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Purva Mathur

Publications and source records attributed to Purva Mathur.

14 recordsLinked to original sources
PubMed2006

Visceral leishmaniasis/human immunodeficiency virus co-infection in India: the focus of two epidemics.

India contributes heavily to the global burden of visceral leishmaniasis (VL, kala-azar) and human immunodeficiency virus (HIV)/AIDS. The prevalence of HIV seropositivity in VL patients at a tertiary care centre in northern India, as observed during a prospective study over a period of 2 years, is presented. Of the 104 cases of VL/post-kala-azar dermal leishmaniasis, six (5.7 %) were found to be HIV positive, compared to 11 (5.5 %) seropositive for HIV of 198 patients with fever due to other causes. Four of the six (67 %) VL/HIV co-infected patients had a chronic/relapsing course, not responding to antileishmanial treatment. A CD4 T-cell count of < 200 mm(-3) was found in four of the five (80 %) co-infected patients in whom the test was done. Although the level of HIV/VL co-infection in the present study was lower than that of Mediterranean countries, there is a trend towards rising co-infection. The VL-endemic states of India have a huge population of migrant labourers, who work in high-HIV-prevalence states. The reported increase in the prevalence of HIV in the VL-endemic, populous states of India is a cause of grave concern, and co-infection may assume epidemic proportions in the coming decade if left unchecked.

Adolescent↗
PubMed2005

Evaluation of a rapid immunochromatographic test for diagnosis of kala-azar & post kala-azar dermal leishmaniasis at a tertiary care centre of north India.

BACKGROUND & OBJECTIVE: Definitive diagnosis of kala-azar requires demonstration of parasites by diagnostic protocols based on invasive organ aspirations. We evaluated in the present study the diagnostic utility of an immunochromatographic test (ICT) for detection of anti- rK-39 antibodies for the non-invasive diagnosis of kala-azar and post kala-azar dermal leishmaniasis (PKDL) at a tertiary care centre of north India. METHODS: The study was conducted in the Department of Microbiology, All India Institute of Medical Sciences, New Delhi, from July 2003 to October 2004. Of the 120 samples tested, 57 were found to be positive by ICT; of which, 51 were diagnosed as kala-azar and 6 as PKDL. The controls included individuals from endemic (50) and non endemic (19) areas with malignancies, haemolytic disorders, chronic liver diseases, hypersplenism, portal hypertension, metabolic disorders and sarcoidosis. In addition, 47 sera from confirmed cases of tuberculosis, malaria, typhoid, filariasis, leptospirosis, histoplasmosis, toxoplasmosis, invasive aspergillosis, amoebic liver abscess, AIDS, leprosy, cryptococcosis, strongyloidiasis, cyclosporosis, patients having collagen vascular diseases and hypergammaglobulinaemia were also tested to check the specificity of the test. RESULTS: Of the 51 cases with kala-azar 43 were males, children accounted for 25 per cent of these cases. All had fever of duration ranging from <1 month to 1.5 yr (median 4.5 months). All PKDL patients (n=6, 4 males) gave a history of having suffered from kala-azar in the past, and their slit skin test smears were microscopically positive for Leishman-Donovan (LD) bodies. The strip test was positive in all the cases of kala-azar and PKDL (estimated sensitivity 100%), all control sera were negative by the ICT (specificity 100%). INTERPRETATION & CONCLUSION: The rK-39 ICT is a highly sensitive and specific test, and may be suitable for a rapid, cost-effective and reliable field diagnosis of kala-azar and PKDL.

Adolescent↗
PubMed2004

Streptococcus pyogenes meningitis.

Group A Streptococcus (GAS) is a rare cause of meningitis. Although it has a high mortality, the condition is easily treatable if diagnosed early since the bacteria retains its sensitivity to many antimicrobials. The authors report here two cases of GAS meningitis along with a review of world literature.

Anti-Bacterial Agents↗
PubMed2004

Comparison of trypsin treatment method and standard laboratory technique for diagnosis of dermatomycosis.

Dermatomycosis is prevalent worldwide. Discrepancy between microscopic examination and culture findings can create problems in the diagnosis of this common infection. In this study, samples from 60 patients were processed after trypsin treatment and examined by neutral red staining to distinguish viable and non-viable fungal elements. The trypsin treatment method was compared with standard laboratory techniques. A higher number of direct-microscopy-positive, culture-negative samples were obtained without trypsin treatment. Trypsin treatment increased the isolation of fungi from clinical samples, and neutral red staining was able to distinguish viable fungal elements.

Candida↗
PubMed2003

Infection with an extended-spectrum beta-lactamase-producing strain of Serratia marcescens following tongue reconstruction.

We report a case of postsurgical wound infection of polymicrobial etiology caused by Serratia marcescens and Pseudomonas aeruginosa following the use of a radial forearm free flap for oncological tongue reconstruction. S. marcescens was a producer of SHV-12 extended-spectrum beta-lactamase (ESBL). This is the first report from India of this ESBL. S. marcescens and P. aeruginosa were resistant to the empirical perioperative antibiotics administered. Delay in the recognition of the type of infection and in the institution of appropriate therapy resulted in total loss of the free flap.

Adult↗
PubMed2003

Molecular epidemiology of rotaviruses in India.

Rotaviruses cause an estimated 140 million cases of gastroenteritis and 800,000 deaths in children between the ages of 6 months to 2 yr in developing countries. In India, one of every 250 children or about 100-150,000 children die of rotavirus diarrhoea each year. The prevalence of rotavirus diarrhoea in India has been found to vary from 5-71 per cent in hospitalized children <5 yr of age with acute gastroenteritis. The seasonal variation of rotavirus diarrhoea in India varies in different geographical regions with high incidence in winter months at low relative humidity in north India. The distinctive features of rotavirus infection in India include the occurrence of severe disease at an early age and common neonatal rotavirus infections which are often asymptomatic. Rotavirus shows genetic and antigenic diversity in terms of subgroup, electropherotypes and G and P serotypes/genotypes. There are a few studies in terms of prevalence of different antigenic and genetic variants from various regions of India. In most studies on subgroup distribution from India a higher prevalence of subgroup II was reported compared to subgroup I. Electropherotyping has also demonstrated that a number of multiple electropherotypes co-circulate at one time in a particular community leading to extensive genomic variation and the appearance of new strains which may become the predominant electropherotype during the peak season. The most common G types reported from India are G1 and G2 and P types are P[4] and P[8]. A significant number of children also have mixed rotavirus infections. G9 strains are also quite commonly seen in Indian children. In addition P6 strains of probable bovine origin have been reported from India. A novel neonatal strain P type 11 human rotavirus (116 E) was isolated from neonates in Delhi, the VP4 of which was closely related to the bovine serotype G10P[11] strain B223 and VP7 was closely related to the human serotype G9 strain. Another neonatal strain G10P[11] was reported from Bangalore. G10P[11] strains also have a high prevalence in calves with diarrhoea, in India. The occurrence of these unusual rotavirus strains which are natural reassortants of human and bovine rotaviruses, suggests that reassortment may be an important mechanism for generation of rotavirus strains of newborns. This is catalyzed by the age old traditions of calves and humans living in the same household and socio-economic conditions in India. The diversity of rotavirus strains and the high prevalence of mixed infections in India are unique features of rotavirus epidemiology in India and emphasizes that vaccines should be formulated against a broad range of strains. Another important aspect is that vaccines in India should also target G9 strains. Since neonates acquiring rotavirus infection are protected against severe diarrhoea, neonatal rotavirus strains can be effective potential vaccine candidates and vaccines based on these neonatal strains are being indigenously developed in India.

Child↗
PubMed2003

Spectrum of beta-haemolytic streptococcal soft tissue infections at a tertiary care hospital of north india.

BACKGROUND & OBJECTIVES: An increase in the incidence of invasive beta haemolytic streptococcal infections has been observed in many Western countries. However, the role of beta-haemolytic streptococci in soft tissue infections is not well documented in developing countries. A retrospective study was carried out to review the spectrum of soft tissue infections caused by beta-haemolytic streptococci (betaHS) in a tertiary care hospital of north India. METHODS: The laboratory records of all patients with betaHS isolated from soft tissues between January 1996 and December 2000 were reviewed. Detailed clinical, laboratory and demographic data were recorded for all patients. RESULTS: A total of 39288 samples from soft tissue infections were received in the bacteriology laboratory for bacterial culture during the study period. betaHS were recovered from 205 samples. Of these, 56 per cent isolates were obtained from patients of suspected osteomyelitis. A seasonal pattern was observed with maximum isolation occuring in the winter months. Group A was the commonest isolate (75%), followed by group B Streptococcus (11%). Group C and G betaHS together accounted for about 3 per cent of all the isolates. All the isolates were sensitive to penicillin. INTERPRETATION & CONCLUSION: Soft tissue infections due to betaHS are common in our country. Group A streptococci were encountered most frequently with these infections though other groups of betaHS also contributed substantially. Since these infections are life threatening, there is a need to develop preventive, diagnostic and therapeutic strategies against betaHS.

Adolescent↗
PubMed2003

Antimicrobial resistance in Enterococcus faecalis at a tertiary care centre of northern India.

BACKGROUND & OBJECTIVES: Multiresistant enterococci are emerging as a leading nosocomial pathogen. Knowledge of the profile of antimicrobial resistance is essential to formulate treatment guidelines for infections caused by enterococci. This study reports the antimicrobial sensitivity of enterococci isolated during a one year period from clinical samples of patients admitted to a teriary care hospital of Delhi. METHODS: A total of 444 isolates of Enterococcus faecalis were screened for antimicrobial susceptibility by the disk diffusion technique as recommended by the National Committee for Clinical Laboratory Standards (NCCLS). Screening for vancomycin resistance was done by the vancomycin screen agar method recommended by NCCLS, which was confirmed by determination of minimum inhibitory concentration (MIC) using microbroth dilution and E-test methods. Vancomycin resistance phenotypes were determined by polymerase chain reaction. RESULTS: A total of 115 (26%) isolates had high level aminoglycoside resistance, 293 (66%) were resistant to ampicillin, 391 (88%) to ciprofloxacin and 377 (85%) to erythromycin. Vancomycin resistance was found in five (1%) isolates, of which four had van A phenotype and one had van B phenotype. INTERPRETATION & CONCLUSION: Emergence of vancomycin resistant enterococci is of concern due to the limited therapeutic options. Implementation of infection control measures can contain the spread of these resistant bacteria.

Base Sequence↗
PubMed2002

Prevalence of extended spectrum beta lactamase producing gram negative bacteria in a tertiary care hospital.

BACKGROUND & OBJECTIVES: Extended spectrum beta lactamase (ESBL) producing Gram negative bacteria are increasingly being associated with hospital infections thereby rendering all beta lactams, except carbapenems ineffective in the treatment of infections related to these organisms. A knowledge about their prevalence is essential to guide the appropriate antibiotic treatment of severe infections in hospitalized patients. The present work was carried out to study the prevalence of ESBL producing Gram negative bacteria in a tertiary care hospital. METHODS: A total of 678 Gram negative bacteria were included in the study. They were isolated from various clinical samples obtained from indoor patients admitted to the All India Institute of Medical Sciences, New Delhi during March to June 2001. These isolates were screened for ESBL production by the inhibitor based test recommended by the National Committee for Clinical Laboratory Standards (NCCLS) using Klebsiella pneumoniae ATCC 700603 as positive control and Escherichia coli ATCC 25922 and Pseudomonas aeruginosa ATCC 27853 as negative controls. RESULTS: Out of the 678 strains tested, 458 (68%) were found to be ESBL producers. Among the bacterial species, ESBL production was most common in Klebsiella spp. (80%). The proportion of ESBL positive isolates was highest from intensive care units (79%), followed by Medical Oncology (75%), Medical (54%) and Surgical wards (50%). INTERPRETATION & CONCLUSION: A high prevalence of ESBL positive isolates was found in our hospital. This has important implications as carbapenems remain the only choice of treatment for infections caused by these organisms. The control measures include judicious use of antibiotics and implementation of appropriate infection control measures to control the spread of these strains in the hospital.

Cross Infection↗