Publications by authors named "Purva Mathur"

Background: Central line-associated bloodstream infections (CLABSIs) are preventable health-care-associated infections (HAIs) that cause considerable morbidity and mortality. Understanding the epidemiology of CLABSIs through large, quality-assured, hospital-based datasets could help to enable development of preventive protocols suited to specific health-care systems. We aimed to describe the profile of CLABSIs in intensive care units (ICUs) at tertiary care centres in India.

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Background: Early pathogen identification in the bloodstream has long been a key focus for microbiologists and clinicians, given its crucial role in patient management. Matrix-assisted laser desorption ionization-time of flight mass spectrometry has emerged as a valuable tool for the direct and rapid identification of organisms from positive blood cultures.

Objective: This study aimed to evaluate the accuracy, productivity, and feasibility of two methods for the rapid detection of bloodstream infections.

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Background: Rising antimicrobial resistance (AMR) necessitates innovative metrics, such as days of antibiotic spectrum coverage (DASC), to optimize antibiotic stewardship. This study evaluated antibiotic use in an Indian trauma center using DASC, defined daily doses (DDD), and the World Health Organization (WHO) Access, Watch, Reserve (AWaRe) classification.

Methods: This retrospective cohort study analyzed data from 1,812 adult inpatients (mean age: 35 years; 70% male; 80% with polytrauma) admitted to a 250-bed Level-1 Trauma Center at the All India Institute of Medical Sciences (AIIMS), India, from August to October 2022.

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Introduction: Catheter-associated urinary tract infections (CAUTIs) are one of the most common device-associated infections acquired in a hospital. Trauma patients are highly susceptible to CAUTI, as catheterization is a lifesaving measure often required for their management. This study focuses on the profile of CAUTI, the organism profile with antibiotic susceptibility patterns, and the clinical outcomes in the ICUs of a trauma care center.

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Object: The dissemination of Klebsiella pneumoniae is becoming a major concern, as this organism is responsible for a significant proportion of hospital acquired infections. Due to complexity of this organism adequate knowledge on the epidemiology and infection control practices associated with the dissemination is highly required. Therefore, this study designed to include consecutive samples from environment and patients to assess the similarity pattern among isolates from different sources.

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Background: Double gloving is recommended for protecting surgical personnel from infections, but it is not a universal practice, especially in low- and middle-income countries where risk is very high. Evidence for double gloving is still only moderate, and for indicator double gloves, it is even rare. This systematic review and meta-analysis includes recent trials to analyse outcomes like glove perforations (inner/outer/matched/intraoperatively detected) and hand contamination rates for single versus double including indicator double-gloved conditions and identify factors to be considered for deciding double gloving.

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Background & objectives Surgical site infections (SSIs) are among the most prevalent healthcare-associated infections (HCAIs). They cause significant morbidity, leading to excess health expenditures and increased length of hospital stay. Despite a high population burden, data on post-discharge SSIs is lacking from low-and middle-income countries (LMICs).

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Aim This study aims to investigate the seroconversion of antibodies against SARS-CoV-2 infection in pregnant women during their first and third trimesters, specifically during the second wave of the COVID-19 pandemic. Methodology This is a longitudinal follow-up study of pregnant women during the second peak of the COVID-19 pandemic. Patients in their first trimester (six to 12 weeks) were tested for SARS-CoV-2 IgM and IgG levels, with a repeat test conducted in the third trimester (28-40 weeks) using the automated VIDAS® (bioMérieux SA, Marcy-l'Étoile, France) system.

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Background: Healthcare-associated bloodstream infections (BSI) threaten patient safety and are the third most common healthcare-associated infection (HAI) in low- and middle-income countries. An intensive-care-unit (ICU) based HAI surveillance network recording BSIs was started in India in 2017. We evaluated this surveillance network's ability to detect BSI to identify best practices, challenges, and opportunities in its implementation.

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Article Synopsis
  • This study tested two new antibiotics, cefiderocol and cefepime/zidebactam, against NDM-producing Enterobacterales in India, aiming to address challenges posed by metallo-β-lactamases.
  • Cefiderocol showed limited effectiveness, with variable susceptibility rates, while cefepime/zidebactam showed high susceptibility (≥90%) across the tested isolates.
  • The research highlights the need for new treatment options for infections caused by carbapenem-resistant bacteria, particularly with the dominance of NDM in the region.
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Objectives: In vitro activity of β-lactam enhancer/β-lactam combination zidebactam/cefepime was evaluated against carbapenem- and colistin-resistant Klebsiella pneumoniae isolates.

Methods: Non duplicate K. pneumoniae (n=185), resistant to colistin as well as non-susceptible to carbapenems were collected (2018-2019) at two large tertiary care hospitals in India.

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Background: Streptococcus dysgalactiae subsp equisimilis (SDSE) is an emerging pathogen causing pharyngitis and post-streptococcal sequelae like S. pyogenes. SDSE was initially considered a commensal microorganism inhabiting the upper respiratory tract and skin.

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Article Synopsis
  • - The study investigated the prevalence of multi-drug resistant (MDR) organisms in the gut flora of healthy individuals in a rural area of northern India, specifically in the Nuh district of Haryana.
  • - Out of 153 participants, 27.4% were found to carry MDR organisms, with E. coli being the most frequently isolated pathogen.
  • - The research showed a significant presence of extended-spectrum beta-lactamase (ESBL) genes, with 33.3% of individuals testing positive, indicating a concerning level of antibiotic resistance in this population.
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  • The study investigates the prevalence and impact of candidaemia in 67 ICUs across India, assessing how the COVID-19 pandemic influenced its rates and mortality.* -
  • Data from 401,601 patient days revealed higher candidaemia rates in COVID-19 ICUs (2.52/1000 patient days) compared to non-COVID-19 ICUs (1.05/1000 patient days), with associated mortality significantly higher in COVID-19 cases (61% vs. 41%).* -
  • Analysis identified C. tropicalis as the most common isolated species (26.7%), while C. auris, which had a high mortality rate, accounted for 17.5% of isolates
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Background: Ventilator-associated pneumonia (VAP) is a major cause of morbidity and mortality in patients receiving mechanical ventilation in India. Surveillance of VAP is essential to implement data-based preventive measures. Implementation of ventilator-associated events (VAE) criteria for surveillance has major constraints for low resource settings, which can lead to significant underreporting.

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Introduction: Kodamaea ohmeri is a rare, recognized pathogen that has previously been isolated from environmental sources. The patients commonly affected by this yeast include immunocompromised as well as immunocompetent patients having several associated risk factors.

Methodology: We report three cases in which K.

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The availability of syndrome-based panels for various ailments has widened the scope of diagnostics in many clinical settings. These panels can detect a multitude of pathogens responsible for a particular condition, which can lead to a timely diagnosis and better treatment outcomes. In contrast to traditional identification methods based on pathogen growth on culture, syndrome-based panels offer a quicker diagnosis, which can be especially beneficial in situations requiring urgent care, such as intensive care units.

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Introduction: Invasive mould infections (IMIs) are a leading cause of death in patients with compromised immune systems. Proven invasive mould infection requires detection of a fungus by histopathological analysis of a biopsied specimen, sterile culture, or fungal DNA amplification by PCR in tissue. However, the clinical performance of a PCR assay on blood samples taken from patients suspected of invasive mould disease has not been fully evaluated, particularly for the differential diagnosis of invasive aspergillosis (IA) and invasive Mucormycosis (IM).

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Background: Secondary bacterial infections during COVID-19 hospitalization have been reported in about 6-15% of patients.

Aims: To study the secondary bacterial infections that affected the COVID-19 patients during their hospitalisation and to unearth the bacteriological profile of samples obtained after their demise.

Settings And Design: This prospective study was carried out at a COVID-19 dedicated, apex tertiary care centre in North India from July 2020 to April 2021.

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Background: This study was conducted to understand the effect of the COVID-19 pandemic on urine culture and sensitivity results in an outpatient setting. There are plenty of data from inpatient and ICU settings but there is a paucity of data in outpatient or community settings. Thus, this study primarily targeted change in antibiotic resistance of urinary tract infection (UTI) agents in the pre- and post-COVID-19 period.

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Article Synopsis
  • Candida auris is a serious pathogen that forms biofilms, leading to infections, and this study focused on diagnosing its infections in a hospital over three years.
  • The diagnosis involved multiple methods, including HiCrome™ agar, Vitek 2, MALDI-TOF, and PCR to confirm the identity of the pathogen.
  • Results showed that all patients had common risk factors like central lines and broad-spectrum antibiotics, and the study confirmed effective identification techniques and assessed biofilm formation in C. auris isolates.
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 Intestinal parasitic infections continue to loom in developing countries with low sanitation and socioeconomic conditions. Pandemic times are especially important to study the prevalence of these pathogens since the focus of all healthcare services was coronavirus disease 2019 (COVID-19). This study aimed to evaluate the prevalence and time-trend of intestinal parasitic infections in the capital region of India during the pandemic times.

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Aim: The increasing burden of resistance in Gram-negative bacteria (GNB) is becoming a major issue for hospital-acquired infections. Therefore, understanding the molecular mechanisms is important.

Methodology: Resistance genes of phenotypically colistin-resistant GNB (n = 60) were determined using whole genome sequencing.

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