Drug-resistant Diseases Research Articles

To Analysis the Necessity of Advance Sewage Treatment Plant (STP) Waste Management In Primary Health Care Centers (A Review)

The effluent from medical facilities poses a serious risk to human health because of how vulnerable people are to certain diseases. Additionally, the COVID-19 pandemic has called for a global awareness of the need to monitor infections and other resistant organisms in hospital wastewater and remove them. Apart from that, the presence of various resistant organics, pharmaceutically active compounds (PhACs), etc., creates a complicated pollution stack that affects biological systems and water resources. This survey has provided information on the occurrence, persistence, and removal of drug-resistant microbes, infectious diseases, and other micropollutants. The implementation of several pilot/full-scale measures has been evaluated with respect to the removal of pathogens, PhACs, biochemical oxygen demand (BOD), chemical oxygen demand (COD), total suspended solids (TSS), etc. Many organic forms, including constructed wetlands, actuated slime handles, and film bioreactors, were discovered to provide more than 80% evacuation of BOD, COD, TSS, etc. Nevertheless, some stubborn natural toxins are not as amenable to such treatments and necessitate the use of tertiary drugs such adsorption, UV treatment, ozone treatment, and so forth. Following the treatment of clinic wastewater, antibiotic-resistant bacteria and illnesses were discovered to be very persistent, necessitating high dosages of chlorination or UV therapy to render them inactive. This project involves the Govthospital exectting STP supplanted by modern innovation STP.

Recent Progress in Multifunctional Stimuli-Responsive Combinational Drug Delivery Systems for the Treatment of Biofilm-Forming Bacterial Infections.

Drug-resistant infectious diseases pose a substantial challenge and threat to medical regimens. While adaptive laboratory evolution provides foresight for encountering such situations, it has inherent limitations. Novel drug delivery systems (DDSs) have garnered attention for overcoming these hurdles. Multi-stimuli responsive DDSs are particularly effective due to their reduced background leakage and targeted drug delivery to specific host sites for pathogen elimination. Bacterial infections create an acidic state in the microenvironment (pH: 5.0-5.5), which differs from normal physiological conditions (pH: 7.4). Infected areas are characterized by the overexpression of hyaluronidase, gelatinase, phospholipase, and other virulence factors. Consequently, several effective stimuli-responsive DDSs have been developed to target bacterial pathogens. Additionally, biofilms, structured communities of bacteria encased in a self-produced polymeric matrix, pose a significant challenge by conferring resistance to conventional antimicrobial treatments. Recent advancements in nano-drug delivery systems (nDDSs) show promise in enhancing antimicrobial efficacy by improving drug absorption and targeting within the biofilm matrix. nDDSs can deliver antimicrobials directly to the biofilm, facilitating more effective eradication of these resilient bacterial communities. Herein, this review examines challenges in DDS development, focusing on enhancing antibacterial activity and eradicating biofilms without adverse effects. Furthermore, advances in immune system modulation and photothermal therapy are discussed as future directions for the treatment of bacterial diseases.

IQGAP1 domesticates macrophages to favor mycobacteria survival via modulating NF-κB signal and augmenting VEGF secretion

Tuberculosis, caused by Mycobacterium tuberculosis (Mtb), still ranks among the leading causes of annual human death by infectious disease. Mtb has developed several strategies to survive for years at a time within the host despite the presence of a robust immune response, including manipulating the progression of the inflammatory response and forming granulomatous lesions. Here we demonstrate that IQGAP1, a highly conserved scaffolding protein, compartmentalizes and coordinates multiple signaling pathways in macrophages infected with Mycobacterium marinum (Mm or M.marinum), the closest relative of Mtb. Upregulated IQGAP1 ultimately suppresses TNF-α production by repressing the MKK3 signal and reducing NF-κBp65 translocation, deactivating the p38MAPK pathway. Accordingly, IQGAP1 silencing and overexpression significantly alter p38MAPK activity by modulating the production of phosphorylated MKK3 during mycobacterial infection. Pharmacological inhibition of IQGAP1-associated microtubule assembly not only alleviates tissue damage caused by M.marinum infection but also significantly decreases the production of VEGF—a critical player for granuloma-associated angiogenesis during pathogenic mycobacterial infection. Similarly, IQGAP1 silencing in Mm-infected macrophages diminishes VEGF production, while IQGAP1 overexpression upregulates VEGF. Our data indicate that mycobacteria induce IQGAP1 to hijack NF-κBp65 activation, preventing the expression of proinflammatory cytokines as well as promoting VEGF production during infection and granuloma formation. Thus, therapies targeting host IQGAP1 may be a promising strategy for treating tuberculosis, particularly in drug-resistant diseases.

Advances in Antimicrobial Coatings for Preventing Infections of Head-Related Implantable Medical Devices

During surgery and after, pathogens can contaminate indwelling and implanted medical devices, resulting in serious infections. Microbial colonization, infection, and later biofilm formation are major complications associated with the use of implants and represent major risk factors in implant failure. Despite the fact that aseptic surgery and the use of antimicrobial medications can lower the risk of infection, systemic antibiotic use can result in a loss of efficacy, increased tissue toxicity, and the development of drug-resistant diseases. This work explores the advancements in antimicrobial coatings for head-related implantable medical devices, addressing the critical issue of infection prevention. It emphasizes the significance of these coatings in reducing biofilm formation and microbial colonization and highlights various techniques and materials used in creating effective antimicrobial surfaces. Moreover, this article presents a comprehensive overview of the current strategies and future directions in antimicrobial coating research, aiming to improve patient outcomes by preventing head-related implant-associated infections.

Assessment of critical impact of superbugs in human health: A known beyond

A superbug is described as a bacterium that has seen to develop resistance to traditional treatment of antibiotics. The World health organization has produced the first-ever fulfilled report on the AMR danger, which consists the information from 114 nations and ranks it amongst the one of the severe global health hazards of the 21 century. Every year, about 1 million people die due to the non-treatable drug-resistant diseases caused by these superbugs. Bacterial resistance is on the rise, putting many of our current antibacterial treatments in danger. Discovery of brand-new antibiotics has lagged behind the growth of germs resistant to them. Numerous novel approaches to target different substances in bacterial cells have been developed and are being researched. The present review emphasizes on the various types of superbugs with its possible solution. Also, it illustrates that, we should not be startled by the fast emergence of resistant pathogens dubbed "superbugs" by the media but what has been astonishing is the rapidity with which these superbugs have evolved and spread resistance, frequently at little or no cost to their health. The article provides an overview of the most prevalent forms of superbugs and potential novel medicines that might be utilized in a clinical setting shortly to fight these superbugs.

Computational Study of Antimicrobial Peptides for Promising Therapeutic Applications Against Methicillin-resistant Staphylococcus Aureus.

Methicillin-resistant Staphylococcus aureus (MRSA) is a causative agent for multiple drug-resistant diseases and is a prime health concern. Currently, antibiotics like vancomycin, daptomycin, fluoroquinolones, linezolid, fifth-generation cephalosporin and others are available in the market for the treatment of MRSA infection. With the increasing prevalence of drug-resistant cases, researchers are actively investigating alternative strategies to combat MRSA, including the exploration of peptide therapeutics. This study employed computational methods to prospect for potential Antimicrobial Peptides (AMPs). A total of One hundred and fifty antimicrobial peptides were explored based on physicochemical properties. The results showed that Clavanin B was the most appropriate candidate. Molecular Docking and Molecular Dynamics Simulation results showed the protein-peptide interaction of the MRSA target proteins, Penicillin Binding Protein 2a and Panton-Valentine Leukocidin Toxin, with the Antimicrobial Peptide Clavanin B. Currently, the antimicrobial peptide database highlights Clavanin B's role as an anti-HIV peptide. Moreover, this investigation proposes Clavanin B as a viable repurposed drug for treating MRSA, underscoring its potential deployment in the management of MRSA infections.

Antisense Therapy for Infectious Diseases.

Infectious diseases, particularly Tuberculosis (TB) caused by Mycobacterium tuberculosis, pose a significant global health challenge, with 1.6 million reported deaths in 2021, making it the most fatal disease caused by a single infectious agent. The rise of drug-resistant infectious diseases adds to the urgency of finding effective and safe intervention therapies. Antisense therapy uses antisense oligonucleotides (ASOs) that are short, chemically modified, single-stranded deoxyribonucleotide molecules complementary to their mRNA target. Due to their designed target specificity and inhibition of a disease-causing gene at the mRNA level, antisense therapy has gained interest as a potential therapeutic approach. This type of therapy is currently utilized in numerous diseases, such as cancer and genetic disorders. Currently, there are limited but steadily increasing studies available that report on the use of ASOs as treatment for infectious diseases. This review explores the sustainability of FDA-approved and preclinically tested ASOs as a treatment for infectious diseases and the adaptability of ASOs for chemical modifications resulting in reduced side effects with improved drug delivery; thus, highlighting the potential therapeutic uses of ASOs for treating infectious diseases.

New Imidazolium Alkaloids with Broad Spectrum of Action from the Marine Bacterium Shewanella aquimarina.

The continuous outbreak of drug-resistant bacterial and viral infections imposes the need to search for new drug candidates. Natural products from marine bacteria still inspire the design of pharmaceuticals. Indeed, marine bacteria have unique metabolic flexibility to inhabit each ecological niche, thus expanding their biosynthetic ability to assemble unprecedented molecules. The One-Strain-Many-Compounds approach and tandem mass spectrometry allowed the discovery of a Shewanella aquimarina strain as a source of novel imidazolium alkaloids via molecular networking. The alkaloid mixture was shown to exert bioactivities such as: (a) antibacterial activity against antibiotic-resistant Staphylococcus aureus clinical isolates at 100 µg/mL, (b) synergistic effects with tigecycline and linezolid, (c) restoration of MRSA sensitivity to fosfomycin, and (d) interference with the biofilm formation of S. aureus 6538 and MRSA. Moreover, the mixture showed antiviral activity against viruses with and without envelopes. Indeed, it inhibited the entry of coronavirus HcoV-229E and herpes simplex viruses into human cells and inactivated poliovirus PV-1 in post-infection assay at 200 µg/mL. Finally, at the same concentration, the fraction showed anthelminthic activity against Caenorhabditis elegans, causing 99% mortality after 48 h. The broad-spectrum activities of these compounds are partially due to their biosurfactant behavior and make them promising candidates for breaking down drug-resistant infectious diseases.

An Overview of Stimuli-Responsive Intelligent Antibacterial Nanomaterials.

Drug-resistant bacteria and infectious diseases associated with biofilms pose a significant global health threat. The integration and advancement of nanotechnology in antibacterial research offer a promising avenue to combat bacterial resistance. Nanomaterials possess numerous advantages, such as customizable designs, adjustable shapes and sizes, and the ability to synergistically utilize multiple active components, allowing for precise targeting based on specific microenvironmental variations. They serve as a promising alternative to antibiotics with diverse medical applications. Here, we discuss the formation of bacterial resistance and antibacterial strategies, and focuses on utilizing the distinctive physicochemical properties of nanomaterials to achieve inherent antibacterial effects by investigating the mechanisms of bacterial resistance. Additionally, we discuss the advancements in developing intelligent nanoscale antibacterial agents that exhibit responsiveness to both endogenous and exogenous responsive stimuli. These nanomaterials hold potential for enhanced antibacterial efficacy by utilizing stimuli such as pH, temperature, light, or ultrasound. Finally, we provide a comprehensive outlook on the existing challenges and future clinical prospects, offering valuable insights for the development of safer and more effective antibacterial nanomaterials.

Strategic Approaches to Improvise Peptide Drugs as Next Generation Therapeutics.

In recent years, the occurrence of a wide variety of drug-resistant diseases has led to an increase in interest in alternate therapies. Peptide-based drugs as an alternate therapy hold researchers’ attention in various therapeutic fields such as neurology, dermatology, oncology, metabolic diseases, etc. Previously, they had been overlooked by pharmaceutical companies due to certain limitations such as proteolytic degradation, poor membrane permeability, low oral bioavailability, shorter half-life, and poor target specificity. Over the last two decades, these limitations have been countered by introducing various modification strategies such as backbone and side-chain modifications, amino acid substitution, etc. which improve their functionality. This has led to a substantial interest of researchers and pharmaceutical companies, moving the next generation of these therapeutics from fundamental research to the market. Various chemical and computational approaches are aiding the production of more stable and long-lasting peptides guiding the formulation of novel and advanced therapeutic agents. However, there is not a single article that talks about various peptide design approaches i.e., in-silico and in-vitro along with their applications and strategies to improve their efficacy. In this review, we try to bring different aspects of peptide-based therapeutics under one article with a clear focus to cover the missing links in the literature. This review draws emphasis on various in-silico approaches and modification-based peptide design strategies. It also highlights the recent progress made in peptide delivery methods important for their enhanced clinical efficacy. The article would provide a bird’s-eye view to researchers aiming to develop peptides with therapeutic applications.

The Hidden Cost of COVID-19: Focus on Antimicrobial Resistance in Bloodstream Infections.

Antibiotic resistance is one of the greatest growing public health threats and a worldwide priority. According to the WHO, drug-resistant diseases may cause 10 million deaths a year by 2050 and have a substantial impact on the global economy, driving up to 24 million people into poverty. The ongoing COVID-19 pandemic has exposed the fallacies and vulnerability of healthcare systems worldwide, displacing resources from existing programs and reducing funding for antimicrobial resistance (AMR) fighting efforts. Moreover, as already seen for other respiratory viruses, such as flu, COVID-19 is often associated with superinfections, prolonged hospital stays, and increased ICU admissions, further aggravating healthcare disruption. These events are accompanied by widespread antibiotic use, misuse, and inappropriate compliance with standard procedures with a potential long-term impact on AMR. Still, COVID-19-related measures such as increasing personal and environmental hygiene, social distancing, and decreasing hospital admissions could theoretically help the AMR cause. However, several reports have shown increased antimicrobial resistance during the COVID-19 pandemic. This narrative review focuses on this "twindemic", assessing the current knowledge of antimicrobial resistance in the COVID-19 era with a focus on bloodstream infections and provides insights into the lessons learned in the COVID-19 field that could be applied to antimicrobial stewardship initiatives.

Nano-Antibacterial Materials as an Alternative Antimicrobial Strategy

Bacterial infections continue to be a leading cause of death and disability worldwide. Considering the increment in bacteria resistant to antibiotic and the prevalence of illnesses linked to biofilms, it is imperative that new strategies of killing bacteria be developed. As a result, recent years have seen a surge in interest in nanoparticle-based materials for use in antimicrobial chemotherapy. Bacterial infections have remained a significant source of death and morbidity, despite the availability of many powerful antibiotics and other antimicrobial measures. Because of rising worries about drug-resistant bacteria and diseases linked to biofilms, there is an urgent need to create new bactericidal techniques. As a result, the science of antimicrobial chemotherapeutic has focused heavily on recently developed nanoparticle-based materials. Nanoparticles are discussed in this article in terms of their antimicrobial properties, their method of action, their influence on drug-resistant microorganisms, and the hazards associated with their usage. Nanoparticles' special characteristics and their mode of action as antimicrobial properties are examined in depth, as are the factors that contribute to their performance in a clinical environment.

Biosynthesis of silver nanoparticles (Ag-NPs) using Senna alexandrina grown in Saudi Arabia and their bioactivity against multidrug-resistant pathogens and cancer cells

There is no doubt that the risk of drug-resistant pathogens and cancer diseases is on the rise. So, the goal of this study was to find out how effective silver nanoparticles (Ag-NPs) made by Senna alexandrina are at fighting these threats.In this work, S. alexandrina collected from Medina, Saudi Arabia was used and the biosynthesis method was applied to produce the Ag-NPs. The characterization of Ag-NPs was done using different analytical techniques, including UV spectroscopy, FT-IR, TEM, and XRD analysis. The MIC, MBC, and MTT protocols were applied to confirm the bioactivity of the Ag-NPs as antibacterial and anticancer bioagents. The findings reported indicating that the aqueous extract of S. alexandrina leaves, grown naturally in Saudi Arabia, is ideal for the production of bioactive Ag-NPs. The hydroxyl, aliphatic, alkene, N–H bend of primary amines, C–H bonds, and C-O bonds of alcohol were detected in this product. The small, sphere-shaped particles (4–7 nm) were the most prevalent among the bioactive Ag-NPs produced in this work. These nanoparticles inhibited some important multidrug-resistant pathogens (MDRPs) (Escherichia coli, Acinetobacter baumanii/haemolyticus, Staphylococcus epidermidis, and Methicillin-resistant Staphylococcus aureus (MRSA)), as well as their ability to inhibit breast cancer cells (MCF-7 cells). The MIC of Ag-NPs ranged from 0.03 to 0.6 mg/mL, while their MBC ranged from 0.06 to 2.5 mg/mL.Anticancer activity test showed that IC50 of the Ag-NPs against tested breast cancer cells was 61.9 ± 3.8 µg/mL. According to the current results, biosynthesis using S. alexandrina leaves grown naturally in Saudi Arabia was an ideal technique for producing bioactive Ag-NPs that could be used to combat a variety of MDRPs and cancer diseases.

Genetic analysis of Vibrio alginolyticus challenged by Fructus schisandrae reveals the mechanism of virulence genes

Due to the abusive use of antibiotics, bacterial resistance has become a global problem and poses severe threats to aquaculture. The drug-resistant diseases caused by Vibrio alginolyticus have caused significant economic losses to cultured marine fish. Fructus schisandrae is used to treat inflammatory diseases in China and Japan. There have been no reports of bacterial molecular mechanisms associated with F. schisandrae stress. In this study, the inhibiting effect of F. schisandrae on the growth of V. alginolyticus was detected to understand response mechanisms at the molecular level. The antibacterial tests were analyzed via next-generation deep sequencing technology (RNA sequencing, RNA-seq). Wild V. alginolyticus (CK) was compared with V. alginolyticus, F. schisandrae incubated for 2 h, and V. alginolyticus, F. schisandrae incubated for 4 h. Our results revealed that there were 582 genes (236 upregulated and 346 downregulated) and 1068 genes (376 upregulated and 692 downregulated), respectively. Differentially expressed genes (DEGs) were involved in the following functional categories: metabolic process, single-organism process, catalytic activity, cellular process, binding, membrane, cell part, cell, and localization. FS_2 h was compared with FS_4 h, and 21 genes (14 upregulated and 7 downregulated) were obtained. The RNA-seq results were validated by detecting the expression levels of 13 genes using quantitative real-time polymerase chain reaction (qRT-PCR). The qRT-PCR results matched those of the sequencing, which reinforced the reliability of the RNA-seq. The results revealed the transcriptional response of V. alginolyticus to F. schisandrae, which will provide new ideas for studying V. alginolyticus' complex virulence molecular mechanism and the possibility of developing Schisandra to prevent and treat drug-resistant diseases.

Study of hematoporphyrin monomethyl ether-mediated blue-light photodynamic therapy in the treatment of oral ulcers infected with Staphylococcus aureus: In vivo evaluation.

Clinical suppurative infection is mainly caused by Staphylococcus aureus. Although many antibiotics can be used to kill S. aureus, the resulting resistance problem is difficult to solve. Therefore, it is necessary to seek a new sterilizing method to solve the problem of drug resistance of S. aureus and improve the therapeutic effect of infectious diseases. Photodynamic therapy (PDT) has become an alternative for the treatment of a variety of drug-resistant infectious diseases due to its advantages of non-invasive, specific targeting, and no drug resistance. We have confirmed the advantages and experimental parameters of blue-light PDT sterilization in vitro experiments. This study aimed to treat buccal mucosa ulcer of hamster infected with S. aureus according to the parameters obtained in vitro experiment, and observe the bactericidal effect of hematoporphyrin monomethyl ether (HMME) mediated blue-light PDT in vivo and its therapeutic effect on tissue infection. The results indicated that HMME mediated blue-light PDT can effectively kill S. aureus in vivo and promote the healing of the oral infectious wound.The study findings lay a foundation for carrying out more HMME mediated blue-light PDT sterilizing therapy.

The Role of Brain-Derived Neurotrophic Factor (BDNF) in Diagnosis and Treatment of Epilepsy, Depression, Schizophrenia, Anorexia Nervosa and Alzheimer's Disease as Highly Drug-Resistant Diseases: A Narrative Review.

Brain-derived neurotrophic factor (BDNF) belongs to the family of neurotrophins, which are growth factors with trophic effects on neurons. BDNF is the most widely distributed neurotrophin in the central nervous system (CNS) and is highly expressed in the prefrontal cortex (PFC) and hippocampus. Its distribution outside the CNS has also been demonstrated, but most studies have focused on its effects in neuropsychiatric disorders. Despite the advances in medicine in recent decades, neurological and psychiatric diseases are still characterized by high drug resistance. This review focuses on the use of BDNF in the developmental assessment, treatment monitoring, and pharmacotherapy of selected diseases, with a particular emphasis on epilepsy, depression, anorexia, obesity, schizophrenia, and Alzheimer's disease. The limitations of using a molecule with such a wide distribution range and inconsistent method of determination are also highlighted.

The Role of Biosynthesized Metallic and Metal Oxide Nanoparticles in Combating Anti-Microbial Drug Resilient Pathogens

Because of their high efficiency, antibiotics have long been the primary treatment for infections, but the rise of drug-resistant pathogens has become a therapeutic concern. Nanoparticles, as novel biomaterials, are currently gaining global attention to combat them. Drug-resistant diseases may need the use of nanoparticles as a viable therapeutic option. By altering target locations and enzymes, decreasing cell permeability, inactivating enzymes, and increasing efflux by overexpressing efflux pumps, they can bypass conventional resistance mechanisms. Therefore, understanding how metal and metal oxide nanoparticles affect microorganisms that are resistant to antimicrobial drugs is the main objective of this review. Accordingly, the uses of metal and metal oxide nanoparticles in the fight against drug-resistant diseases appear promising. However, their mechanism of action, dose, and possible long-term effects require special attention and future research. Furthermore, repeated use of silver nanoparticles may cause gram-negative microorganisms to acquire resistance, necessitating additional study.

Inhibitory Activity of Chitin, (2-Acetamido-2-Deoxy-Hexopyranose) against Penicillin-Binding Proteins of Staphylococcus aureus

Antibacterial compounds from aquatic sources have the potential to contribute significantly to the treatment of the ever-increasing drug-resistant infectious diseases. The chitin 2-acetamido-2-deoxy-hexopyranose from the freshwater prawn Caridina gracilirostris showed antibacterial activity against Staphylococcus aureus. Two different types of chitin films, (1) chitin and starch, and (2) chitin, starch, and ascorbic acid were tested against S. aureus using in silico molecular docking. The inhibitory action of 2-acetamido-2-deoxy-hexopyranose was recorded against the penicillin-binding protein (PBP2a) of S. aureus. The chitin films exhibited their potential as an effective antibacterial agent through binding energy and ligand efficiency. Further, the inhibitory constant also indicated the potent antibacterial nature of the chitin films. The hydrogen bond interaction of chitin with PBP2a was with serine 49 and threonine 413, at 2.2 Å and 3.4 Å, respectively. The druggability of 2-acetamido-2-deoxy-hexopyranose showed good oral bioavailability, and pharmacokinetics properties were within a normal range. The chitin did not undergo any metabolism and appeared to be of a nontoxic nature. The 2-acetamido-2-deoxy-hexopyranose could be suggested as a novel drug against S. aureus.

How MALDI-TOF Mass Spectrometry Technology Contributes to Microbial Infection Control in Healthcare Settings.

Healthcare settings have been utilizing matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) since 2010. MALDI-TOF MS has various benefits over the conventional method of biochemical identification, including ease of use, speed, accuracy, and low cost. This approach can solve many of the obstacles to identifying bacteria, fungi and viruses. As technology advanced, more and more databases kept track of spectra, allowing species with similar morphological, genotypic, and biochemical traits to be identified. Using MALDI-TOF MS for identification has become more accurate and quicker due to advances in sample preparation and database enrichment. Rapid sample detection and colony identification using MALDI-TOF MS have produced promising results. A key application of MALDI-TOF MS is quickly identifying highly virulent and drug-resistant diseases. Here, we present a review of the scientific literature assessing the effectiveness of MALDI-TOF MS for locating clinically relevant pathogenic bacteria, fungi, and viruses. MALDI-TOF MS is a useful strategy for locating clinical pathogens, however, it also has some drawbacks. A small number of spectra in the database and inherent similarities among organisms can make it difficult to distinguish between different species, which can result in misidentifications. The majority of the time additional testing may correct these problems, which happen very seldom. In conclusion, infectious illness diagnosis and clinical care are being revolutionized by the use of MALDI-TOF MS in the clinical microbiology laboratory.

Rationale and guidance for strengthening infection prevention and control measures and antimicrobial stewardship programs in Bangladesh: a study protocol

BackgroundHospital-acquired infections (HAIs) and antimicrobial resistance (AMR) are major global health challenges. Drug-resistant infectious diseases continue to rise in developing countries, driven by shortfalls in infection control measures, antibiotic misuse, and scarcity of reliable diagnostics. These escalating global challenges have highlighted the importance of strengthening fundamental infection prevention and control (IPC) measures and implementing effective antimicrobial stewardship programs (ASP). This study aims to present a framework for enhancing IPC measures and ASP efforts to reduce the HAI and AMR burden in Bangladesh.MethodsThis implementation approach will employ a mixed-methods strategy, combining both quantitative and qualitative data from 12 tertiary hospitals in Bangladesh. A baseline assessment will be conducted using the Infection Prevention and Control Assessment Framework (IPCAF) developed by the WHO. We will record IPC practices through direct observations of hand hygiene, personal protective equipment (PPE) utilization, and hospital ward IPC infrastructure. Additionally, data on healthcare providers’ knowledge, attitudes, and practices regarding IPC and antibiotic prescribing will be collected using both structured questionnaires and qualitative interviews. We will also assist the hospital leadership with establishing and/or strengthening IPC and ASP committees. Based on baseline assessments of each healthcare facility, tailored interventions and quality improvement projects will be designed and implemented. An end-line assessment will also be conducted after 12 months of intervention using the same assessment tools. The findings will be compared with the baseline to determine changes in IPC and antibiotic stewardship practices.DiscussionComprehensive assessments of healthcare facilities in low-resource settings are crucial for strengthening IPC measures and ASP activities,. This approach to assessing existing IPC and ASP activities will provide policy-relevant data for addressing current shortfalls. Moreover, this framework proposes identifying institutionally-tailored solutions, which will ensure that response activities are appropriately contextualized, aligned with stakeholder priorities, and offer sustainable solutions.ConclusionFindings from this study can guide the design and implementation of feasible and sustainable interventions in resource-constrained healthcare settings to address gaps in existing IPC and ASP activities. Therefore, this protocol will be applicable across a broad range of settings to improve IPC and ASP and reduce the burden of hospital-acquired infections and AMR.