ICU stay were observed to associate with increased morbidity (p < 0.05) and hence, more chances of infections with VRE among the trauma patients. The overall rate of wound and soft tissue infections with Enterococcus sp. was 8.6 per 1,000 admissions during the study period. Conclusion: Enterococcal wound infection is much prevalent in trauma care facilities especially in the ICUs. Here, a microbiologist can act as a sentinel, help in empirical therapeutic decisions and also in preventing such infections.
    No preview · Article · Nov 2014 · Journal of global infectious diseases
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    ABSTRACT: Introduction: As most trauma patients require long term hospital stay and long term antibiotic therapy, the risk of fungal infections in such patients are steadily increasing. Early diagnosis and rapid treatment is life saving in such critically ill trauma patients. Aims: To see the distribution of various species of Candida among trauma patients and compare the accuracy, rapid identification and cost effectiveness between VITEK 2, CHROMagar and conventional methods Settings and design: Retrospective laboratory-based surveillance study performed over a period of 52 months (January, 2009 – April, 2013) at a level I trauma centre in New Delhi, India. Methods and material: All microbiological samples positive for Candida were processed for microbial identification using standard methods. Identification of Candida was done using chromogenic medium and by automated VITEK 2 Compact system and later confirmed using the conventional method. Time to identification in both was noted and accuracy compared with conventional method. Statistical analysis used: Performed using the SPSS software for Windows (SPSS Inc. Chicago, IL, version 15.0). P values calculated using χ2 test for categorical variables. A p < 0.05 was considered significant. Results: Out of 445 yeasts isolates, C. tropicalis (217, 49%) was the species which was maximally isolated. VITEK 2 was able to correctly identify 354 (79.5%) isolates but could not identify 48 (10.7%) isolates and wrongly identified or showed low discrimination in 43 (9.6%) isolates but CHROM agar correctly identified 381 (85.6%) isolates with 64 (14.4%) misidentification. Highest rate of misidentification was seen in C. tropicalis and C. glabrata (13, 27.1% each) by VITEK 2 and among C. albicans (9, 14%) by CHROMagar. Conclusions: Though CHROMagar gives identification at a lower cost compared to VITEK 2 Wand are more accurate, which is useful in low resource countries, its main drawback is the long duration taken for complete identification.
    No preview · Article · Oct 2014 · Indian Journal of Medical Microbiology

  • No preview · Article · Oct 2014 · Journal of Postgraduate Medicine