Rationally designed dual functional block copolymers for bottlebrush-like coatings: In vitro and in vivo antimicrobial, antibiofilm, and antifouling properties

Cathelicidin LL-37 Expression in Human Breast Implant Capsules

BACKGROUND

Capsular contracture is the most common complication following breast implant placement. Cathelicidin LL-37 is a cationic peptide involved in innate immunity. Initially investigated for its antimicrobial role, it was found to have pleiotropic activities, such as immunomodulation, angiogenesis stimulation, and tissue healing. The aim of the study was to investigate the expression and localization of LL-37 in human breast implant capsules and its relationship with capsular formation, remodeling, and clinical outcomes.

METHODS

The study enrolled 28 women (29 implants) who underwent expander substitution with definitive implant. Contracture severity was evaluated. Specimens were stained with hematoxylin and eosin, Masson trichrome, immunohistochemistry, and immunofluorescence for LL-37, CD68, α-smooth muscle actin, collagen type I and type III, CD31, and Toll-like receptor-4.

RESULTS

LL-37 was expressed in macrophages and myofibroblasts of capsular tissue in 10 (34%) and nine (31%) of the specimens, respectively. In eight cases (27.5%), it was expressed by both macrophages and myofibroblasts of the same specimen. In infected capsules, expression by both cell types was found in all (100%) specimens. LL-37 expression by myofibroblasts positively correlated with its expression by macrophages ( P < 0.001). Moreover, LL-37 expression by macrophages of periexpander capsules negatively correlated with the severity of capsular contracture on definitive implants ( P = 0.04).

CONCLUSIONS

This study demonstrates the expression of LL-37 in macrophages and myofibroblasts of capsular tissue and its negative correlation with the severity of capsular contracture following permanent implant placement. Expression or up-regulation of LL-37 may be involved in myofibroblast and macrophage modulation, thus playing a role in the pathogenic fibrotic process underlying capsular contracture.

CLINICAL RELEVANCE STATEMENT

This is the first study to demonstrate LL37 expression in capsular tissue and to hypothesize its role in contracture and as a prognostic marker for contracture severity. If confirmed, medical strategies or implant coating could be implemented to reduce the risk of contracture for high-risk patients.

Fabrication of silicon-based nickel nanoflower-encapsulated gelatin microspheres as an active antimicrobial carrier

Local antibiotic application might mitigate the burgeoning problem of rapid emergence of antibiotic resistance in pathogenic microbes. To accomplish this, delivery systems must be engineered. Hydrogels have a wide range of physicochemical properties and can mimic the extracellular matrix, rendering them promising materials for local antibacterial agent application. Here, we synthesized antibacterial silicon (Si)-based nickel (Ni) nanoflowers (Si@Ni) and encapsulated them in gelatin methacryloyl (GelMA) using microfluidic and photo-crosslink technology, constructing uniform micro-sized hydrogel spheres (Si@Ni-GelMA). Si@Ni and Si@Ni-GelMA were characterized using X-ray diffraction, transmission electron microscopy, and scanning electron microscopy. Injectable Si@Ni-GelMA exhibited excellent antibacterial activities owing to the antibiotic effect of Ni against Pseudomonas aeruginosa, Klebsiella pneumoniae, and methicillin-resistant Staphylococcus aureus, while showing negligible cytotoxicity. Therefore, the Si@Ni-GelMA system can be used as drug carriers owing to their injectability, visible light-mediated crosslinking, degradation, biosafety, and superior antibacterial properties.

Tackling catheter-associated urinary tract infections with next-generation antimicrobial technologies

Urinary catheters and other medical devices associated with the urinary tract such as stents are major contributors to nosocomial urinary tract infections (UTIs) as they provide an access path for pathogens to enter the bladder. Considering that catheter-associated urinary tract infections (CAUTIs) account for approximately 75% of UTIs and that UTIs represent the most common type of healthcare-associated infections, novel anti-infective device technologies are urgently required. The rapid rise of antimicrobial resistance in the context of CAUTIs further highlights the importance of such preventative strategies. In this review, the risk factors for pathogen colonization in the urinary tract are dissected, taking into account the nature and mechanistics of this unique environment. Moreover, the most promising next-generation preventative strategies are critically assessed, focusing in particular on anti-infective surface coatings. Finally, emerging approaches in this field and their likely clinical impact are examined.

Current status of development and biomedical applications of peptide-based antimicrobial hydrogels

Microbial contamination poses a serious threat to human life and health. Through the intersection of material science and modern medicine, advanced bionic hydrogels have shown great potential for biomedical applications due to their unique bioactivity and ability to mimic the extracellular matrix environment. In particular, as a promising antimicrobial material, the synthesis and practical biomedical applications of peptide-based antimicrobial hydrogels have drawn increasing research interest. The synergistic effect of peptides and hydrogels facilitate the controlled release of antimicrobial agents and mitigation of their biotoxicity while achieving antimicrobial effects and protecting the active agents from degradation. This review reports on the progress and trends of researches in the last five years and provides a brief outlook, aiming to provide theoretical background on peptide-based antimicrobial hydrogels and make suggestions for future related work.

Facile Construction of Antimicrobial Surface via One-Step Co-Deposition of Peptide Polymer and Dopamine

The infections associated with implantable medical devices can greatly affect the therapeutic effect and impose a heavy financial burden. Therefore, it is of great significance to develop antimicrobial biomaterials for the prevention and mitigation of healthcare-associated infections. Here, a facile construction of antimicrobial surface via one-step co-deposition of peptide polymer and dopamine is reported. The co-deposition of antimicrobial peptide polymer DLL60 BLG40 with dopamine (DA) on the surface of thermoplastic polyurethane (TPU) provides peptide polymer-modified TPU surface (TPU-DLL60 BLG40 ). The antimicrobial test shows that the TPU-DLL60 BLG40 surfaces of the sheet and the catheter both exhibit potent killing of 99.9% of methicillin-resistant Staphylococcus aureus (MRSA) and Escherichia coli (E. coli). In addition, the TPU-DLL60 BLG40 surface also exhibits excellent biocompatibility. This one-step antimicrobial modification method is fast and efficient, implies promising application in surface antimicrobial modification of implantable biomaterials and medical devices.

Exposure to endocrine disruptors promotes biofilm formation and contributes to increased virulence of Pseudomonas aeruginosa

Anthropogenic activities contribute to the spread of chemicals considered as endocrine disruptors (ED) in freshwater ecosystems. While several studies have reported interactions of EDs with organisms in those ecosystems, very few have assessed the effect of these compounds on pathogenic bacteria. Here we have evaluated the impact of five EDs found in aquatic resources on the virulence of human pathogen P. aeruginosa. ED concentrations in French aquatic resources of bisphenol A (BPA), dibutyl phthalate (DBP), ethylparaben (EP), methylparaben (MP) and triclosan (TCS) at mean molar concentration were 1.13, 3.58, 0.53, 0.69, and 0.81 nM respectively. No impact on bacterial growth was observed at EDs highest tested concentration. Swimming motility of P. aeruginosa decreased to 28.4% when exposed to EP at 100 μM. Swarming motility increased, with MP at 1 nM, 10 and 100 μM (1.5-fold); conversely, a decrease of 78.5%, with DBP at 100 μM was observed. Furthermore, exposure to 1 nM BPA, DBP and EP increased biofilm formation. P. aeruginosa adhesion to lung cells was two-fold higher upon exposure to 1 nM EP. We demonstrate that ED exposure may simultaneously decrease mobility and increase cell adhesion and biofilm formation, which may promote colonisation and establishment of the pathogen.

Surface Engineering of Central Venous Catheters via Combination of Antibacterial Endothelium-Mimicking Function and Fibrinolytic Activity for Combating Blood Stream Infection and Thrombosis

Long-term blood-contacting devices (e.g., central venous catheters, CVCs) still face the highest incidence of blood stream infection and thrombosis in clinical application. To effectively address these complications, this work reports a dual-functional surface engineering strategy for CVCs by organic integration of endothelium-mimicking and fibrinolytic functions. In this proposal, a lysine (Lys)/Cu2+ -incorporated zwitterionic polymer coating (defined as PDA/Lys/Cu-SB) is designed and robustly fabricated onto commercial CVCs using a facile two-step process. Initially, adhesive ene-functionalized dopamine is covalently reacted with Lys and simultaneously coordinated with bactericidal Cu2+ ions, leading to the deposition of a PDA/Lys/Cu coating on CVCs through mussel foot protein inspired surface chemistry. Next, zwitterionic poly(sulfobetaine methacrylate) (pSB) brushes are grafted onto the PDA/Lys/Cu coating to endow lubricant and antifouling properties. In the final PDA/Lys/Cu-SB coating, endothelium-mimicking function is achieved by combining the catalytic generation of nitric oxide from the chelated Cu2+ with antifouling pSB brushes, which led to significant prevention of thrombosis, and bacterial infection in vivo. Furthermore, the immobilized Lys with fibrinolytic activity show remarkably enhanced long-term anti-thrombogenic properties as evidenced in vivo by demonstrating the capability to lyse nascent clots. Therefore, this developed strategy provides a promising solution for long-term blood-contacting devices to combat thrombosis and infection.

Recent Strategies and Future Recommendations for the Fabrication of Antimicrobial, Antibiofilm, and Antibiofouling Biomaterials

Biomaterials and biomedical devices induced life-threatening bacterial infections and other biological adverse effects such as thrombosis and fibrosis have posed a significant threat to global healthcare. Bacterial infections and adverse biological effects are often caused by the formation of microbial biofilms and the adherence of various biomacromolecules, such as platelets, proteins, fibroblasts, and immune cells, to the surfaces of biomaterials and biomedical devices. Due to the programmed interconnected networking of bacteria in microbial biofilms, they are challenging to treat and can withstand several doses of antibiotics. Additionally, antibiotics can kill bacteria but do not prevent the adsorption of biomacromolecules from physiological fluids or implanting sites, which generates a conditioning layer that promotes bacteria's reattachment, development, and eventual biofilm formation. In these viewpoints, we highlighted the magnitude of biomaterials and biomedical device-induced infections, the role of biofilm formation, and biomacromolecule adhesion in human pathogenesis. We then discussed the solutions practiced in healthcare systems for curing biomaterials and biomedical device-induced infections and their limitations. Moreover, this review comprehensively elaborated on the recent advances in designing and fabricating biomaterials and biomedical devices with these three properties: antibacterial (bacterial killing), antibiofilm (biofilm inhibition/prevention), and antibiofouling (biofouling inhibition/prevention) against microbial species and against the adhesion of other biomacromolecules. Besides we also recommended potential directions for further investigations.

Design of Microstructure-Engineered Polymers for Energy and Environmental Conservation

With the ever-growing demand for sustainability, designing polymeric materials using readily accessible feedstocks provides potential solutions to address the challenges in energy and environmental conservation. Complementing the prevailing strategy of varying chemical composition, engineering microstructures of polymer chains by precisely controlling their chain length distribution, main chain regio-/stereoregularity, monomer or segment sequence, and architecture creates a powerful toolbox to rapidly access diversified material properties. In this Perspective, we lay out recent advances in utilizing appropriately designed polymers in a wide range of applications such as plastic recycling, water purification, and solar energy storage and conversion. With decoupled structural parameters, these studies have established various microstructure-function relationships. Given the progress outlined here, we envision that the microstructure-engineering strategy will accelerate the design and optimization of polymeric materials to meet sustainability criteria.

Brush Polymer Coatings with Hydrophilic Main-Chains for Improving Surface Antibacterial Properties

Polymer coatings with improved surface antibacterial properties are of great importance for the application and development of implantable medical devices. Herein, we report the design, preparation, and antibacterial properties of a series of brush polymers (Dex-KEs) with hydrophilic dextran main-chains and mixed-charge polypeptide (KE) side-chains. Dex-KEs showed higher bactericidal activity and antifouling and antibiofilm properties than maleic acid modified dextran (Dex-Ma), KE, Dex-Ma/KE blend coatings, and brush polymer coatings with hydrophobic main-chains (AcDex-KEs). They also showed negligible in vitro cytotoxicity toward different mammalian cells and good in vivo biocompatibility. Dex-KE-coated implants exhibited potent in vivo resistance to bacterial infection before or after implantation.

Self-Assembly of Antimicrobial Peptide-Based Micelles Breaks the Limitation of Trypsin

Targeting the limitation of antimicrobial peptides (AMPs) application in vivo, self-assembled AMPs library with specific nanostructures is expected to gradually overtake monomer AMPs libraries in the future. Peptide polymers are fascinating self-assembling nanoscale structures that have great advantage in biomedical applications because of their satisfactory biocompatibility and versatile properties. Herein, we describe a strategy for inducing the self-assembly of T9W into nanostructured antimicrobial micelles with evidently improved pharmacological properties, that is, PEGylation at the C-terminal of T9W (CT9W₁₀₀₀), an antibacterial biomaterial that self-assembles in aqueous media without exogenous excipients, has been developed. Compared with parental molecular, the CT9W₁₀₀₀ is more effective against Pseudomonas aeruginosa, and its antibacterial spectrum had also been broadened. Additionally, CT9W₁₀₀₀ micelles had higher stability under salt ion, serum, and acid-base environments. Importantly, the self-assembled structure is highly resistant to trypsin degradation, probably allowing T9W to be applied in clinical settings in the future. Mechanistically, by acting on membranes and through supplementary bactericidal mechanisms, CT9W₁₀₀₀ micelles contribute to the antibacterial process. Collectively, CT9W₁₀₀₀ micelles exhibited good biocompatibility in vitro and in vivo, resulting in highly effective treatment in a mouse acute lung injury model induced by P. aeruginosa PAO1 without drug resistance. These advances may profoundly accelerate the clinical transformation of T9W and promote the development of a combination of peptide-based antibiotics and PEGylated nanotechnology.

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.

Multifunctionalized carbon-fiber-reinforced polyetheretherketone implant for rapid osseointegration under infected environment

Carbon fiber reinforced polyetheretherketone (CFRPEEK) possesses a similar elastic modulus to that of human cortical bone and is considered as a promising candidate to replace metallic implants. However, the bioinertness and deficiency of antibacterial activities impede its application in orthopedic and dentistry. In this work, titanium plasma immersion ion implantation (Ti-PIII) is applied to modify CFRPEEK, achieving unique multi-hierarchical nanostructures and active sites on the surface. Then, hybrid polydopamine (PDA)@ZnO-EDN1 nanoparticles (NPs) are introduced to construct versatile surfaces with improved osteogenic and angiogenic properties and excellent antibacterial properties. Our study established that the modified CFRPEEK presented favorable stability and cytocompatibility. Compared with bare CFRPEEK, improved osteogenic differentiation of rat mesenchymal stem cells (BMSCs) and vascularization of human umbilical vein endothelial cells (HUVECs) are found on the functionalized surface due to the zinc ions and EDN1 releasing. In vitro bacteriostasis assay confirms that hybrid PDA@ZnO NPs on the functionalized surface provided an effective antibacterial effect. Moreover, the rat infected model corroborates the enhanced antibiosis and osteointegration of the functionalized CFRPEEK. Our findings indicate that the multilevel nanostructured PDA@ZnO-EDN1 coated CFRPEEK with enhanced antibacterial, angiogenic, and osteogenic capacity has great potential as an orthopedic/dental implant material for clinical application.

Research progress of stimulus-responsive antibacterial materials for bone infection

Infection is one of the most serious complications harmful to human health, which brings a huge burden to human health. Bone infection is one of the most common and serious complications of fracture and orthopaedic surgery. Antibacterial treatment is the premise of bone defect healing. Among all the antibacterial strategies, irritant antibacterial materials have unique advantages and the ability of targeted therapy. In this review, we focus on the research progress of irritating materials, the development of antibacterial materials and their advantages and disadvantages potential applications in bone infection.

Temperature-Responsive Polymer Brush Coatings for Advanced Biomedical Applications

Modern biomedical technologies predict the application of materials and devices that not only can comply effectively with specific requirements, but also enable remote control of their functions. One of the most prospective materials for these advanced biomedical applications are materials based on temperature-responsive polymer brush coatings (TRPBCs). In this review, methods for the fabrication and characterization of TRPBCs are summarized, and possibilities for their application, as well as the advantages and disadvantages of the TRPBCs, are presented in detail. Special attention is paid to the mechanisms of thermo-responsibility of the TRPBCs. Applications of TRPBCs for temperature-switchable bacteria killing, temperature-controlled protein adsorption, cell culture, and temperature-controlled adhesion/detachment of cells and tissues are considered. The specific criteria required for the desired biomedical applications of TRPBCs are presented and discussed.

Recent Developments in Multifunctional Antimicrobial Surfaces and Applications toward Advanced Nitric Oxide-Based Biomaterials

Implant-associated infections arising from biofilm development are known to have detrimental effects with compromised quality of life for the patients, implying a progressing issue in healthcare. It has been a struggle for more than 50 years for the biomaterials field to achieve long-term success of medical implants by discouraging bacterial and protein adhesion without adversely affecting the surrounding tissue and cell functions. However, the rate of infections associated with medical devices is continuously escalating because of the intricate nature of bacterial biofilms, antibiotic resistance, and the lack of ability of monofunctional antibacterial materials to prevent the colonization of bacteria on the device surface. For this reason, many current strategies are focused on the development of novel antibacterial surfaces with dual antimicrobial functionality. These surfaces are based on the combination of two components into one system that can eradicate attached bacteria (antibiotics, peptides, nitric oxide, ammonium salts, light, etc.) and also resist or release adhesion of bacteria (hydrophilic polymers, zwitterionic, antiadhesive, topography, bioinspired surfaces, etc.). This review aims to outline the progress made in the field of biomedical engineering and biomaterials for the development of multifunctional antibacterial biomedical devices. Additionally, principles for material design and fabrication are highlighted using characteristic examples, with a special focus on combinational nitric oxide-releasing biomedical interfaces. A brief perspective on future research directions for engineering of dual-function antibacterial surfaces is also presented.

Recent Development of Polydopamine Anti-Bacterial Nanomaterials

Polydopamine (PDA), as a mussel-inspired material, exhibits numerous favorable performance characteristics, such as a simple preparation process, prominent photothermal transfer efficiency, excellent biocompatibility, outstanding drug binding ability, and strong adhesive properties, showing great potential in the biomedical field. The rapid development of this field in the past few years has engendered substantial progress in PDA antibacterial materials. This review presents recent advances in PDA-based antimicrobial materials, including the preparation methods and antibacterial mechanisms of free-standing PDA materials and PDA-based composite materials. Furthermore, the urgent challenges and future research opportunities for PDA antibacterial materials are discussed.

Injectable hyaluronic acid hydrogel encapsulated with Si-based NiO nanoflower by visible light cross-linking: Its antibacterial applications

Bacterial infections have become a severe threat to human health and antibiotics have been developed to treat them. However, extensive use of antibiotics has led to multidrug-resistant bacteria and reduction of their therapeutic effects. An efficient solution may be localized application of antibiotics using a drug delivery system. For clinical application, they need to be biodegradable and should offer a prolonged antibacterial effect. In this study, a new injectable and visible-light-crosslinked hyaluronic acid (HA) hydrogel loaded with silicon (Si)-based nickel oxide (NiO) nanoflowers (Si@NiO) as an antibacterial scaffold was developed. Si@NiO nanoflowers were synthesized using chemical bath deposition before encapsulating them in the HA hydrogel under a mild visible-light-crosslinking conditions to generate a Si@NiO-hydrogel. Si@NiO synthesis was confirmed using scanning electron microscopy, transmission electron microscopy, and powder X-ray diffraction. As-prepared Si@NiO-hydrogel exhibited enhanced mechanical properties compared to a control bare hydrogel sample. Moreover, Si@NiO-hydrogel exhibits excellent antibacterial properties against three bacterial strains (P. aeruginosa, K. pneumoniae, and methicillin-resistant Staphylococcus aureus (>99.9% bactericidal rate)) and negligible cytotoxicity toward mouse embryonic fibroblasts. Therefore, Si@NiO-hydrogel has the potential for use in tissue engineering and biomedical applications owing to its injectability, visible-light crosslink ability, degradability, biosafety, and superior antibacterial property.

Stimuli-Responsive Antibacterial Materials: Molecular Structures, Design Principles, and Biomedical Applications

Infections are regarded as the most severe complication associated with human health, which are urgent to be solved. Stimuli-responsive materials are appealing therapeutic platforms for antibacterial treatments, which provide great potential for accurate theranostics. In this review, the advantages, the response mechanisms, and the key design principles of stimuli-responsive antibacterial materials are highlighted. The biomedical applications, the current challenges, and future directions of stimuli-responsive antibacterial materials are also discussed. First, the categories of stimuli-responsive antibacterial materials are comprehensively itemized based on different sources of stimuli, including external physical environmental stimuli (e.g., temperature, light, electricity, salt, etc.) and bacterial metabolites stimuli (e.g., acid, enzyme, redox, etc.). Second, structural characteristics, design principles, and biomedical applications of the responsive materials are discussed, and the underlying interrelationships are revealed. The molecular structures and design principles are closely related to the sources of stimuli. Finally, the challenging issues of stimuli-responsive materials are proposed. This review will provide scientific guidance to promote the clinical applications of stimuli-responsive antibacterial materials.

Rational design of dual-functional surfaces on polypropylene with antifouling and antibacterial performances via a micropatterning strategy

The hydrophobicity and inertness of the polypropylene (PP) material surface usually lead to serious biofouling and bacterial infections, which hamper its potential application as a biomedical polymer. Many strategies have been developed to improve its antifouling or antibacterial properties, yet designing a surface to achieve both antifouling and antibacterial performances simultaneously remains a challenge. Herein, we construct a dual-function micropatterned PP surface with antifouling and antibacterial properties through plasma activation, photomask technology and ultraviolet light-induced graft polymerization. Based on the antifouling agent poly(2-methacryloyloxyethyl phosphate choline) (PMPC) and the antibacterial agent quaternized poly(N,N-dimethylamino)ethyl methacrylate (QPDMAEMA), two different micropatterning structures have been successfully prepared: PP-PMPC-QPDMAEMA in which QPDMAEMA is the micropattern and PMPC is the coating polymer, and PP-QPDMAEMA-PMPC in which PMPC is the micropattern and QPDMAEMA is the coating polymer. The composition, elemental distribution and surface morphology of PP-PMPC-QPDMAEMA and PP-QPDMAEMA-PMPC have been thoroughly characterized by Fourier transform infrared (FT-IR) spectroscopy, X-ray photoelectron spectroscopy (XPS) and scanning electron microscopy (SEM), respectively. Compared with pristine PP, the two types of micropatterned PP films exhibit good surface hydrophilicity as characterized by water contact angle measurements. The results of anti-protein adsorption, platelet adhesion and antibacterial evaluation showed that PP-PMPC-QPDMAEMA and PP-QPDMAEMA-PMPC had good anti-protein adsorption properties, especially for lysozyme (Lyz). They can effectively prevent platelet adhesion, and the anti-platelet adhesion performance of PP-QPDMAEMA-PMPC is slightly better than that of the PP-PMPC-QPDMAEMA sample. The sterilization rate of S. aureus and E. coli is as high as 95% for the two types of micropatterned PP films. Due to the rational design of micropatterns on the PP surface, the two classes of dual-functional PP materials realize both the resistance of protein and platelet adhesion, and the killing of bacteria at the same time. We anticipate that this work could provide a design strategy for the construction of multifunctional biomedical polymer materials.

Preparation of a Novel Type of Zwitterionic Polymer and the Antifouling PDMS Coating

As awareness of environmental protection increases, environmentally friendly coatings have been receiving great interest. Zwitterionic polymers are considered promising candidates due to their biocompatibility and excellent antifouling properties. In this paper, a type of polypeptoid containing zwitterions on the side chain was synthesized via ring-opening polymerization (ROP) and post-modification. This obtained polypeptoid was subsequently grafted onto the surface of polydimethylsiloxane (PDMS) via plasma and UV-induced surface polymerization. Surface morphology and protein adsorption tests of the resulting coating were systematically carried out. The results show that the modified coating has excellent antifouling properties and thus has great potential for environmentally friendly coating applications.

Imidazolium-Based Polypeptide Coating with a Synergistic Antibacterial Effect and a Biofilm-Responsive Property

Surface modification with cationic polymer coatings represented an important strategy to address the medical device-related infection issues. However, limited antibacterial activities and high cytotoxicity have hampered their development. Herein, we report a facile method to enhance the surface antibacterial activity by construction of an imidazolium-based polypeptide with fosfomycin counteranions (i.e., S₄-PIL-FS). The polypeptide coating displayed a synergistic antibacterial effect from the combination of membrane disruption and inhibition of initial cell wall synthesis, leading to higher in vitro and in vivo surface antibacterial activities than cationic polypeptide or fosfomycin sodium alone. S₄-PIL-FS also showed a decrease in the hemolytic ratio and cytotoxicity toward different mammalian cells. Moreover, we observed an interesting biofilm-responsive property of S₄-PIL-FS originating from the esterase-induced cleavages of side-chain ester bonds that enabled an antibiofilm property of the cationic polypeptide coating.

Biocompatible Materials in Otorhinolaryngology and Their Antibacterial Properties

For decades, biomaterials have been commonly used in medicine for the replacement of human body tissue, precise drug-delivery systems, or as parts of medical devices that are essential for some treatment methods. Due to rapid progress in the field of new materials, updates on the state of knowledge about biomaterials are frequently needed. This article describes the clinical application of different types of biomaterials in the field of otorhinolaryngology, i.e., head and neck surgery, focusing on their antimicrobial properties. The variety of their applications includes cochlear implants, middle ear prostheses, voice prostheses, materials for osteosynthesis, and nasal packing after nasal/paranasal sinuses surgery. Ceramics, such as as hydroxyapatite, zirconia, or metals and metal alloys, still have applications in the head and neck region. Tissue engineering scaffolds and drug-eluting materials, such as polymers and polymer-based composites, are becoming more common. The restoration of life tissue and the ability to prevent microbial colonization should be taken into consideration when designing the materials to be used for implant production. The authors of this paper have reviewed publications available in PubMed from the last five years about the recent progress in this topic but also establish the state of knowledge of the most common application of biomaterials over the last few decades.

Antimicrobial Peptides and Macromolecules for Combating Microbial Infections: From Agents to Interfaces

Bacterial resistance caused by the overuse of antibiotics and the shelter of biofilms has evolved into a global health crisis, which drives researchers to continuously explore antimicrobial molecules and strategies to fight against drug-resistant bacteria and biofilm-associated infections. Cationic antimicrobial peptides (AMPs) are considered to be a category of potential alternative for antibiotics owing to their excellent bactericidal potency and lesser likelihood of inducing drug resistance through their distinctive antimicrobial mechanisms. In this review, the hitherto reported plentiful action modes of AMPs are systematically classified into 15 types and three categories (membrane destructive, nondestructive membrane disturbance, and intracellular targeting mechanisms). Besides natural AMPs, cationic polypeptides, synthetic polymers, and biopolymers enable to achieve tunable antimicrobial properties by optimizing their structures. Subsequently, the applications of these cationic antimicrobial agents at the biointerface as contact-active surface coatings and multifunctional wound dressings are also emphasized here. At last, we provide our perspectives on the development of clinically significant cationic antimicrobials and related challenges in the translation of these materials.

"Dual-functional" strontium titanate nanotubes designed based on fusion peptides simultaneously enhancing anti-infection and osseointegration

Currently, there is an increasing clinical demand for implants that effectively resist bacterial infections while promoting osseointegration. In this study, the fusion peptide technology was used to linearly fuse the antimicrobial peptide (AMP, HHC36) and the bone-promoting peptide (RGD), so that the titanium (Ti)-based implant modified by the polypeptide had the dual function of "antibacterial-promoting bone". Firstly, self-organized vertically-oriented strontium-doped titanium dioxide nanotubes (STN) were manufactured by anodizing and hydrothermal synthesis methods. Secondly, the fusion peptide (HHC36-RGD) was loaded into the tubular structure by a simple vacuum-assisted physical adsorption method. Finally, STN loaded with HHC36-RGD (H-R-STN) was obtained. The characterization results demonstrated that the surface of the H-R-STN had a roughness and hydrophilicity that promoted cell adhesion. Additionally, electrochemical tests showed that H-R-STN coating can reduce the corrosion rate of pure Ti. The fusion peptide and Sr²⁺ in H-R-STN were released in the initial fast and subsequent slow kinetic model. Expected, H-R-STN can kill more than 99% of clinically common pathogenic bacteria (Staphylococcus aureus and Escherichia coli), and significantly inhibit the formation of bacterial biofilms. Simultaneously, under the synergistic effect of RGD in the fusion peptide and strontium in STN, H-R-STN markedly promoted the adhesion and proliferation of mouse osteoblasts, and significantly promoted osteogenic markers (alkaline phosphatase, runt-related transcription, collagen, mineralization) expression. In summary, the bifunctional titanium-based implant constructed by H-R-STN in this article can effectively prevent bacterial infections and promote early osseointegration. The main advantage of the titanium surface treatment method of the study was that its simplicity, low cost, especially its versatility made it a promising anti-infective bone repair material.

A Self-defense Hierarchical Antibacterial Surface with Inherent Antifouling and Bacteria-activated Bactericidal Properties for Infection Resistance

Biomedical device-associated infection (BAI) is one of the main reasons for the function failure of implants in clinic practices. Development of high-efficiency antibacterial materials is of great significance to reduce...

Biomaterial-based delivery of antimicrobial therapies for the treatment of bacterial infections

The rise in antibiotic-resistant bacteria, including strains that are resistant to last-resort antibiotics, and the limited ability of antibiotics to eradicate biofilms, have necessitated the development of alternative antibacterial therapeutics. Antibacterial biomaterials, such as polycationic polymers, and biomaterial-assisted delivery of non-antibiotic therapeutics, such as bacteriophages, antimicrobial peptides and antimicrobial enzymes, have improved our ability to treat antibiotic-resistant and recurring infections. Biomaterials not only allow targeted delivery of multiple agents, but also sustained release at the infection site, thereby reducing potential systemic adverse effects. In this Review, we discuss biomaterial-based non-antibiotic antibacterial therapies for the treatment of community- and hospital-acquired infectious diseases, with a focus in in vivo results. We highlight the translational potential of different biomaterial-based strategies, and provide a perspective on the challenges associated with their clinical translation. Finally, we discuss the future scope of biomaterial-assisted antibacterial therapies.

WEB SUMMARY

The development of antibiotic tolerance and resistance has demanded the search for alternative antibacterial therapies. This Review discusses antibacterial biomaterials and biomaterial-assisted delivery of non-antibiotic therapeutics for the treatment of bacterial infectious diseases, with a focus on clinical translation.

A multifunctional colorimetric sensor array for bacterial identification and real-time bacterial elimination to prevent bacterial contamination

The constructed sensor array has simple operation and successfully integrates bacterial identification and inactivation.

Crosslinked polypeptide films via RAFT mediated continuous assembly of polymers

Polypeptide coatings are a cornerstone in the field of surface modification due to their widespread biological potential. As their properties are dictated by their structural features, subsequent control thereof using unique fabrication strategies is important. Herein, we report a facile method of precisely creating densely crosslinked polypeptide films with unusually high random coil conformations through continuous assembly polymerization via reversible addition-fragmentation chain transfer (CAP-RAFT). CAP-RAFT was fundamentally investigated using methacrylated poly- L -lysine (PLLMA) and methacrylated poly- L -glutamic acid (PLGMA). Careful technique refinement resulted in films up to 36.1 ± 1.1 nm thick which could be increased to 94.9 ± 8.2 nm after using this strategy multiple times. PLLMA and PLGMA films were found to have 30-50% random coil conformations. Degradation by enzymes present during wound healing reveals potential for applications in drug delivery and tissue engineering.

Hybrid "Kill and Release" Antibacterial Cellulose Papers Obtained via Surface-Initiated Atom Transfer Radical Polymerization

Infectious diseases triggered by bacteria cause a severe risk to human health. To counter this issue, surfaces coated with antibacterial materials have been widely used in daily life to kill these bacteria. The substrates enabled with a hybrid kill and release strategy can be employed not only to kill the bacteria but also to wash them using external stimuli (temperature, pH, etc.). Utilizing this concept, we develop thermoresponsive antibacterial-cellulose papers to exhibit hybrid kill and release properties. Thermoresponsive copolymers [p(NIPAAm-co-AEMA)] are grafted on cellulose papers using a surface-initiated atom transfer radical polymerization approach for bacterial debris release. Later for antibacterial properties, silver nanoparticles (AgNPs) are immobilized on thermoresponsive copolymer-grafted cellulose papers using electrostatic interactions. We confirm the thermoresponsive copolymer grafting and AgNP coating by attenuated total reflection Fourier transform infrared spectroscopy, X-ray photoelectron spectroscopy, and scanning electron microscopy. Thermoresponsiveness and reusability of the modified cellulose papers are confirmed through water contact angle measurements. The interaction potency between AgNPs and modified cellulose is validated by inductively coupled plasma atomic emission spectroscopy analysis. Gram-negative bacteria Escherichia coli (E. coli DH5-α) is used to demonstrate antibacterial hybrid kill and release performance. Agar-diffusion testing demonstrates the antibacterial nature of the modified cellulose papers. The fluorescence micrograph reveals that modified cellulose papers can effectively release almost all the dead bacterial debris from their surfaces after thermal stimulus wash. The modified cellulose paper surfaces are expected to have wide applications in the field of exploring more antibacterial and smart surfaces.

Universal Antifouling and Photothermal Antibacterial Surfaces Based on Multifunctional Metal-Phenolic Networks for Prevention of Biofilm Formation

Biofilms formed from the pathogenic bacteria that attach to the surfaces of biomedical devices and implantable materials result in various persistent and chronic bacterial infections, posing serious threats to human health. Compared to the elimination of matured biofilms, prevention of the formation of biofilms is expected to be a more effective way for the treatment of biofilm-associated infections. Herein, we develop a facile method for endowing diverse substrates with long-term antibiofilm property by deposition of a hybrid film composed of tannic acid/Cu ion (TA/Cu) complex and poly(ethylene glycol) (PEG). In this system, the TA/Cu complex acts as a multifunctional building block with three different roles: (i) as a versatile "glue" with universal adherent property for substrate modification, (ii) as a photothermal biocidal agent for bacterial elimination under irradiation of near-infrared (NIR) laser, and (iii) as a potent linker for immobilization of PEG with inherent antifouling property to inhibit adhesion and accumulation of bacteria. The resulted hybrid film shows negligible cytotoxicity and good histocompatibility and could prevent biofilm formation for at least 15 days in vitro and suppress bacterial infection in vivo, showing great potential for practical applications to solve the biofilm-associated problems of biomedical materials and devices.

Single-Chain Nanoparticle-Based Coatings with Improved Bactericidal Activity and Antifouling Properties

Dual-function antibacterial surfaces have exhibited promising potential in addressing implant-associated infections. However, both bactericidal and antifouling properties need to be further improved prior to practical uses. Herein, we report the preparation and properties of a linear block copolymer coating (LP-KF) and a single-chain nanoparticle coating (NP-KF) with poly(ethylene glycol) (PEG) and cationic polypeptide segments. NP-KF with cyclic PEG segments and densely charged polypeptide segments was expected to display improved bactericidal and antifouling properties. LP-KF was prepared by the combination of ring-opening polymerization of N-carboxyanhydride (NCA) monomers and subsequent deprotection. NP-KF was prepared by intramolecular cross-linking of LP-KF in diluted solutions. Both LP-KF- and NP-KF-coated PDMS surfaces were prepared by dipping with polydopamine-coated surfaces. They showed superior in vitro bactericidal activity against both Staphylococcus aureus and Escherichia coli with >99.9% killing efficacy, excellent protein adsorption resistance, antibacterial adhesion, and low cytotoxicity. The NP-KF coating showed higher bactericidal activity and antifouling properties than its linear counterpart. It also showed significant anti-infective property and histocompatibility in vivo, which makes it a good candidate for implants and biomedical device applications.

Molecular engineering of antimicrobial peptide (AMP)-polymer conjugates

As antimicrobial resistance becomes an increasing threat, bringing significant economic and health burdens, innovative antimicrobial treatments are urgently needed. While antimicrobial peptides (AMPs) are promising therapeutics, exhibiting high activity against resistant bacterial strains, limited stability and toxicity to mammalian cells has hindered clinical development. Attaching AMPs to polymers provides opportunities to present AMPs in a way that maximizes bacterial killing while enhancing compatibility with mammalian cells, stability, and solubility. Conjugation of an AMP to a linear hydrophilic polymer yields the desired improvements in stability, mammalian cell compatibility, and solubility, yet often markedly reduces bactericidal effects. Non-linear polymer architectures and supramolecular assemblies that accommodate multiple AMPs per polymer chain afford AMP-polymer conjugates that strike a superior balance of antimicrobial activity, mammalian cell compatibility, stability, and solubility. Therefore, we review the design criteria, building blocks, and synthetic strategies for engineering AMP-polymer conjugates, emphasizing the connection between molecular architecture and antimicrobial performance to inspire and enable further innovation to advance this emerging class of biomaterials.

Three-dimensionally printable shear-thinning triblock copolypeptide hydrogels with antimicrobial potency

Through rational design, block sequence controlled triblock copolypeptides comprising cysteine and tyrosine as well as a lysine or glutamic acid central block are devised. In these copolypeptides, each block contributes a specific property to the hydrogels to render them extrusion printable and antimicrobial. Three-dimensional (3D) printing of complex hydrogel structures with high shape retention is demonstrated. Moreover, composition dependent potent antimicrobial activity in contact-killing assays is elucidated.

Poly(α-l-lysine)-based nanomaterials for versatile biomedical applications: Current advances and perspectives

Poly(α-l-lysine) (PLL) is a class of water-soluble, cationic biopolymer composed of α-l-lysine structural units. The previous decade witnessed tremendous progress in the synthesis and biomedical applications of PLL and its composites. PLL-based polymers and copolymers, till date, have been extensively explored in the contexts such as antibacterial agents, gene/drug/protein delivery systems, bio-sensing, bio-imaging, and tissue engineering. This review aims to summarize the recent advances in PLL-based nanomaterials in these biomedical fields over the last decade. The review first describes the synthesis of PLL and its derivatives, followed by the main text of their recent biomedical applications and translational studies. Finally, the challenges and perspectives of PLL-based nanomaterials in biomedical fields are addressed.

High-throughput screening and rational design of biofunctionalized surfaces with optimized biocompatibility and antimicrobial activity

Peptides are widely used for surface modification to develop improved implants, such as cell adhesion RGD peptide and antimicrobial peptide (AMP). However, it is a daunting challenge to identify an optimized condition with the two peptides showing their intended activities and the parameters for reaching such a condition. Herein, we develop a high-throughput strategy, preparing titanium (Ti) surfaces with a gradient in peptide density by click reaction as a platform, to screen the positions with desired functions. Such positions are corresponding to optimized molecular parameters (peptide densities/ratios) and associated preparation parameters (reaction times/reactant concentrations). These parameters are then extracted to prepare nongradient mono- and dual-peptide functionalized Ti surfaces with desired biocompatibility or/and antimicrobial activity in vitro and in vivo. We also demonstrate this strategy could be extended to other materials. Here, we show that the high-throughput versatile strategy holds great promise for rational design and preparation of functional biomaterial surfaces.

The recent advances in surface antibacterial strategies for biomedical catheters

As one of the most common hospital-acquired infections, catheter-related infections (CRIs) which are caused by microbial colonization lead to increasing morbidity and mortality of patients and life threat for medical staffs. In this case, a variety of efforts have been made to design functional materials to limit bacterial colonization and biofilm formation. In this review, we focus on the recent advances in surface modification strategies of biomedical catheters used to prevent CRIs. The tests for the evaluation of the performances of modified catheters are listed. Future prospects of surface antibacterial strategies for biomedical catheters are also outlined.

A multifunctional shape-adaptive and biodegradable hydrogel with hemorrhage control and broad-spectrum antimicrobial activity for wound healing

Hemorrhage is the leading cause of preventable death of injured military and civilian patients, and subsequent infection risks endanger their lives or impede the healing of their wounds. Here, we report an injectable biodegradable hydrogel with hemostatic, antimicrobial, and healing-promoting properties. The hydrogel was prepared by dynamic cross-linking of a natural polysaccharide (dextran) with antimicrobial peptide ε-poly-l-lysine (EPL) and encapsulating base fibroblast growth factor (bFGF). The amino groups of EPL were allowed to react with the aldehyde of oxidized dextran (OD) through the Schiff-base reaction for the generation of hydrogels that have fast self-healing and injectable characteristics and adapt to the shapes of wounds. The prepared OD/EPL hydrogels promoted blood clotting in vitro and stopped bleeding in a rat liver injury model within 6 min through their platelet-aggregating ability and sealing effect. These hydrogels exhibited inherent antimicrobial effects without the use of antibiotics and effectively killed a broad spectrum of pathogenic microbes, including Gram-positive methicillin-resistant Staphylococcus aureus (MRSA), Gram-negative Escherichia coli, and Pseudomonas aeruginosa and fungus Candida albicans in vitro. Moreover, these OD/EPL hydrogels were compatible with mammalian cells in vitro and in vivo and biodegradable in the mouse body. The loaded bFGF can be released sustainably, and it can promote angiogenesis, endothelial cell migration, and consequently accelerate the healing of wounds. The OD/EPL hydrogel inhibited MRSA infection in a rat full-thickness skin wound model and promoted healing. This kind of multifunctional hydrogel is a promising wound dressing for the emergency treatment of acute deep or penetrating injuries.

Design of nanoengineered antibacterial polymers for biomedical applications

Pathogenic bacteria have become global threats to public health. Since the advent of antibiotics about 100 years ago, their use has been embraced with great enthusiasm because of their effective treatment of bacterial infections. However, the evolution of pathogenic bacteria with resistance to conventional antibiotics has resulted in an urgent need for the development of a new generation of antibiotics. The use of antimicrobial polymers offers the promise of enhancing the efficacy of antimicrobial agents. Of the various antibacterial polymers that effectively eradicate pathogenic bacteria, those that are nanoengineered have garnered significant research interest in their design and biomedical applications. Because of their high surface area and high reactivity, these polymers show greater antibacterial activity than conventional antibacterial agents, by inhibiting the growth or destroying the cell membrane of pathogenic bacteria. This review summarizes several strategies for designing nanoengineered antibacterial polymers, explores the factors that affect their antibacterial properties, and examines key features of their design. It then comments briefly on the future prospects for nanoengineered antibacterial polymers. This review thus provides a feasible guide to developing nanoengineered antibacterial polymers by presenting both broad and in-depth bench research, and it offers suggestions for their potential in biomedical applications.

Antimicrobial Polymeric Structures Assembled on Surfaces

Pathogenic microbes are the main cause of various undesired infections in living organisms, including humans. Most of these infections are favored in hospital environments where humans are being treated with antibiotics and where some microbes succeed in developing resistance to such drugs. As a consequence, our society is currently researching for alternative, yet more efficient antimicrobial solutions. Certain natural and synthetic polymers are versatile materials that have already proved themselves to be highly suitable for the development of the next-generation of antimicrobial systems that can efficiently prevent and kill microbes in various environments. Here, we discuss the latest developments of polymeric structures, exhibiting (reinforced) antimicrobial attributes that can be assembled on surfaces and coatings either from synthetic polymers displaying antiadhesive and/or antimicrobial properties or from blends and nanocomposites based on such polymers.

Multifunctional natural polymer-based metallic implant surface modifications

High energy traumas could cause critical damage to bone, which will require permanent implants to recover while functionally integrating with the host bone. Critical sized bone defects necessitate the use of bioactive metallic implants. Because of bioinertness, various methods involving surface modifications such as surface treatments, the development of novel alloys, bioceramic/bioglass coatings, and biofunctional molecule grafting have been utilized to effectively integrate metallic implants with a living bone. However, the applications of these methods demonstrated a need for an interphase layer improving bone-making to overcome two major risk factors: aseptic loosening and peri-implantitis. To accomplish a biologically functional bridge with the host to prevent loosening, regenerative cues, osteoimmunomodulatory modifications, and electrochemically resistant layers against corrosion appeared as imperative reinforcements. In addition, interphases carrying antibacterial cargo were proven to be successful against peri-implantitis. In the literature, metallic implant coatings employing natural polymers as the main matrix were presented as bioactive interphases, enabling rapid, robust, and functional osseointegration with the host bone. However, a comprehensive review of natural polymer coatings, bridging and grafting on metallic implants, and their activities has not been reported. In this review, state-of-the-art studies on multifunctional natural polymer-based implant coatings effectively utilized as a bone tissue engineering (BTE) modality are depicted. Protein-based, polysaccharide-based coatings and their combinations to achieve better osseointegration via the formation of an extracellular matrix-like (ECM-like) interphase with gap filling and corrosion resistance abilities are discussed in detail. The hypotheses and results of these studies are examined and criticized, and the potential future prospects of multifunctional coatings are also proposed as final remarks.

Advances of peptides for antibacterial applications

In the past few decades, peptide antibacterial products with unique antibacterial mechanisms have attracted widespread interest. They can effectively reduce the probability of drug resistance of bacteria and are biocompatible, so they possess tremendous development prospects. This review provides recent research and analysis on the basic types of antimicrobial peptides (including poly (amino acid)s, short AMPs, and lipopeptides) and factors to optimize antimicrobial effects. It also summarizes the two most important modes of action of antimicrobial peptides and the latest developments in the application of AMPs, including antimicrobial agent, wound healing, preservative, antibacterial coating and others. Finally, we discuss the remaining challenges to improve the antibacterial peptides and propose prospects in the field.

Synthetic Antimicrobial Polymers in Combination Therapy: Tackling Antibiotic Resistance

Antibiotic resistance is a critical global healthcare issue that urgently needs new effective solutions. While small molecule antibiotics have been safeguarding us for nearly a century since the discovery of penicillin by Alexander Fleming, the emergence of a new class of antimicrobials in the form of synthetic antimicrobial polymers, which was driven by the advances in controlled polymerization techniques and the desire to mimic naturally occurring antimicrobial peptides, could play a key role in fighting multidrug resistant bacteria in the near future. By harnessing the ability to control chemical and structural properties of polymers almost at will, synthetic antimicrobial polymers can be strategically utilized in combination therapy with various antimicrobial coagents in different formats to yield more potent (synergistic) outcomes. In this review, we present a short summary of the different combination therapies involving synthetic antimicrobial polymers, focusing on their combinations with nitric oxide, antibiotics, essential oils, and metal- and carbon-based inorganics.

Mussel-Inspired Polymeric Coatings to Realize Functions from Single and Dual to Multiple Antimicrobial Mechanisms

Numerous efforts to fabricate antimicrobial surfaces by simple yet universal protocols with high efficiency have attracted considerable interest but proved to be particularly challenging. Herein, we designed and fabricated a series of antimicrobial polymeric coatings with different functions from single to multiple mechanisms by selectively utilizing diethylene glycol diglycidyl ether (PEGDGE), polylysine, and poly[glycidylmethacrylate-co-3-(dimethyl(4-vinylbenzyl)ammonium)propyl sulfonate] (poly(GMA-co-DVBAPS)) via straightforward mussel-inspired codeposition techniques. Bactericidal polylysine endowed the modified surfaces with a high ability (∼90%) to kill attached bacteria, while PEGDGE components with unique surface hydration prevented bacterial adhesion, avoiding the initial biofilm formation. Moreover, excellent salt-responsive poly(GMA-co-DVBAPS) enabled reactant polymeric coatings to change chain conformations from shrinkable to stretchable state and subsequently release >90% attached bacteria when treated with NaCl solution, even after repeated cycles. Therefore, the obtained polymeric coatings, polydopamine/poly(GMA-co-DVBAPS) (PDA/PDV), polydopamine/polylysine/poly(GMA-co-DVBAPS) (PDA/l-PDV), and polydopamine/polylysine/poly(GMA-co-DVBAPS)/diethylene glycol diglycidyl ether (PDA/l-PDV-PEGDGE), controllably realized functions from single and dual to multiple antimicrobial mechanisms, as evidenced by long-term antifouling activity to bacteria, high bactericidal efficiency, and salt-responsive bacterial regeneration performance with several bacterial killing-release cycles. This study not only contributes to mussel-inspired chemistry for polymeric coatings with controllable functions but also provides a series of reliable and highly efficient antimicrobial surfaces for potential biomedical applications.