Measuring the effectiveness of an integrated intervention package to improve the level of infection prevention and control: a multi-centre study in Bangladesh.

BACKGROUND: Infection prevention and control (IPC) is a critical component of delivering safe, effective and high-quality healthcare services, and eliminating avoidable healthcare-associated infections (HAIs) in health facilities, predominantly in population-dense settings such as Bangladesh. AIM: Our study aimed to assess the effect of an integrated intervention package in improving the IPC level of the health facilities in Bangladesh. METHODS: We conducted a pre-post intervention study in six district hospitals (DHs) and 13 Upazila Health Complexes (UHCs) in the six districts of Bangladesh. Baseline and endline assessments were conducted between March and December 2021 using the adapted World Health Organization Infection Prevention and Control Assessment Framework (WHO-IPCAF) tool. The IPCAF score, ranging from 0-800, was calculated by adding the scores of eight components, and the IPC promotion and practice level was categorized as Inadequate (0-200), Basic (201-400), Intermediate (401-600) and Advanced (601-800). The integrated intervention package including IPC committee formation, healthcare provider training, logistics provision, necessary guidelines distribution, triage/flu corners establishment, and infrastructure development was implemented in all facilities. RESULTS: The average IPCAF score across all the facilities showed a significant increase from 16% (95% CI: 11.5-20.65%) to 54% (95% CI: 51.4-57.1%). Overall, the IPCAF score increased by 34 percentage points (P<0.001) in DHs and 40 percentage points (P<0.001) in UHCs. Following the intervention, 12 (three DHs, nine UHCs) of 19 facilities progressed from inadequate to intermediate, and another three DHs upgraded from basic to intermediate in terms of IPC level. CONCLUSION: The integrated intervention package improved IPCAF score in all facilities.

Synthesis and antimicrobial testing of some new S-substituted-thiopyridines, thienopyridines, pyridothienopyrimidines and pyridothienotriazines.

The reaction of 5-acetyl-4-aryl-3-cyano-6-methylpyridine-2(1H)-thiones (1a, b) with 4-methylphenacyl bromide, chloro-N-arylacetamides or chloroacetonitrile gave the corresponding S-substituted thiopyridines 2a-c, 4a-f and 6a-c, respectively. The latter compounds underwent intramolecular Thorpe-Ziegler cyclization to give 2-substituted 5-acetyl-3-amino-4-aryl-6-methylthieno[2,3-b]pyridines 3a-c, 5a-f and 7a-c. Compounds 5a-f and 7b, c are key intermediates in the synthesis of the target compounds. Some compounds showed remarkable antimicrobial activity.

Synthesis, reactions and antimicrobial activity of new cyclopenta[e]thieno[2,3-b]pyridines and related heterocyclic systems.

Reaction of the arylidene cyanothioacetamides 1a, b with cyclopentanone was proved to give a mixture of 4-aryl-3-cyanocyclopenta[b]pyridine-2(1H)-thiones 2a, b and the corresponding 7-arylidene derivatives 3a, b. Compounds 2a, b were reacted with ethyl chloroacetate or chloroacetamide to give the promising S-substituted thiopyridines 6a-d. On treatment of the latter compounds with sodium ethoxide in boiling ethanol, they underwent intramolecular Thorpe-Ziegler cyclization to yield the corresponding 3-amino-4-aryl-2-functionalized-cyclopenta[e]thieno[2,3-b]pyridines (7a-d). Most of these thienopyridines were reacted with a variety of reagents to produce other new cyclopentathienopyridines as well as numerous of their condensed heterocyclic derivatives. Some of the compounds synthesized were tested in vitro for their antibacterial and antifungal activity.

s-triazole systems. Part IV: Novel substituted thio-s-triazole derivatives.

Interaction of (3-aryloxymethyl-4-phenyl-s-triazol-5-yl)thioacethydrazid e (1a-c) with phenyl isocyanate and/or with methyl/phenyl isothiocyanate gave semicarbazides (2a-c) and thiosemicarbazides (3a-f) respectively. Cyclization of (3a-f) yielded s-triazoles (4a-f). Compounds 4b,d,f were easily alkylated giving S-substituted thio-s-triazoles (5a-e). Furthermore, compounds 4b,d,f underwent a Mannich reaction to give the expected Mannich bases (6a-f). All compounds were fully confirmed by elemental and spectral analyses and have been screened in vitro for antimicrobial activity.

Synthesis and biological activity of some new benzimidazolyl-azetidin-2-ones and -thiazolidin-4-ones.

Arylidene-2-aminobenzimidazoles (1) were prepared by condensation of 2-aminobenzimidazole with aromatic aldehydes. Cyclocondensation of mercaptoacetic acid, chloracetylchloride and phthaloyl glycyl chloride on 1 giving the corresponding 4-thiazolidinones (2) and azetidinones (3 and 4) respectively, in good yields. The biological activities of the prepared compounds were screened against several strains of bacteria.

Synthesis of some new heterocyclic 1,3,4-oxadiazoles with antibacterial activity.

2-N-Aryl/heterocyclic carboxamidomethylthio-5-p-chlorophenyl-1,3,4-oxadiazoles have been synthesized by the reaction of 1 and N-aryl/heterocyclic-2-chloracetamides in presence of basic medium. 2 and 3 react with heterocyclic thiols in ethanolic potassium hydroxide to give 3-S-substituted-mercaptomethyl-5-substituted-phenyl-1,3,4-oxadiazol-2-thione 5 and 6 respectively. Tert. amines react with 2 to yield the corresponding amino chlorides in good yield. Some of the prepared compounds were tested as antibacterials against Gram-positive and Gram-negative organism.