Dual-function antibacterial surfaces for biomedical applications

Maximizing membrane antifouling potential: The impact of fluoride positioning in multifunctional designs

Fluoropolymers with low surface energy demonstrate outstanding potential for fouling release. However, their limited effectiveness in practical antifouling applications requires integration with other strategies. This study explored the significant impact of fluoropolymers in a multifunctional approach that combines antiadhesion (S), antibacterial (M), and fouling release (H) properties to enhance the performance of thin-film-composite (TFC) membranes for controlling biofouling (The letters S, M and H originate from the initial letters of the corresponding functional monomers). We constructed membrane surface functionalities with fluoropolymers placed in different layers: p(H-M-S), which incorporates fluoropolymers in the innermost layer as a release-antibacterial-antiadhesion membrane; p(M-H-S), where fluoropolymers are in the middle layer as an antibacterial-release-antiadhesion membrane; and p(M-S-H), with fluoropolymers in the outermost layer as an antibacterial-antiadhesion-release membrane. This multifunctional approach resulted in superior membrane transport properties and varying resistance to biofouling. During repeated filtration cycles, the p(H-M-S) membrane showed the most effective biofouling mitigation and long-term durability, achieving an 82 % flux recovery in the third cycle due to the synergistic effects of its three combined functions. The p(M-H-S) membrane displayed strong antiadhesion performance in the early stages but had limited durability over time. In contrast, the p(M-S-H) membrane revealed the weakest fouling resistance, likely because of the hydrophobic nature of the fluorinated components in the outermost layer. Bacterial adhesion assay and protein release tests further demonstrated that the p(M-H-S) membrane reduced bacterial adhesion by 66 % and released 23 % of the protein foulants. This effectiveness is attributed to the antifouling activity provided by the hydrophilic zwitterions and bactericidal quaternary ammonium compounds, as well as the fouling-release capability of fluoropolymers, which facilitates the detachment of foulants under hydraulic forces. Microscopic analysis, coupled with interfacial energy evaluations, confirmed the presence of various multi-defense mechanisms based on the different functional architectures of the membranes. These findings offer valuable insights for designing optimized multifunctional antifouling membranes with improved performance and stability.

Antifouling Polymer Coatings for Bioactive Surfaces

Bioactive surfaces play a pivotal role in biomedical applications by enabling precise biological interactions through immobilized functional molecules. However, their performance is often hindered by nonspecific protein adsorption and cell adhesion. Antifouling polymer coatings have emerged as an effective solution, creating hydration barriers to preserve functionality and reduce biofouling. This review provides an overview of the recent advances in the development of antifouling polymer coatings for bioactive surfaces, with particular focus on nonionic polymers, such as polyethylene glycol (PEG), and zwitterionic polymers like poly(2-methacryloyloxyethyl phosphorylcholine) (PMPC). Among them, zwitterionic polymers, with their unique charge-balanced structures, exhibit exceptional hydration, protein resistance, and stability, making them particularly promising for biomedical applications. In addition, key applications of these bioactive surfaces, including their use in anticoagulant materials, antibacterial coatings, and biosensor interfaces, are also discussed. The discussion concludes with an address of the field's challenges and future directions, highlighting the need for innovative materials that balance antifouling properties, biocompatibility, and long-term stability for both clinical and industrial use. This review aims to review the latest advancements in antifouling polymer coatings for bioactive surfaces and provide insights into optimizing multifunctional bioactive surfaces to meet the evolving and dynamic demands of the biomedical field.

Antifouling and Bactericidal Zwitterionic Polymer Coatings with Synergistic Inhibitory and Killing Properties

Polymeric coatings that combine resistance to adhesion ("defending") and killing ("attacking") of biocontaminants were proposed to endow the surface with nonadhesive and bactericidal capabilities. In contrast, a zwitterionic copolymer P(GMA-co-DMAPS) with antifouling groups ([2-(methacryloyloxy)ethyl]dimethyl-(3-sulfopropyl)ammonium hydroxide, DMAPS) and a zwitterionic/cationic copolymer P(GMA-co-DMAPS-co-DMC) with bactericidal groups ([2-(methacryloyloxy)ethyl]trimethylammonium chloride, DMC) were synthesized, of which the latter exhibited synergistic inhibitory and killing properties. The distinct feed ratios of monomers were conducted, and the optimal molar ratio was obtained. The polymer coating was chemically bonded to the surface of substrates such as stainless steel via the addition-elimination reaction of epoxy groups and hydroxyl groups. Stainless steel surfaces grafted with G20D80-5DMC exhibited fine antifouling and bactericidal properties. The results showed that a highly efficient defending-attacking synergistic effect was achieved with antiprotein adsorption of more than 90% and bactericidal rates against Staphylococcus aureus and Escherichia coli of 98.6% and 96.6%, respectively. The polymers proposed in this study can effectively play an antifouling and antibacterial synergistic role and can be grafted onto substrates through a simple and effective method, showing attractive potential in marine, biomedical, and industrial applications.

Graveyard effects of antimicrobial nanostructured titanium over prolonged exposure to drug resistant bacteria and fungi

Innovations in nanostructured surfaces have found a practical place in the medical area with use in implant materials for post-operative infection prevention. These textured surfaces should be dual purpose: (1) bactericidal on contact and (2) resistant to biofilm formation over prolonged periods. Here, hydrothermally etched titanium surfaces were tested against two highly antimicrobial resistant microbial species, methicillin-resistant Staphylococcus aureus and Candida albicans. Two surface types - unmodified titanium and nanostructured titanium - were incubated in a suspension of each microbial strain for 1 day and 7 days. Surface topography and cross-sectional information of the microbial cells adhered to the surfaces, along with biomass volume and live/dead rate, showed that while nanostructured titanium was able to kill microbes after 1 day of exposure, after 7 days, the rate of death becomes negligible when compared to the unmodified titanium. This suggests that as biofilms mature on a nanostructured surface, the cells that have lysed conceal the nanostructures and prime the surface for planktonic cells to adhere, decreasing the possibility of structure-induced lysis. Synchrotron macro-attenuated total reflection Fourier transform infrared (macro ATR-FTIR) micro-spectroscopy was used to elucidate the biochemical changes occurring following exposure to differing surface texture and incubation duration, providing further understanding into the effects of surface morphology on the biochemical molecules (lipids, proteins and polysaccharides) in an evolving and growing microbial colony.

Evaluation of bacterial anti-adhesion and sustained antimicrobial abilities of chlorhexidine gluconate-loaded phase-transited lysozyme nanoparticle suspension on dentine: An ex vivo study

AIM

To evaluate the effect of chlorhexidine gluconate-loaded phase-transited lysozyme (CHG@PTL) coating on inhibiting bacterial adhesion and biofilm formation in an ex vivo root canal dentine model.

METHODOLOGY

The physicochemical and structural characteristics of CHG@PTL nanoparticle suspension and its coating formed on the dentine surface were analysed by thioflavin T fluorescence assay, transmission electron microscopy and confocal laser scanning microscopy (CLSM). The sustained chlorhexidine release profile of the CHG@PTL coating on the dentine surface was compared with that of the 2% CHG solution. By comparing with phosphate-buffered saline, 1% sodium hypochlorite and 2% CHG solutions, the sustained antibacterial ability of the CHG@PTL coating and its effects on adhesion and biofilm formation of three types of bacteria (E. faecalis, S. mutans, and A. viscous) were analysed in ex vivo root canal dentine models using the serial plate transfer test (SPTT) and CLSM with live/dead bacterial staining, respectively.

RESULTS

CHG promoted the lysozyme protein to form a higher proportion of β-sheet structure during phase transition. In the CHG@PTL nanoparticle suspension, characteristic drug-loaded nanospheres with a high concentration of CHG molecules inside and an outer PTL nanofilm were observed, and they formed a thinner and tighter coating on the dentine surface. The CHG@PTL coating on the dentine surface showed a significantly higher cumulative release amount of chlorhexidine than that of 2% CHG (p < .05). The results of SPTT showed that the CHG@PTL coating had a longer antibacterial duration than the control groups. After 12 h of incubation, a higher number of bacteria were agglutinated on the CHG@PTL coating surface compared to the control groups (p < .05). After 7 days of incubation, the number of agglutinated bacteria significantly decreased. At two time points, the percentage of dead bacteria on the CHG@PTL coating surface was the highest among all experimental groups based on CLSM observation (over 99.9% for all three bacteria, p < .001).

CONCLUSIONS

CHG@PTL nanoparticle suspension could form an antimicrobial coating on the surface of dentine with a novel 'agglutinating bacteria and sterilizing' mode.

Dual-action defense: A photothermal and controlled nitric oxide-releasing coating for preventing biofilm formation

Biofilms formed by pathogenic bacteria on biomedical devices and implants pose a considerable challenge due to their resistance to conventional treatments and their role in severe infections. Preventing biofilm formation is strategically more advantageous than attempting to eliminate the mature biofilms, particularly in addressing the persistence of such formations. In this context, a dual-action antibiofilm coating is developed, utilizing S-nitrosothiols functionalized candle soot (CS), which capitalizes on CS's strong light absorption for photothermal therapy and the controlled release of nitric oxide (NO) from S-nitrosothiols to inhibit biofilm formation. This coating exhibits stable and efficient light-to-heat conversion, along with the ability to release NO gradually at physiological temperatures and to rapidly release NO on demand when triggered by a near-infrared (NIR) laser. Under NIR irradition, the coating generates heat swiftly and releases substantial amounts of NO, which synergistically disrupts bacterial membranes, leading to the leakage of intracellular components and the effective eradication of surface-adhered bacteria. In the absence of NIR irradiation, the coating continuously releases low concentrations of NO, which depletes exopolysaccharides and impedes biofilm formation. The antibiofilm efficacy of this coating is assessed against Staphylococcus aureus and Pseudomonas aeruginosa, demonstrating marked reductions in bacterial viability and biofilm formation in vitro. Additionally, the coating exhibits minimal cytotoxicity and can be easily applied to diverse substrates. This study underscores the potential of this coating as a broad-spectrum, non-toxic approach for preventing biofilm-related complications in biomedical applications.

A cross-linked coating loaded with antimicrobial peptides for corrosion control, early antibacterial, and sequential osteogenic promotion on a magnesium alloy as orthopedic implants

Magnesium (Mg)-based alloys have been recognized as desirable biodegradable materials for orthopedic implants. However, their clinical application has been limited by rapid degradation rates, insufficient antibacterial and osteogenic-promotion properties. Herein, a MgF2 priming layer was first constructed on AZ31 surface. Then, dopamine and polyphenols (EGCG) were cross-linked onto this AZ31-F surface to promote osteogenesis and further enhance corrosion protection, followed by chemical grafting of antimicrobial peptides (AMPs) via Michael-addition and Schiff-base reaction to confer antibacterial properties. In vitro electrochemical corrosion tests showed that icorr of AZ31-FE/AMPs (4.36×10-7 A/cm2) is two orders of magnitude lower than that of AZ31 (4.17×10-5 A/cm2). In vitro immersion degradation showed that AZ31-FE/AMPs exhibited the lowest hydrogen release (2.38 mL) after 400 h immersion with the lowest hydrogen evolution rate among them. Further, AZ31-FE/AMPs displayed inhibitory effects against S. aureus and E. coil in the initial stage and even after 7 days immersion in PBS (antibacterial rate > 85 %). AZ31-FE/AMPs promoted ALP secretion and calcium nodule formation in MC3T3-E1 cells. Transcriptome sequencing results indicated that osteogenic promotion mechanism of AZ31-FE/AMPs in MC3T3-E1 may involve the PI3K-Akt signalling pathway. Further, AZ31-FE/AMPs enhanced new bone formation when implanted in a rat femoral bone defect model. This coating strategy addresses initial antibacterial and later osteogenesis needs based on the corrosion control, which is crucial for the surface design of Mg-based implants. STATEMENT OF SIGNIFICANCE: It is critical for magnesium-based orthopedic implants to achieve sequential functions in the bone repair process while controlling an appropriate degradation rate. A MgF2 priming layer/phenolic-amine grafted AMPs (antimicrobial peptides) duplex coating was constructed on AZ31 surface in this study. The MgF2 layer provided a basic corrosion protection to magnesium substrate, and dopamine and polyphenols (EGCG) were then cross-linked to the MgF2 pretreated AZ31 to promote osteogenesis and enhance corrosion resistance, followed by chemical grafting of AMPs to confer antibacterial property. This strategy effectively meets the initial need for infection resistance and later osteogenic promotion on the basis of controlling the substrate corrosion rate, thus holding significant implications for the surface design of magnesium-based implants.

Virucidal Coatings Active Against SARS-CoV-2

Three types of coatings (contact-based, release-based, and combined coatings with both contact-based and release-based actions) were prepared and tested for the ability to inactivate SARS-CoV-2. In these coatings, quaternary ammonium surfactants were used as active agents since quaternary ammonium compounds are some of the most commonly used disinfectants. To provide contact-based action, the glass and silicon surfaces with covalently attached quaternary ammonium cationic surfactant were prepared using a dimethyloctadecyl[3-(trimethoxysilyl)propyl]ammonium chloride modifier. Surface modification was confirmed by attenuated total reflection infrared spectroscopy, X-ray photoelectron spectroscopy (XPS), scanning electron microscopy, and contact angle measurements. The grafting density of the modifier was estimated by XPS and elemental analysis. To provide release-based action, the widely used quaternary ammonium cationic disinfectant, benzalkonium chloride (BAC), and a newly synthesized cationic gemini surfactant, C18-4-C18, were bound non-covalently to the surface either through hydrophobic or electrostatic interactions. Virus titration revealed that the surfaces with combined contact-based and release-based action and the surfaces with only release-based action completely inactivate SARS-CoV-2. Coatings containing only covalently bound disinfectant are much less effective; they only provide up to 1.25 log10 reduction in the virus titer, probably because of the low disinfectant content in the surface monolayer. No pronounced differences in the activity between the flat and structured surfaces were observed for any of the coatings under study. Comparative studies of free and electrostatically bound disinfectants show that binding to the surface of nanoparticles diminishes the activity. These data indicate that SARS-CoV-2 is more sensitive to the free disinfectants.

Exploring Biosurfactants as Antimicrobial Approaches

Antibacterial resistance is one of the most important global threats to human health. Several studies have been performed to overcome this problem and infection-preventive approaches appear as promising solutions. Novel antimicrobial preventive molecules are needed and microbial biosurfactants have been explored in that scope. Considering their structure, these biomolecules can be divided into different classes, glycolipids and lipopeptides being the most studied. Besides their antimicrobial activity, biosurfactants have the advantage of being biocompatible, biodegradable, and non-toxic, which favor their application in several areas, including the health sector. Often, the most difficult infections to fight are associated with biofilm formation, particularly in medical devices. Strategies to overcome micro-organism attachment are thus emergent, and it is possible to take advantage of the antimicrobial/antibiofilm properties of biosurfactants to produce surfaces that are more resistant to the deposition/attachment of bacteria. Approaches such as the covalent bond of biosurfactants to the medical device surface leading to repulsive physical-chemical interactions or contact killing can be selected. Simpler strategies such as the absorption of biosurfactants on surfaces are also possible, eliminating micro-organisms in the vicinity. This review will focus on the physical and chemical characteristics of biosurfactants, their antimicrobial activity, antimicrobial/antibiofilm approaches, and finally on their structure-activity relationship.

Tailoring of bioactive glass and glass-ceramics properties for in vitro and in vivo response optimization: a review

Bioactive glasses are inorganic biocompatible materials that can find applications in many biomedical fields. The main application is bone and dental tissue engineering. However, some applications in contact with soft tissues are emerging. It is well known that both bulk (such as composition) and surface properties (such as morphology and wettability) of an implanted material influence the response of cells in contact with the implant. This review aims to elucidate and compare the main strategies that are employed to modulate cell behavior in contact with bioactive glasses. The first part of this review is focused on the doping of bioactive glasses with ions and drugs, which can be incorporated into the bioceramic to impart several therapeutic properties, such as osteogenic, proangiogenic, or/and antibacterial ones. The second part of this review is devoted to the chemical functionalization of bioactive glasses using drugs, extra-cellular matrix proteins, vitamins, and polyphenols. In the third and final part, the physical modifications of the surfaces of bioactive glasses are reviewed. Both top-down (removing materials from the surface, for example using laser treatment and etching strategies) and bottom-up (depositing materials on the surface, for example through the deposition of coatings) strategies are discussed.

Antibacterial Iodine-Releasing Coatings of Cross-Linked Poly(N-vinylpyrrolidone) Synthesized by Solvent-Free Initiated Chemical Vapor Deposition

Biomaterial-associated infections caused by bacteria pose a great threat to human health, and therefore, various antibacterial coatings have been developed to control bacterial infections. Povidone iodine (PVP-I) is a broad-spectrum antimicrobial agent without drug resistance to most pathogenic microorganisms and has been widely used in the clinic. However, its applications in the field of coatings are limited due to its strong water solubility. Here, we used initiated Chemical Vapor Deposition (iCVD) technique to synthesize cross-linked poly(N-vinylpyrrolidone-co-ethylene glycol dimethacrylate) (PVE) coatings to firmly immobilize poly(N-vinylpyrrolidone) (PVP) on surfaces. After complexation with iodine, PVE-I coatings exhibited potent bacteria-killing and antifouling activities against Gram-negative Escherichia coli and Gram-positive Staphylococcus aureus in vitro owing to the antibacterial effect of iodine and the hydrophilicity of VP, respectively. The killing and antifouling effects were positively correlated with the VP content. The PVE-I-2 coating displayed excellent anti-infection performance in a rat subcutaneous implantation model in vivo. This study provided a simple method for preparing stable povidone iodine coatings on surfaces via solvent-free iCVD, and combined bacteria-killing and antifouling strategies to fabricate multifunctional antibacterial coatings against bacterial infections on biomaterial surfaces.

Quaternary Ammonium Salts-Based Materials: A Review on Environmental Toxicity, Anti-Fouling Mechanisms and Applications in Marine and Water Treatment Industries

The adherence of pathogenic microorganisms to surfaces and their association to form antibiotic-resistant biofilms threatens public health and affects several industrial sectors with significant economic losses. For this reason, the medical, pharmaceutical and materials science communities are exploring more effective anti-fouling approaches. This review focuses on the anti-fouling properties, structure-activity relationships and environmental toxicity of quaternary ammonium salts (QAS) and, as a subclass, ionic liquid compounds. Greener alternatives such as QAS-based antimicrobial polymers with biocide release, non-fouling (i.e., PEG, zwitterions), fouling release (i.e., poly(dimethylsiloxanes), fluorocarbon) and contact killing properties are highlighted. We also report on dual-functional polymers and stimuli-responsive materials. Given the economic and environmental impacts of biofilms in submerged surfaces, we emphasize the importance of less explored QAS-based anti-fouling approaches in the marine industry and in developing efficient membranes for water treatment systems.

Synergistic antibacterial effect and mechanism between Cu2O nanoparticles and quaternary ammonium salt in moisture-curable acrylic coatings

Combining with various antibacterial mechanisms is the preferred strategy to fabricate coatings with effective antibacterial performance. Herein, Cu2O nanoparticles and dimethyloctadecyl [3-(trimethoxysilyl) propyl] ammonium chloride, a kind of quaternary ammonium salt (QAS), were simultaneously incorporated into a moisture-curable acrylic resin in order to achieve both contact-killing and release-killing abilities for antibacterial coatings. The surface morphology, surface composition and basic properties of the coatings were thoroughly characterized. The antibacterial performance of the coatings was determined by in-vitro bacteriostatic test. Under the constant total mass fraction of antibacterial agents, both Cu2O and QAS content possessed the highest value on the coating surface at Cu2O/QAS mass ratio of 1:1, and correspondingly, the coatings reached sterilizing rate above 99 % against both E. coli and S. loihica, indicating the existence of synergistic effect between Cu2O and QAS. The synergistic antibacterial mechanism of the coatings involved two aspects. Firstly, the combination of contact-killing and release-killing biocides resulted in high bactericidal and antibiofilm activity against different bacteria. Further, the grafting of QAS molecules on the surface of Cu2O particles brought about the spontaneous migration of nanoparticles to the coating surface. The interaction between Cu2O and QAS also inhibited the phase separation of QAS and prolonged the release of Cu2+ at the same time. The coatings, therefore, exhibited stable antibacterial performance at varied service conditions.

Evaluation of layer-by-layer assembly systems for drug delivery and antimicrobial properties in orthopaedic application

Layer-by-layer self-assembly systems were developed using monolayer and multilayer carriers to prevent infections and improve bone regeneration of porous Ti-6Al-4V scaffolds. These polymeric carriers incorporated (Gel/Alg-IGF-1 + Chi-Cef) and (4Gel/Alg-IGF-1 + Chi-Cef) on the surface of porous implants produced via electron beam melting (EBM). The results showed that the drug release from multilayer carriers was higher than that of monolayers after 14 days. However, the carrier containing Gel/Alg-IGF-1 + Chi-Cef exhibited more sustained behavior. Cell morphology was characterized, revealing that multilayer carriers had higher cell adhesion than monolayers. Additionally, cell differentiation was significantly greater for (Gel/Alg-IGF-1) + Chi-Cef, and (4Gel/Alg-IGF-1) + Chi-Cef multilayer carriers than for the monolayer groups after 7 days. Notably, the drug dosage was effective and did not interfere, and the cell viability assay showed safe results. Antibacterial evaluations demonstrated that both multilayer carriers had a greater effect on Staphylococcus aureus during treatment. The carriers containing lower alginate had notably less effect than the other studied carriers. This study aimed to test systems for controlling drug release, which will be applied to improve MG63 cell behavior and prevent bacterial accumulation during orthopaedic applications.

Phytic Acid-Promoted Deposition of Gold Nanoparticles with Grafted Cationic Polymer Brushes for the Construction of Synergistic Contact-Killing and Photothermal Bactericidal Coatings

Medical implants are constantly facing the risk of bacterial infections, especially infections caused by multidrug resistant bacteria. To mitigate this problem, gold nanoparticles with alkyl bromide moieties (Au NPs-Br) on the surfaces were prepared. Xenon light irradiation triggered the plasmon effect of Au NPs-Br to induce free radical graft polymerization of 2-(dimethylamino)ethyl methacrylate (DMAEMA), leading to the formation of poly(DMAEMA) brush-grafted Au NPs (Au NPs-g-PDM). The Au NPs-g-PDM nanocomposites were conjugated with phytic acid (PA) via electrostatic interaction and van der Waals interaction. The as-formed aggregates were deposited on the titanium (Ti) substrates to form the PA/Au NPs-g-PDM (PAP) hybrid coatings through surface adherence of PA and the gravitational effect. Synergistic bactericidal effects of contact-killing caused by the cationic PDM brushes, and local heating generated by the Au NPs under near-infrared irradiation, conferred strong antibacterial effects on the PAP-deposited Ti (Ti-PAP) substrates. The synergistic bactericidal effects reduced the threshold temperature required for the photothermal sterilization, which in turn minimized the secondary damage to the implant site. The Ti-PAP substrates exhibited 97.34% and 99.97% antibacterial and antiadhesive efficacy, respectively, against Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli), compared to the control under in vitro antimicrobial assays. Furthermore, the as-constructed Ti-PAP surface exhibited a 99.42% reduction in the inoculated S. aureus under in vivo assays. In addition, the PAP coatings exhibited good biocompatibility in the hemolysis and cytotoxicity assays as well as in the subcutaneous implantation of rats.

Antimicrobial coatings based on amine-terminated graphene oxide and Nafion with remarkable thermal resistance

We present a novel type of layer-by-layer (LbL) waterborne coating based on Nafion and amine-terminated graphene oxide (GO-NH2) that inhibits the growth of Escherichia coli and Staphylococcus aureus by more than 99% and this performance is not compromised upon extensive thermal annealing at 200 °C. Quartz crystal microbalance (QCM) sensorgrams allow the real time monitoring of the build-up of the LbL assemblies, a process that relies on the strong electrostatic interactions between Nafion (pH = 2.7, ζ = -54.8 mV) and GO-NH2 (pH = 2, ζ = 26.7 mV). Atomic force microscopy (AFM), contact angle and zeta potential measurements were used to characterise the multilayer assemblies. We demonstrate here that Nafion/GO-NH2 advanced coatings can offer drug-free and long-lasting solutions to microbial colonization and can withstand dry heat sterilization, without any decline in their performance.

Engineering a self-healing grafted chitosan-sodium alginate based hydrogel with potential keratinocyte cell migration property and inhibitory effect against fluconazole resistance Candida albicans biofilm

Biofilms developed by microorganisms cause an extremely severe clinical problem that leads to drug failure. Bioactive polymeric hydrogels display potential for controlling the formation of microorganism-based biofilms, but their rapid biodegradability in these biofilm sites is still a major challenge. To overcome this, chitosan (CS), a natural functional biomaterial, has been used because of its effective penetrability in the cell wall of microorganisms; however, its fast biodegradability has restricted its further use. Hence, in this study, to improve the stability of CS and increase its penetration retention inside a biofilm, grafted CS was prepared and then crosslinked with sodium alginate (SA) to synthesize CS-poly(MA-co-AA)SA hydrogel via a free radical grafting method, therefore enhancing its antibiofilm efficiency against biofilms. The prepared hydrogel demonstrated excellent effectiveness against (≥90 % inhibition) biofilms of Candida albicans. Additionally, in vitro and in vivo safety assays established that the prepared hydrogel can be used in a biofilm microenvironment and might reduce drug resistance burden owing to its long-term antibiofilm effect and improved CS stability at the biofilm site. Furthermore, in vitro wound healing outcomes of hydrogel indicated its potential application for chronic wound treatment. This research opens a new advanced strategy for biofilm-associated infection treatment, including wound treatment.

A Versatile Approach for the Synthesis of Antimicrobial Polymer Brushes on Natural Rubber/Graphene Oxide Composite Films via Surface-Initiated Atom-Transfer Radical Polymerization

A simple strategy was adopted for the preparation of an antimicrobial natural rubber/graphene oxide (NR/GO) composite film modified through the use of zwitterionic polymer brushes. An NR/GO composite film with antibacterial properties was prepared using a water-based solution-casting method. The composited GO was dispersed uniformly in the NR matrix and compensated for mechanical loss in the process of modification. Based on the high bromination activity of α-H in the structure of cis-polyisoprene, the composite films were brominated on the surface through the use of N-bromosuccinimide (NBS) under the irradiation of a 40 W tungsten lamp. Polymerization was carried out on the brominated films using sulfobetaine methacrylate (SBMA) as a monomer via surface-initiated atom transfer radical polymerization (SI-ATRP). The NR/GO composite films modified using polymer brushes (PSBMAs) exhibited 99.99% antimicrobial activity for resistance to Escherichia coli and Staphylococcus aureus. A novel polymer modification strategy for NR composite materials was established effectively, and the enhanced antimicrobial properties expand the application prospects in the medical field.

Photo-Controlled Gating of Selective Bacterial Membrane Interaction and Enhanced Antibacterial Activity for Wound Healing

Reversible biointerfaces are essential for on-demand molecular recognition to regulate stimuli-responsive bioactivity such as specific interactions with cell membranes. The reversibility on a single platform allows the smart material to kill pathogens or attach/detach cells. Herein, we introduce a 2D-MoS2 functionalized with cationic azobenzene that interacts selectively with either Gram-positive or Gram-negative bacteria in a light-gated fashion. The trans conformation (trans-Azo-MoS2 ) selectively kills Gram-negative bacteria, whereas the cis form (cis-Azo-MoS2 ), under UV light, exhibits antibacterial activity against Gram-positive strains. The mechanistic investigation indicates that the cis-Azo-MoS2 exhibits higher affinity towards the membrane of Gram-positive bacteria compared to trans-Azo-MoS2 . In case of Gram-negative bacteria, trans-Azo-MoS2 internalizes more efficiently than cis-Azo-MoS2 and generates intracellular ROS to kill the bacteria. While the trans-Azo-MoS2 exhibits strong electrostatic interactions and internalizes faster into Gram-negative bacterial cells, cis-Azo-MoS2 primarily interacts with Gram-positive bacteria through hydrophobic and H-bonding interactions. The difference in molecular mechanism leads to photo-controlled Gram-selectivity and enhanced antibacterial activity. We found strain-specific and high bactericidal activity (minimal bactericidal concentration, 0.65 μg/ml) with low cytotoxicity, which we extended to wound healing applications. This methodology provides a single platform for efficiently switching between conformers to reversibly control the strain-selective bactericidal activity regulated by light.

Superomniphobic and Photoactive Surface Presents Antimicrobial Properties by Repelling and Killing Pathogens

Healthcare-acquired infections place a significant burden on the cost and quality of patient care in hospitals. Reducing contamination on surfaces within healthcare environments is critical for halting the spread of these infections. Herein, we report a bifunctional─repel and kill─surface developed using photoactive TiO2 nanoparticles integrated into a hierarchical scaffold (OmniKill). To quantify the repellency of OmniKill, we developed a touch-based assay, capable of simulating the transfer of individual pathogens, multiple pathogens, or pathogen-latent fecal matter from hands to surfaces. OmniKill repels bacterial pathogens by at least 2.77-log (99.8%). The photoactive material within OmniKill further reduces the viability of transferred pathogens on the surface by an additional 2.43-log (99.6%) after 1 h of light exposure. The antipathogenic effects─repel and kill─remain robust under complex biological contaminates such as feces. These findings show the potential use of OmniKill in reducing the physical transmission of bacterial pathogens in healthcare settings.

Research progress of biomimetic materials in oral medicine

Biomimetic materials are able to mimic the structure and functional properties of native tissues especially natural oral tissues. They have attracted growing attention for their potential to achieve configurable and functional reconstruction in oral medicine. Though tremendous progress has been made regarding biomimetic materials, significant challenges still remain in terms of controversy on the mechanism of tooth tissue regeneration, lack of options for manufacturing such materials and insufficiency of in vivo experimental tests in related fields. In this review, the biomimetic materials used in oral medicine are summarized systematically, including tooth defect, tooth loss, periodontal diseases and maxillofacial bone defect. Various theoretical foundations of biomimetic materials research are reviewed, introducing the current and pertinent results. The benefits and limitations of these materials are summed up at the same time. Finally, challenges and potential of this field are discussed. This review provides the framework and support for further research in addition to giving a generally novel and fundamental basis for the utilization of biomimetic materials in the future.

Recent Advances in Dual-Function Superhydrophobic Antibacterial Surfaces

Bacterial adhesion and subsequent biofilm formation on the surfaces of synthetic materials imposes a significant burden in various fields, which can lead to infections in patients or reduce the service life of industrial devices. Therefore, there is increasing interest in imbuing surfaces with antibacterial properties. Bioinspired superhydrophobic surfaces with high water contact angles (>150°) exhibit excellent surface repellency against contaminations, thereby preventing initial bacterial adhesion and inhibiting biofilm formation. However, conventional superhydrophobic surfaces typically lack long-term durability and are incapable of achieving persistent efficacy against bacterial adhesion. To overcome these limitations, in recent decades, dual-function superhydrophobic antibacterial surfaces with both bacteria-repelling and bacteria-killing properties have been developed by introducing bactericidal components. These surfaces have demonstrated improved long-term antibacterial performance in addressing the issues associated with surface-attached bacteria. This review summarizes the recent advancements of these dual-function superhydrophobic antibacterial surfaces. First, a brief overview of the fabrication strategies and bacteria-repelling mechanism of superhydrophobic surfaces is provided and then the dual-function superhydrophobic antibacterial surfaces are classified into three types based on the bacteria-killing mechanism: i) mechanotherapy, ii) chemotherapy, and iii) phototherapy. Finally, the limitations and challenges of current research are discussed and future perspectives in this promising area are proposed.

Leveraging the Dielectric Barrier Discharge Plasma Process to Create Regenerative Biocidal ePTFE Membranes

The utilization of dielectric barrier discharge (DBD) plasma treatment for modifying substrate surfaces constitutes an easy and simple approach with a potential for diverse applications. This technique was used to modify the surface of a commercial porous expanded poly(tetrafluoroethylene) (ePTFE) film with either dimethylaminoethyl methacrylate (DMAEMA) or (trimethylamino)ethyl methacrylate chloride (TMAEMA) monomers, aiming to obtain antibacterial ePTFE. Physicochemical analyses of the membranes revealed that DBD successfully enhanced the surface energy and surface charge of the membranes while maintaining high porosity (>75%) and large pore size (>1.0 μm). Evaluation of the bacteria killing-releasing (K-R) function revealed that both DMAEMA and TMAEMA endowed ePTFE with the ability to kill Escherichia coli bacteria. However, only TMAEMA-grafted ePTFE allowed for the release of dead bacteria from the surface upon washing with sodium hexametaphosphate (SHMP) saline solution, owing to its cationic charge derived from the quaternary amine. Washing with SHMP disturbed the electrostatic force between the polymer brushes and dead bacteria, which caused the release of the dead bacteria. Lastly, dead-end bacteria filtration showed that the TMAEMA-grafted ePTFE was able to kill 99.78% of the bacteria, while approximately 61.55% of bacteria were killed upon contact. The present findings support the feasibility of using DBD plasma treatment for designing surfaces that target bacteria and aid in the containment of disease-causing pathogens.

A near-infrared light-triggered nano-domino system for efficient biofilm eradication: Activation of dispersing and killing functions by generating nitric oxide and peroxynitrite via cascade reactions

One of the serious threats to global public health is the bacterial biofilm, which results in numerous persistent and recurrent infections. Herein, we proposed a near-infrared (NIR) light-triggered "nano-domino" system with "dispersing and killing" functionality for biofilm eradication. The nanoplatform was fabricated by the self-assembly of chitosan conjugated with L-arginine (L-Arg, a natural nitric oxide (NO) donor) and indocyanine green (ICG, a phototherapy agent). Using an NIR irradiation "trigger", a series of reactive oxygen species (ROS) including singlet oxygen (1O2), hydrogen peroxide (H2O2), and superoxide anions (·O2-), as well as heat were generated from ICG aggregates. Subsequently, 1O2 and H2O2 catalyzed L-Arg to produce NO, which dispersed the biofilm and reacted with ·O2- to form peroxynitrite to kill bacteria with ROS collaboratively. Meanwhile, the generated heat increased the permeability of bacterial membranes, aggravating the damage to biofilm bacteria. The experiments on biofilm eradication demonstrated that this "nano-domino" system was capable to eradicate over 99.99% of biofilms formed by Methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa under 5-min NIR irradiation. Notably, these integrated benefits allowed the system to promote the healing of MRSA biofilm-infected wounds in vivo with negligible toxicity. Overall, this reported NIR-triggered "nano-domino" system holds great promise for addressing the difficulties associated with bacterial biofilm eradication. STATEMENT OF SIGNIFICANCE: Novel agents for biofilm eradication are urgently needed due to the alarming rise in antimicrobial resistance to conventional antibiotics and the critical shortage of new drugs. In this study, we created a nano-domino system that uses near-infrared (NIR) light as a trigger to eradicate mature biofilms. In response to a short-term NIR irradiation, the proposed nanoplatform could generate nitric oxide and peroxynitrite to disperse the biofilm and kill the bacteria inside, respectively, leading to efficient eradication of Methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa biofilms with minimal cytotoxicity. The findings, therefore, indicate that this nanoplatform with enhanced antibiofilm performance might provide a reliable and promising solution to biofilm-related problems.

Current antibacterial agents in dental bonding systems: a comprehensive overview

Dental caries is mainly caused by oral biofilm acid, and the most common dental restoration treatment is composite dental restorations. The main cause of failure is secondary caries adjacent to the restoration. Long-term survival of dental materials is improved by the presence of antibacterial agents, which selectively inhibit bacterial growth or survival. Chemical, natural and biomaterials have been studied for their antimicrobial activities and antibacterial bonding agents have been improved. Their usage has been increased to inhibit the growth of invading and residual bacteria in the oral cavity, as biofilm accumulation increases the risk of treatment failure. In this article, the success and applications of antibacterial agents are discussed in dental bonding systems.

Surface modifications of biomaterials in different applied fields

Biomaterial implantation into the human body plays a key role in the medical field and biological applications. Increasing the life expectancy of biomaterial implants, reducing the rejection reaction inside the human body and reducing the risk of infection are the problems in this field that need to be solved urgently. The surface modification of biomaterials can change the original physical, chemical and biological properties and improve the function of materials. This review focuses on the application of surface modification techniques in various fields of biomaterials reported in the past few years. The surface modification techniques include film and coating synthesis, covalent grafting, self-assembled monolayers (SAMs), plasma surface modification and other strategies. First, a brief introduction to these surface modification techniques for biomaterials is given. Subsequently, the review focuses on how these techniques change the properties of biomaterials, and evaluates the effects of modification on the cytocompatibility, antibacterial, antifouling and surface hydrophobic properties of biomaterials. In addition, the implications for the design of biomaterials with different functions are discussed. Finally, based on this review, it is expected that the biomaterials have development prospects in the medical field.

Effect of the structure of chitosan quaternary phosphonium salt and chitosan quaternary ammonium salt on the antibacterial and antibiofilm activity

N-(4-N', N', N'-trimethylphosphonium chloride) benzoyl chitosan (TMPCS), N-(4-N', N', N'-triphenylphosphonium chloride) benzoyl chitosan (TPPCS), and N-(4-N', N', N'-trimethylmethanaminium chloride) benzoyl chitosan (TMACS) were synthesized. The structures of the products were characterized by Fourier transform infrared spectroscopy, Nuclear magnetic resonance spectroscopy and ultraviolet-visible spectroscopy. Their antibacterial activities against Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus) were investigated in vitro using the antibacterial rate, minimal inhibitory concentration (MIC) and minimum bactericidal concentration (MBC), the antibiofilm activity was investigated by crystal violet assay. The antibacterial assessment revealed that the chitosan quaternary phosphonium salts of similar structure had superior antibacterial activity than chitosan quaternary ammonium salt. The antibacterial rate of CS, TMPCS, TPPCS and TMACS against E. coli at 0.5 mg/mL was 10.4 %, 42.0 %, 58.5 % and 21.6 % respectively. At the same concentration, the antibacterial rate of TMPCS, TPPCS and TMACS against S.aureus was all up to 100 %. The biofilm inhibition rate of CS, TMPCS, TPPCS and TMACS at a half of MIC against E.coli was 28.4 %, 33.9 %, 56.6 % and 57.6 % respectively, and against S.aureus was 30.8 %, 53.8 %, 62.2 % and 58.5 % respectively. The biofilm removal rate of CS, TMPCS, TPPCS, TMACS against E.coli at 2.5 mg/mL was 20.6 %, 46.4 %, 48.9 % and 41.6 % respectively, and against S.aureus at 2.5 mg/mL was 41.5 %, 60.4 %, 69.9 % and 59.01 % respectively.

Antibacterial coatings on orthopedic implants

With the aging of population and the rapid improvement of public health and medical level in recent years, people have had an increasing demand for orthopedic implants. However, premature implant failure and postoperative complications frequently occur due to implant-related infections, which not only increase the social and economic burden, but also greatly affect the patient's quality of life, finally restraining the clinical use of orthopedic implants. Antibacterial coatings, as an effective strategy to solve the above problems, have been extensively studied and motivated the development of novel strategies to optimize the implant. In this paper, a variety of antibacterial coatings recently developed for orthopedic implants were briefly reviewed, with the focus on the synergistic multi-mechanism antibacterial coatings, multi-functional antibacterial coatings, and smart antibacterial coatings that are more potential for clinical use, thereby providing theoretical references for further fabrication of novel and high-performance coatings satisfying the complex clinical needs.

Multifunctional antibacterial chitosan-based hydrogel coatings on Ti6Al4V biomaterial for biomedical implant applications

Among biomedical community, great efforts have been realized to develop antibacterial coatings that avoid implant-associated infections. To date, conventional mono-functional antibacterial strategies have not been effective enough for successful long-term implantations. Consequently, researchers have recently focused their attention on novel bifunctional or multifunctional antibacterial coatings, in which two or more antibacterial mechanisms interact synergistically. Thus, in this work different chitosan-based (CHI) hydrogel coatings were created on Ti6Al4V surface using genipin (Ti-CHIGP) and polyethylene glycol (Ti-CHIPEG) crosslinking agents. Hydrogel coatings demonstrated an exceptional in vivo biocompatibility plus a remarkable ability to promote cell proliferation and differentiation. Lastly, hydrogel coatings demonstrated an outstanding bacteria-repelling (17-28 % of S. aureus and 33-43 % of E. coli repelled) and contact killing (186-222 % of S. aureus and 72-83 % of E. coli damaged) ability. Such bifunctional antibacterial activity could be further improved by the controlled release of drugs resulting in powerful multifunctional antibacterial coatings.

Inorganic hollow mesoporous spheres-based delivery for antimicrobial agents

Microorganisms coexist with human beings and have formed a complex relationship with us. However, the abnormal spread of pathogens can cause infectious diseases thus demands antibacterial agents. Currently available antimicrobials, such as silver ions, antimicrobial peptides and antibiotics, have diverse concerns in chemical stability, biocompatibility, or triggering drug resistance. The "encapsulate-and-deliver" strategy can protect antimicrobials against decomposing, so to avoid large dose release induced resistance and achieve the controlled release. Considering loading capacity, engineering feasibility, and economic viability, inorganic hollow mesoporous spheres (iHMSs) represent one kind of promising and suitable candidates for real-life antimicrobial applications. Here we reviewed the recent research progress of iHMSs-based antimicrobial delivery. We summarized the synthesis of iHMSs and the drug loading method of various antimicrobials, and discussed the future applications. To prevent and mitigate the spread of an infective disease, multilateral coordination at the national level is required. Moreover, developing effective and practicable antimicrobials is the key to enhancing our capability to eliminate pathogenic microbes. We believe that our conclusion will be beneficial for researches on the antimicrobial delivery in both lab and mass production phases.

Natural rubber latex films with effective growth inhibition against S. aureus via surface conjugated gentamicin

Hospital-associated infections and related complications are of extreme concern in the healthcare sector since biofilms generated over material surfaces not only create turbulence in the healthcare practices followed but also ruin the device performance, and increased medication, leading to significant chances of drug resistance. Natural rubber latex (NRL) being the first choice for the manufacture of several conventional biomedical devices, it is essential to ensure the surfaces of the same are inherently inactive against most microorganisms. This study presents NRL film surface conjugated with a well-known antibiotic, gentamicin through an amide linkage to generate antibacterial activity to the surface with a significant growth inhibition rate, especially against Staphylococcus aureus. The NRL films were surface-oxidized under controlled acidic conditions to generate carboxyl groups exploring the unsaturation of the base monomer unit. The carboxyl group reacts with the amine groups of gentamicin facilitating its surface conjugation. The surface anchoring was authenticated by FTIR-ATR complimented further by contact angle measurement as a function of hydrophilicity and elemental analysis by EDX spectroscopy. The antibacterial efficacy of modified NRL films was evaluated using antibacterial drop test and the results indicated a substantial growth inhibition rate (>60%) against Pseudomonas aeruginosa and Staphylococcus aureus. The study could be further optimized and proposed as a viable route for the conjugation of active molecules over inert polymer molecules.

Triclosan to Improve the Antimicrobial Performance of Universal Adhesives

To solve the proble ms of composite restoration failure caused by secondary caries, this study reports a light curable antibacterial triclosan derivative (TCS-IH), which was synthesized and added to the existing commercial universal adhesive to achieve a long-term antibacterial effect The effect of mixing different mass percentages of TCS-IH on the bond strength of dentin was also investigated.TCS-IH was synthesized by solution polymerization and characterized by nuclear magnetic resonance hydrogen spectroscopy (1H NMR) and Fourier transform infrared (FTIR) spectroscopy. Two commercial universal adhesives, Single Bond Universal and All Bond Universal, were selected and used as the control group, and universal adhesives with different mass percentages (1 wt%, 3 wt%, 5 wt% and 7 wt%) of TCS-IH were used as the experimental group. The antibacterial properties were analysed by means of colony count experiments, biofilm formation detection, plotting of growth curves, biofilm metabolic activity detection, insoluble extracellular polysaccharide measurements and observations by confocal laser scanning microscopy and scanning electron microscopy (SEM). The effect of adhesives on biofilm formation, metabolism, extracellular matrix production, distribution of live and dead bacteria, and bacterial morphology of Streptococcus mutans (S. mutans) was analysed. The mechanical properties were evaluated by the degree of conversion and microtensile bonding strength under different conditions. Its biosafety was tested. We found that the addition of TCS-IH significantly improved the antibacterial performance of the universal adhesive, with the 5 wt% and 7 wt% groups showing the best antibacterial effect and effectively inhibiting the formation of biofilm. In addition, the adhesive strength test results showed that there was no statistical difference (p < 0.05) in the microtensile bond strength measured under various factors in all experimental groups except for the 7 wt% group in the self-etch bonding mode, and all of them had good biosafety. In summary, the 5 wt% group of antibacterial monomer TCS-IH was selected as the optimum addition to the universal adhesive to ensure the antimicrobial properties of the universal adhesive and the stability and durability of the adhesive interface. This study provides a reference for the clinical application of adhesives with antimicrobial activity to improve the stability and durability of adhesive restorations.

Antibacterial brush polypeptide coatings with anionic backbones

Preventing initial colonization of bacteria on biomaterial surfaces is crucial to address the medical device-associated infection issues. Antimicrobial peptide (AMP) or cationic polymer modified surfaces have shown promising potentials to inhibit the initial colonization of bacteria by contact killing. However, their development has been impeded because of bacterial adhesion and high cytotoxicity. Herein, we report a series of brush polypeptide coatings with anionic backbones and cationic AMP mimetic side-chains that displayed superior bactericidal activity, antibacterial adhesion property, and biocompatibility. The cationic side-chain density played an important role in the bioactivities of the brush polypeptide modified surfaces. Brush polypeptide coating with low side-chain density exhibited improved bactericidal activity and antibacterial adhesion property, ascribing to the cooperative effects of adjacent side-chains and backbones/side-chains, respectively. It also showed negligible hemolysis/cytotoxicity in vitro and potent anti-infection property (≥99.9% bactericidal efficacy) in vivo. Brush polymers with anionic backbones and cationic side-chains can be used as a promising design motif to potentiate both antibacterial property and biocompatibility of coatings for combating device-associated infections. STATEMENT OF SIGNIFICANCE: Device-associated infections (DAIs) have led to increased medical cost, pain, and even mortality of patients. Antimicrobial peptide and cationic polymer coatings provide an important strategy to combat DAIs by preventing initial colonization of bacteria on biomaterial surfaces. Nevertheless, they have suffered bacterial adhesion and cytotoxicity issues. Herein, we developed a brush polypeptide coating with anionic backbones and cationic side-chains. The brush polypeptide coating showed superior bactericidal and antibacterial adhesion properties outperforming conventional antibacterial coatings based on antimicrobial peptide (i.e., melittin), lysozyme (i.e., lysostaphin), cationic polymer, anionic polymer, and the blends of cationic/anionic polymers. It also showed good biocompatibility and potent anti-infection property, making it a promising candidate to combat the DAIs.

Polymethyl methacrylate resin containing ε-poly-L-lysine and 2-methacryloyloxyethyl phosphorylcholine with antimicrobial effects

STATEMENT OF PROBLEM

Polymethyl methacrylate (PMMA) is commonly used in dentistry, including as a denture base material. However, the colonization of a PMMA surface by microbial microorganisms could increase the risk of oral diseases such as denture stomatitis and gingivitis. The development of PMMA with antibacterial properties should improve its clinical application, but whether adding ε-poly-L-lysine (ε-PL) and 2-methacryloyloxyethyl phosphorylcholine (MPC) provides antimicrobial effects is unclear.

PURPOSE

This in vitro study aimed to develop a novel antibacterial PMMA resin containing the natural nontoxic antibacterial agent ε-PL and the protein repellent agent MPC. The mechanical properties, protein repellency, and antimicrobial activities of the resin were then evaluated.

MATERIAL AND METHODS

Different mass fractions of ε-PL and MPC were mixed into PMMA as the experimental groups, with unaltered PMMA as the control group. The flexural strength (n=10) and surface roughness (n=6) of the resulting mixtures were measured to determine their mechanical properties. The antiprotein properties were measured by using the micro bicinchoninic acid method (n=6). The antimicrobial effect of the resin was assessed using live/dead staining (n=6) and methyltransferase (MTT) assays (n=10). According to the variance homogeneity and normal distribution results, 1-way analysis of variance followed by the Tukey honestly significant difference test or the Welch test and the Games-Howell test were used (α=.05 for all tests).

RESULTS

No significant differences were found in the flexural strength values and surface roughness of the specimens containing 1.5% MPC and 1.5% ε-PL compared with those of the control (P>.05). The addition of ε-PL to the PMMA resin alone significantly increased its bactericidal properties (P<.05). Adding both ε-PL and MPC further increased the antibacterial activity of the PMMA resin without increasing protein adhesion more than in the control group.

CONCLUSIONS

The incorporation of both ε-PL and MPC into PMMA improved its antibacterial capacity without affecting its mechanical properties and did not increase protein adhesion. Therefore, the novel PMMA fabricated in this study shows promise for dental applications.

Substrate-independent and widely applicable deposition of antibacterial coatings

Antibacterial coatings are regarded as a necessary tool to prevent implant-related infections. Substrate-independent and widely applicable coating techniques are gaining significant interest to synthesize different types of antibacterial films, which can be relevant from a fundamental and application-oriented perspective. Plasma polymer- and polydopamine-based antibacterial coatings represent the most widely studied and versatile approaches among these coating techniques. Both single- and dual-functional antibacterial coatings can be fabricated with these approaches and a variety of dual-functional antibacterial coating strategies can still be explored in future work. These coatings can potentially be used for a wide range of different implants (material, shape, and size). However, for most implants, significantly more fundamental knowledge needs to be gained before these coatings can find real-life use.

Bioceramic-based scaffolds with antibacterial function for bone tissue engineering: A review

Bone defects caused by trauma, tumor, congenital abnormality and osteoarthritis, etc. have been substantially impacted the lives and health of human. Artificial bone implants, like bioceramic-based scaffolds, provide significant benefits over biological counterparts and are critical for bone repair and regeneration. However, it is highly probable that bacterial infections occur in the surgical procedures or on bioceramic-based scaffolds. Therefore, it is of great significance to obtain bioceramic-based scaffolds with integrative antibacterial and osteogenic functions for treating bone implant-associated infection and promoting bone repair. To fight against infection problems, bioceramic-based scaffolds with various antibacterial strategies are developed for bone repair and regeneration and also have made great progresses. This review summarizes recent progresses in bioceramic-based scaffolds with antibacterial function, which include drug-induced, ion-mediated, physical-activated and their combined antibacterial strategies according to specific antibacterial mechanism. Finally, the challenges and opportunities of antibacterial bioceramic-based scaffolds are discussed.

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Bioceramic-based scaffolds with antibacterial function (BSAF) are reviewed.

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BSAF have a great potential in treating bone infection and promoting bone repair.

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Antibacterial strategies of BSAF include drug, ion, physical and combined ways.

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The combined strategy may be the optimal approach in fighting bone infection.

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Limitations, challenges and perspectives of BSAF are discussed.

Enzyme-triggered smart antimicrobial drug release systems against bacterial infections

The rapid emergence and spread of drug-resistant bacteria, as one of the most pressing public health threats, are declining our arsenal of available antimicrobial drugs. Advanced antimicrobial drug delivery systems that can achieve precise and controlled release of antimicrobial agents in the microenvironment of bacterial infections will retard the development of antimicrobial resistance. A variety of extracellular enzymes are secreted by bacteria to destroy physical integrity of tissue during their invasion of host body, which can be utilized as stimuli to trigger "on-demand" release of antimicrobials. In the past decade, such bacterial enzyme responsive drug release systems have been intensively studied but few review has been released. Herein, we systematically summarize the recent progress of smart antimicrobial drug delivery systems triggered by bacteria secreted enzymes such as lipase, hyaluronidase, protease and antibiotic degrading enzymes. The perspectives and existing key issues of this field will also be discussed to fuel the innovative research and translational application in the future.

Biobased polymer resources and essential oils: a green combination for antibacterial applications

To fight nosocomial infections, the excessive use of antibiotics has led to the emergence of multidrug-resistant microorganisms, which are now considered a relevant public health threat by the World Health Organization. To date, most antibacterial systems are based on the use of petro-sourced polymers, but the global supplies of these resources are depleting. Besides, silver NPs are widely accepted as the most active biocide against a wide range of bacterial strains but their toxicity is an issue. The growing interest in natural products has gained increasing interest in the last decade. Therefore, the design of functional antibacterial materials derived from biomass remains a significant challenge for the scientific community. Consequently, attention has shifted to naturally occurring substances such as essential oils (EOs), which are classified as Generally Recognized as Safe (GRAS). EOs can offer an alternative to the common antimicrobial agents as an inner solution or biocide agent to inhibit the resistance mechanism. Herein, this review not only aims at providing developments in the antibacterial modes of action of EOs against various bacterial strains and the recent advances in genomic and proteomic techniques for the elucidation of these mechanisms but also presents examples of biobased polymer resource-based EO materials and their antibacterial activities. Especially, we describe the antibacterial properties of biobased polymers, e.g. cellulose, starch, chitosan, PLA PHAs and proteins, associated with EOs (cinnamon (CEO), clove (CLEO), bergamot (BEO), ginger (GEO), lemongrass (LEO), caraway (CAEO), rosemary (REO), Eucalyptus globulus (EGEO), tea tree (TTEO), orange peel (OPEO) and apricot (Prunus armeniaca) kernel (AKEO) essential oils). Finally, we discuss the influence of EOs on the mechanical strength of bio-based materials.

Hemocompatibility challenge of membrane oxygenator for artificial lung technology

The artificial lung (AL) technology is one of the membrane-based artificial organs that partly augments lung functions, i.e. blood oxygenation and CO₂ removal. It is generally employed as an extracorporeal membrane oxygenation (ECMO) device to treat acute and chronic lung-failure patients, and the recent outbreak of the COVID-19 pandemic has re-emphasized the importance of this technology. The principal component in AL is the polymeric membrane oxygenator that facilitates the O₂/CO₂ exchange with the blood. Despite the considerable improvement in anti-thrombogenic biomaterials in other applications (e.g., stents), AL research has not advanced at the same rate. This is partly because AL research requires interdisciplinary knowledge in biomaterials and membrane technology. Some of the promising biomaterials with reasonable hemocompatibility - such as emerging fluoropolymers of extremely low surface energy - must first be fabricated into membranes to exhibit effective gas exchange performance. As AL membranes must also demonstrate high hemocompatibility in tandem, it is essential to test the membranes using in-vitro hemocompatibility experiments before in-vivo test. Hence, it is vital to have a reliable in-vitro experimental protocol that can be reasonably correlated with the in-vivo results. However, current in-vitro AL studies are unsystematic to allow a consistent comparison with in-vivo results. More specifically, current literature on AL biomaterial in-vitro hemocompatibility data are not quantitatively comparable due to the use of unstandardized and unreliable protocols. Such a wide gap has been the main bottleneck in the improvement of AL research, preventing promising biomaterials from reaching clinical trials. This review summarizes the current state-of-the-art and status of AL technology from membrane researcher perspectives. Particularly, most of the reported in-vitro experiments to assess AL membrane hemocompatibility are compiled and critically compared to suggest the most reliable method suitable for AL biomaterial research. Also, a brief review of current approaches to improve AL hemocompatibility is summarized. STATEMENT OF SIGNIFICANCE: The importance of Artificial Lung (AL) technology has been re-emphasized in the time of the COVID-19 pandemic. The utmost bottleneck in the current AL technology is the poor hemocompatibility of the polymer membrane used for O₂/CO₂ gas exchange, limiting its use in the long-term. Unfortunately, most of the in-vitro AL experiments are unsystematic, irreproducible, and unreliable. There are no standardized in-vitro hemocompatibility characterization protocols for quantitative comparison between AL biomaterials. In this review, we tackled this bottleneck by compiling the scattered in-vitro data and suggesting the most suitable experimental protocol to obtain reliable and comparable hemocompatibility results. To the best of our knowledge, this is the first review paper focusing on the hemocompatibility challenge of AL technology.

Synthesis and Characterization of Silver and Graphene Nanocomposites and Their Antimicrobial and Photocatalytic Potentials

Microbial pathogens and bulk amounts of industrial toxic wastes in water are an alarming situation to humans and a continuous threat to aquatic life. In this study, multifunctional silver and graphene nanocomposites (Ag)_1−x(GNPs)_x [25% (x = 0.25), 50% (x = 0.50) and 75% (x = 0.75) of GNPs] were synthesized via ex situ approach. Further, the synthesized nanocomposites were explored for their physicochemical characteristics, such as vibrational modes (Raman spectroscopic analysis), optical properties (UV visible spectroscopic analysis), antibacterial and photocatalytic applications. We investigated the antimicrobial activity of silver and graphene nanocomposites (Ag-GNPs), and the results showed that Ag-GNPs nanocomposites exhibit remarkably improved antimicrobial activity (28.78% (E. coli), 31.34% (S. aureus) and 30.31% (P. aeruginosa) growth inhibition, which might be due to increase in surface area of silver nanoparticles (AgNPs)). Furthermore, we investigated the photocatalytic activity of silver (AgNPs) and graphene (GNPs) nanocomposites in varying ratios. Interestingly, the Ag-GNPs nanocomposites show improved photocatalytic activity (78.55% degradation) as compared to AgNPs (54.35%), which can be an effective candidate for removing the toxicity of dyes. Hence, it is emphatically concluded that Ag-GNPs hold very active behavior towards the decolorization of dyes and could be a potential candidate for the treatment of wastewater and possible pathogenic control over microbes. In the future, we also recommend different other in vitro biological and environmental applications of silver and graphene nanocomposites.

Three lines of defense: A multifunctional coating with anti-adhesion, bacteria-killing and anti-quorum sensing properties for preventing biofilm formation of Pseudomonas aeruginosa

Surfaces of synthetic materials are highly susceptible to pathogenic bacteria colonization and further biofilm formation, leading to device failure in both biomedical and industrial applications. Complete elimination of the mature biofilms formed on the surfaces, however, remains a great challenge due to the complexity of chemical composition and physical structure. Therefore, prevention of biofilm formation becomes a preferred strategy for solving the biofilm-associated problems. Herein, a multifunctional coating showing three lines of defense to prevent biofilm formation of Pseudomonas aeruginosa is fabricated by a simple and versatile method. This coating is composed of multilayers of quaternized chitosan with bactericidal property and acylase with anti-quorum sensing property and a topmost layer of hyaluronic acid with anti-adhesion property. The substrate deposited with this coating could suppress initial adhesion of a majority of bacteria, and then kill the attached bacteria and interfere with their quorum sensing systems related to biofilm formation. The results of short-term antibacterial experiments show that our coating reduced 98 ± 2% of attached live bacteria. In long-term antibiofilm experiments, this "three lines of defense" design endows the coating with enhanced antibiofilm property against the biofilm formation for at least 3 days by reducing 98 ± 1% of bacterial proliferation and 71 ± 2% of biomass production. Benefiting from the natural building blocks with good biocompatibility and the versatile and environmentally friendly preparation method, this coating shows negligible cytotoxicity and broad applicability, providing great potential for a variety of biomedical applications. STATEMENT OF SIGNIFICANCE: Pathogenic biofilms formed on the surfaces of medical devices and materials pose an urgent problem, and it remains challenging to treat and eradicate the established biofilms. Herein, we developed an antibiofilm coating showing three lines of defense to prevent biofilm formation, which could be deposited on diverse substrates via a simple and versatile method. This coating was based on three natural materials with anti-adhesive, bactericidal, and anti-quorum sensing properties and showed different function in a self-adaptive way to target the sequential stages of biofilm formation by preventing initial bacterial adhesion, killing attached bacteria and interfering with their quorum sensing system to inhibit bacterial proliferation and biofilm maturation. This coating with improved antibiofilm performance might provide a simple and reliable solution to the problems associated with biofilm on surfaces.

Supramolecular Adhesive Materials with Antimicrobial Activity for Emerging Biomedical Applications

Traditional adhesives or glues such as cyanoacrylates, fibrin glue, polyethylene glycol, and their derivatives have been widely used in biomedical fields. However, they still suffer from numerous limitations, including the mechanical mismatch with biological tissues, weak adhesion on wet surfaces, biological incompatibility, and incapability of integrating desired multifunction. In addition to adaptive mechanical and adhesion properties, adhesive biomaterials should be able to integrate multiple functions such as stimuli-responsiveness, control-releasing of small or macromolecular therapeutic molecules, hosting of various cells, and programmable degradation to fulfill the requirements in the specific biological systems. Therefore, rational molecular engineering and structural designs are required to facilitate the development of functional adhesive materials. This review summarizes and analyzes the current supramolecular design strategies of representative adhesive materials, serving as a general guide for researchers seeking to develop novel adhesive materials for biomedical applications.

Metal organic framework-based antibacterial agents and their underlying mechanisms

Bacteria, as the most abundant living organisms, have always been a threat to human life until the development of antibiotics. However, with the wide use of antibiotics over a long time, bacteria have gradually gained tolerance to antibiotics, further aggravating threat to human beings and environmental safety significantly. In recent decades, new bacteria-killing methods based on metal ions, hyperthermia, free radicals, physical pricks, and the coordination of several multi-mechanisms have attracted increasing attention. Consequently, multiple types of new antibacterial agents have been developed. Among them, metal organic frameworks (MOFs) appear to play an increasingly important role. The unique characteristics of MOFs make them suitable multiple-functional platforms. By selecting the appropriate metastable coordination bonds, MOFs can act as reservoirs and release antibacterial metal ions or organic linkers; by constructing a porous structure, MOFs can act as carriers for multiple types of agents and achieve slow and sustained release; and by designing their composition and the pore structure precisely, MOFs can be endowed with properties to produce heat and free radicals under stimulation. Importantly, in combination with other materials, MOFs can act as a platform to kill bacteria effectively through the synergistic effect of multiple types of mechanisms. In this review, we focus on the recent development of MOF-based antibacterial agents, which are classified according to their antibacterial mechanisms.

Special Issue: Advances in Engineered Nanostructured Antibacterial Surfaces and Coatings

Pathogenic biofilm formation is a major issue of concern in various sectors such as healthcare and medicine, food safety and the food industry, wastewater treatment and drinking water distribution systems, and marine biofouling [...]

Grafted Chitosan-Hyaluronic Acid (CS-g-poly (MA-co-AN) HA) Complex Inhibits Fluconazole-Resistant Candida albicans Biofilm Formation

Fungal resistance that leads to the failure of drug therapy due to biofilm development is a major clinical challenge. Various polysaccharides have been used to control biofilm formation by drug-resistant fungi, and this study was undertaken to develop chitosan (CS)-modified materials and evaluate their abilities to inhibit Candida biofilm growth. CS was grafted with methacrylamide (MA) and acrylonitrile (AN) and, to improve its application characteristics further, was grafted with hyaluronic acid to produce CS-g-poly (MA-co-AN) HA complex. Grafting and complex formation were confirmed using spectroscopic techniques. CS-g-poly (MA-co-AN) HA was tested to investigate its ability to inhibit Candida albicans biofilm formation and showed significant antibiofilm activity at 200 µg/mL. Additionally, CS-g-poly (MA-co-AN) HA did not have any toxic effect on Caenorhabditis elegans. Thus, this study provides an innovative means of preventing microorganism-associated biofilm formation.

Zwitterionic Conducting Polymers: From Molecular Design, Surface Modification, and Interfacial Phenomenon to Biomedical Applications

Conducting polymers (CPs) have gained attention as electrode materials in bioengineering mainly because of their mechanical softness compared to conventional inorganic materials. To achieve better performance and broaden bioelectronics applications, the surface modification of soft zwitterionic polymers with antifouling properties represents a facile approach to preventing unwanted nonspecific protein adsorption and improving biocompatibility. This feature article emphasizes the antifouling properties of zwitterionic CPs, accompanied by their molecular synthesis and surface modification methods and an analysis of the interfacial phenomenon. Herein, commonly used methods for zwitterionic functionalization on CPs are introduced, including the synthesis of zwitterionic moieties on CP molecules and postsurface modification, such as the grafting of zwitterionic polymer brushes. To analyze the chain conformation, the structure of bound water in the vicinity of zwitterionic CPs and biomolecule behavior, such as protein adsorption or cell adhesion, provide critical insights into the antifouling properties. Integrating these characterization techniques offers general guidelines and paves the way for designing new zwitterionic CPs for advanced biomedical applications. Recent advances in newly designed zwitterionic CP-based electrodes have demonstrated outstanding potential in modern biomedical applications.

Microwave-assisted synthesis of Ag/ZnO nanoparticles using Averrhoa carambola fruit extract as the reducing agent and their application in cotton fabrics with antibacterial and UV-protection properties

This is the first time Averrhoa carambola fruit extract has been used as a reducing agent to synthesize Ag/ZnO composites for coating cotton to develop antibacterial activity and UV protection under domestic microwave irradiation. The effects of the molar concentration of silver nitrate solutions, applied power, reaction duration, and pH on the yield of nanoparticles were determined. The treated fabrics were subjected to the investigation of surface morphology and chemical structure using SEM and EDX techniques, respectively. The antibacterial activity of the ZnO NPs and the Ag/ZnO nanocomposite coated on cotton fabric was evaluated against E. coli and S. aureus using the agar well diffusion method. The results revealed good antibacterial activity in the cotton fabric treated with the Ag-doped ZnO composite. The stability of the Ag/ZnO nanocomposite coated fabrics was determined by a wash durability test, the results of which demonstrated that this fabric could retain good antibacterial activity even after 20 wash cycles. The UV-blocking capacity of the treated fabrics was evaluated based on the ultraviolet protection factor (UPF) value determined in the range of 280-400 nm. The UPF value determined for the Ag/ZnO-coated fabric was 69.67 ± 1.53, which indicated an excellent ability to block UV radiation. Collectively, these results demonstrated the Ag/ZnO nanocomposite prepared in the present study as a promising material for preparing textiles with good antibacterial activity and UV protection.

A Metal‐Ion‐Incorporated Mussel‐Inspired Poly(Vinyl Alcohol)‐Based Polymer Coating Offers Improved Antibacterial Activity and Cellular Mechanoresponse Manipulation

Cobalt (Co^II) ions have been an attractive candidate for the biomedical modification of orthopedic implants for decades. However, limited research has been performed into how immobilized Co^II ions affect the physical properties of implant devices and how these changes regulate cellular behavior. In this study we modified biocompatible poly(vinyl alcohol) with terpyridine and catechol groups (PVA‐TP‐CA) to create a stable surface coating in which bioactive metal ions could be anchored, endowing the coating with improved broad‐spectrum antibacterial activity against Escherichia coli and Staphylococcus aureus, as well as enhanced surface stiffness and cellular mechanoresponse manipulation. Strengthened by the addition of these metal ions, the coating elicited enhanced mechanosensing from adjacent cells, facilitating cell adhesion, spreading, proliferation, and osteogenic differentiation on the surface coating. This dual‐functional PVA‐TP‐CA/Co surface coating offers a promising approach for improving clinical implantation outcomes.