Hydrophilic surface coatings with embedded biocidal silver nanoparticles and sodium heparin for central venous catheters

Developments and Trends of Nanotechnology Application in Sepsis: A Comprehensive Review Based on Knowledge Visualization Analysis

Sepsis, a common life-threatening clinical condition, continues to have high morbidity and mortality rates, despite advancements in management. In response, significant research efforts have been directed toward developing effective strategies. Within this scope, nanotechnology has emerged as a particularly promising field, attracting significant interest for its potential to enhance disease diagnosis and treatment. While several reviews have highlighted the use of nanoparticles in sepsis, comprehensive studies that summarize and analyze the hotspots and research trends are lacking. To identify and further promote the development of nanotechnology in sepsis, a bibliometric analysis was conducted on the relevant literature, assessing research trends and hotspots in the application of nanomaterials for sepsis. Next, a comprehensive review of the subjectively recognized research hotspots in sepsis, including nanotechnology-enhanced biosensors and nanoscale imaging for sepsis diagnostics, and nanoplatforms designed for antimicrobial, immunomodulatory, and detoxification strategies in sepsis therapy, is elucidated, while the potential side effects and toxicity risks of these nanomaterials were discussed. Particular attention is given to biomimetic nanoparticles, which mimic the biological functions of source cells like erythrocytes, immune cells, and platelets to evade immune responses and effectively deliver therapeutic agents, demonstrating substantial translational potential. Finally, current challenges and future perspectives of nanotechnology applications in sepsis with a view to maximizing their great potential in the research of translational medicine are also discussed.

An in situ grown ultrathin and robust protein nanocoating for mitigating thromboembolic issues associated with cardiovascular medical devices

Thromboembolism, arising from the utilization of cardiovascular medical devices, remains a prevalent issue entailing substantial morbidity and mortality. Despite the proposal of various surface modification strategies, each approach possesses inherent limitations and drawbacks. Herein, we propose a novel approach for the in situ growth of nanocoatings on various material surfaces through the cooperative assembly of silk fibroin (SF) and lysozyme. The intrinsic in situ growth characteristic enables the nanocoatings to achieve stable and uniform adherence to diverse substrate surfaces, including the inner surface of intravascular catheters, to redefine the surface properties of the material. The features of the hydrophilic and negatively charged nanocoating contribute to its antithrombotic properties, as evidenced by the reduced likelihood of platelet adhesion upon modification of the ultrathin and mechanically robust coating. In vitro assessment confirms a significant reduction in blood clot formation along with the promotion of anticoagulation. Such a SF/Ly nanocoating holds substantial promise as a surface modification strategy to enhance the hemocompatibility of medical devices and other materials that come into contact with blood, particularly in situations where medical-grade materials are temporarily unavailable, thus providing a feasible alternative.

Zwitterionic surface chemistry enhances detachment of bacteria under shear

The ubiquitous nature of microorganisms, especially of biofilm-forming bacteria, makes biofouling a prevalent challenge in many settings, including medical and industrial environments immersed in liquid and subjected to shear forces. Recent studies have shown that zwitterionic groups are effective in suppressing bacteria and protein adhesion as well as biofilm growth. However, the effect of zwitterionic groups on the removal of surface-bound bacteria has not been extensively studied. Here we present a microfluidic approach to evaluate the effectiveness in facilitating bacteria detachment by shear of an antifouling surface treatment using (3-(dimethyl;(3-trimethoxysilyl)propyl)ammonia propane-1-sulfonate), a sulfobetaine silane (SBS). Control studies show that SBS-functionalized surfaces greatly increase protein (bovine serum albumin) removal upon rinsing. On the same surfaces, enhanced bacteria (Pseudomonas aeruginosa) removal is observed under shear. To quantify this enhancement a microfluidic shear device is employed to investigate how SBS-functionalized surfaces promote bacteria detachment under shear. By using a microfluidic channel with five shear zones, we compare the removal of bacteria from zwitterionic and glass surfaces under different shear rates. At times of 15 min, 30 min, and 60 min, bacteria adhesion on SBS-functionalized surfaces is reduced relative to the control surface (glass) under quiescent conditions. However, surface-associated bacteria on the SBS-functionalized glass and control show similar percentages of live cells, suggesting minimal intrinsic biocidal effect from the SBS-functionalized surface. Notably, when exposed to shear rates ranging from 104 to 105 s-1, significantly fewer bacteria remain on the SBS-functionalized surfaces. These results demonstrate the potential of zwitterionic sulfobetaine as effective antifouling coatings that facilitate the removal of bacteria under shear.

Retardation of Bacterial Biofilm Formation by Coating Urinary Catheters with Metal Nanoparticle-Stabilized Polymers

Urinary catheter infections remain an issue for many patients and can complicate their health status, especially for individuals who require long-term catheterization. Catheters can be colonized by biofilm-forming bacteria resistant to the administered antibiotics. Therefore, this study aimed to investigate the efficacy of silver nanoparticles (AgNPs) stabilized with different polymeric materials generated via a one-step simple coating technique for their ability to inhibit biofilm formation on urinary catheters. AgNPs were prepared and characterized to confirm their formation and determine their size, charge, morphology, and physical stability. Screening of the antimicrobial activity of nanoparticle formulations and determining minimal inhibitory concentration (MIC) and their cytotoxicity against PC3 cells were performed. Moreover, the antibiofilm activity and efficacy of the AgNPs coated on the urinary catheters under static and flowing conditions were examined against a clinical isolate of Escherichia coli. The results showed that the investigated polymers could form physically stable AgNPs, especially those prepared using polyvinyl pyrrolidone (PVP) and ethyl cellulose (EC). Preliminary screening and MIC determinations suggested that the AgNPs-EC and AgNPs-PVP had superior antibacterial effects against E. coli. AgNPs-EC and AgNPs-PVP inhibited biofilm formation to 58.2% and 50.8% compared with AgNPs-PEG, silver nitrate solution and control samples. In addition, coating urinary catheters with AgNPs-EC and AgNPs-PVP at concentrations lower than the determined IC50 values significantly (p < 0.05; t-test) inhibited bacterial biofilm formation compared with noncoated catheters under both static and static and flowing conditions using two different types of commercial Foley urinary catheters. The data obtained in this study provide evidence that AgNP-coated EC and PVP could be useful as potential antibacterial and antibiofilm catheter coating agents to prevent the development of urinary tract infections caused by E. coli.

A sulfonate-based polypeptide toward infection-resistant coatings

Multifunctional coatings have gained significant attention for their promising potential to address the issue of medical device-related infections. However, they usually have multiple components in one layer which decreases the density of functional groups on surfaces and hence reduces the biological properties. Herein, we report a mono-component and sulfonate-based anionic polypeptide coating with on-demand antibacterial activity, antifouling property, and biocompatibility. The anionic polypeptide was prepared by ring-opening polymerization of L-cysteine-based N-carboxyanhydride (NCA) with allyl groups and a subsequent thiol-ene reaction to incorporate the sulfonate pendants. It adopted a 17.1-19.5% β-sheet conformation and self-assembled into a spherical nanoparticle. The polypeptide coating showed excellent in vitro antibacterial activity against both Gram-positive (i.e., S. aureus) and Gram-negative bacteria (i.e., E. coli) with >99% killing efficacy after acidic solution treatment and prominent antifouling property and biocompatibility after weak base treatment. An in vivo study revealed that the sulfonate-based polypeptide-coated polydimethylsiloxane (PDMS) exhibited good anti-infection property and histocompatibility.

The prospects of antimicrobial coated medical implants

The implants are increasingly being a part of modern medicine in various surgical procedures for functional or cosmetic purposes. The progressive use of implants is associated with increased infectious complications and prevention of such infections always remains precedence in the clinical settings. The preventive approaches include the systemic administration of antimicrobial agents before and after the surgical procedures as well as the local application of antibiotics. The relevant literature and existing clinical practices have highlighted the role of antimicrobial coating approaches in the prevention of implants associated infections, although the applications of these strategies are not yet standardized, and the clinical efficacy is not much clear. The adequate data from the randomized control trials is challenging because of the unavailability of a large sample size although it is compulsory in this context to assess the clinical efficacy of preemptive practices. This review compares the efficacy of preventive approaches and the prospects of antimicrobial-coated implants in preventing implant-related infections.

Recent updates in the polysaccharides-based Nano-biocarriers for drugs delivery and its application in diseases treatment: A review

With people's increasing awareness of diseases treatment, the researchers began to focus on drug delivery to the exact site of action at the optimal rate. Some researchers have proved that many nanostructures loaded with drugs are significantly better than conventional nanostructures. However, the materials from which the nanostructure determines its performance. To use it as a pharmaceutical ingredient, it must meet strict safety regulatory standards worldwide. Therefore, people's attention has paid to easily available natural substances. As far as we know, bioactive polysaccharides are excellent candidates for realizing these purposes. To be precise, due to the natural availability of polysaccharides, it has been widely used in the research of Nano-biocarriers loaded with drugs. Based on the above analysis, the nanomaterials developed through the laboratory have great potential for upgrading to market products. Therefore, it is of great significance to review the latest progress of polysaccharide-based Nano-biocarriers in drug delivery and their application in diseases treatment. In this work, we focused on the preparation of polysaccharides-based Nano-biocarriers, commonly used polysaccharides for preparing Nano-biocarriers, and drugs loaded on polysaccharides-based Nano-biocarriers to treat diseases. Shortly, polysaccharide-based Nano-biocarriers will be increasingly used in drug delivery and treatment of diseases.

Characteristics and therapeutic applications of antimicrobial peptides

The demand for novel antimicrobial compounds is rapidly growing due to the phenomenon of antibiotic resistance in bacteria. In response, numerous alternative approaches are being taken including use of polymers, metals, combinatorial approaches, and antimicrobial peptides (AMPs). AMPs are a naturally occurring part of the immune system of all higher organisms and display remarkable broad-spectrum activity and high selectivity for bacterial cells over host cells. However, despite good activity and safety profiles, AMPs have struggled to find success in the clinic. In this review, we outline the fundamental properties of AMPs that make them effective antimicrobials and extend this into three main approaches being used to help AMPs become viable clinical options. These three approaches are the incorporation of non-natural amino acids into the AMP sequence to impart better pharmacological properties, the incorporation of AMPs in hydrogels, and the chemical modification of surfaces with AMPs for device applications. These approaches are being developed to enhance the biocompatibility, stability, and/or bioavailability of AMPs as clinical options.

Photo-functionalized TiO2 nanotubes decorated with multifunctional Ag nanoparticles for enhanced vascular biocompatibility

Titanium dioxide (TiO2) has a long history of application in blood contact materials, but it often suffers from insufficient anticoagulant properties. Recently, we have revealed the photocatalytic effect of TiO2 also induces anticoagulant properties. However, for long-term vascular implant devices such as vascular stents, besides anticoagulation, also anti-inflammatory, anti-hyperplastic properties, and the ability to support endothelial repair, are desired. To meet these requirements, here, we immobilized silver nanoparticles (AgNPs) on the surface of TiO2 nanotubes (TiO2-NTs) to obtain a composite material with enhanced photo-induced anticoagulant property and improvement of the other requested properties. The photo-functionalized TiO2-NTs showed protein-fouling resistance, causing the anticoagulant property and the ability to suppress cell adhesion. The immobilized AgNPs increased the photocatalytic activity of TiO2-NTs to enhances its photo-induced anticoagulant property. The AgNP density was optimized to endow the TiO2-NTs with anti-inflammatory property, a strong inhibitory effect on smooth muscle cells (SMCs), and low toxicity to endothelial cells (ECs). The in vivo test indicated that the photofunctionalized composite material achieved outstanding biocompatibility in vasculature via the synergy of photo-functionalized TiO2-NTs and the multifunctional AgNPs, and therefore has enormous potential in the field of cardiovascular implant devices. Our research could be a useful reference for further designing of multifunctional TiO2 materials with high vascular biocompatibility.

Surface modification strategies for hemodialysis catheters to prevent catheter-related infections: A review

Insertion of a central venous catheter is one of the most common invasive procedures applied in hemodialysis therapy for end-stage renal disease. The most important complication of a central venous catheter is catheter-related infections that increase hospitalization and duration of intensive care unit stay, cost of treatment, mortality, and morbidity rates. Pathogenic microorganisms, such as, bacteria and fungi, enter the body from the catheter insertion site and the surface of the catheter can become colonized. The exopolysaccharide-based biofilms from bacterial colonies on the surface are the main challenge in the treatment of infections. Catheter lock solutions and systemic antibiotic treatment, which are commonly used in the treatment of hemodialysis catheter-related infections, are insufficient to prevent and terminate the infections and eventually the catheter needs to be replaced. The inadequacy of these approaches in termination and prevention of infection revealed the necessity of coating of hemodialysis catheters with bactericidal and/or antiadhesive agents. Silver compounds and nanoparticles, anticoagulants (e.g., heparin), antibiotics (e.g., gentamicin and chlorhexidine) are some of the agents used for this purpose. The effectiveness of few commercial hemodialysis catheters that were coated with antibacterial agents has been tested in clinical trials against catheter-related infections of pathogenic bacteria, such as Staphylococcus aureus and Staphylococcus epidermidis with promising results. Novel biomedical materials and engineering techniques, such as, surface micro/nano patterning and the conjugation of antimicrobial peptides, enzymes, metallic cations, and hydrophilic polymers (e.g., poly [ethylene glycol]) on the surface, has been suggested recently.

Minimising Blood Stream Infection: Developing New Materials for Intravascular Catheters

Catheter related blood stream infection is an ever present hazard for those patients requiring venous access and particularly for those requiring long term medication. The implementation of more rigorous care bundles and greater adherence to aseptic techniques have yielded substantial reductions in infection rates but the latter is still far from acceptable and continues to place a heavy burden on patients and healthcare providers. While advances in engineering design and the arrival of functional materials hold considerable promise for the development of a new generation of catheters, many challenges remain. The aim of this review is to identify the issues that presently impact catheter performance and provide a critical evaluation of the design considerations that are emerging in the pursuit of these new catheter systems.

The Impact of Engineered Silver Nanomaterials on the Immune System

Over the last decades there has been a tremendous volume of research efforts focused on engineering silver-based (nano)materials. The interest in silver has been mostly driven by the element capacity to kill pathogenic bacteria. In this context, the main area of application has been medical devices that are at significant risk of becoming colonized by bacteria and subsequently infected. However, silver nanomaterials have been incorporated in a number of other commercial products which may or may not benefit from antibacterial protection. The rapid expansion of such products raises important questions about a possible adverse influence on human health. This review focuses on examining currently available literature and summarizing the current state of knowledge of the impact of silver (nano)materials on the immune system. The review also looks at various surface modification strategies used to generate silver-based nanomaterials and the immunomodulatory potential of these materials. It also highlights the immune response triggered by various silver-coated implantable devices and provides guidance and perspective towards engineering silver nanomaterials for modulating immunological consequences.

Multifunctional 3D Micro-Nanostructures Fabricated through Temporally Shaped Femtosecond Laser Processing for Preventing Thrombosis and Bacterial Infection

Blood-contacting medical devices that directly inhibit thrombosis and bacterial infection without using dangerous anticoagulant and antibacterial drugs can save countless lives but have proved extremely challenging. Here, a useful methodology is proposed that employs temporally shaped femtosecond laser ablation combined with fluorination to fabricate multifunctional three-dimensional (3D) micro-nanostructures with excellent hemocompatibility, zero cytotoxicity, outstanding biocompatibility, bacterial infection prevention, and long-term effectiveness on NiTi alloys. These multifunctional 3D micro-nanostructures present 0.1% hemolysis ratio and almost no platelet adhesion and activation, repel blood to inhibit blood coagulation in vitro, maintain 100% cell viability, and have exceptional stability over 6 months. Moreover, the multifunctional 3D micro-nanostructures simultaneously suppress bacterial colonization to form biofilm and kill 100% colonized Pseudomonas aeruginosa (P. aeruginosa) and 95.6% colonized Staphylococcus aureus (S. aureus) after 24 h of incubation, and bacterial residues can be easily removed. The fabrication method in this work has the advantages of simple processing, high efficiency, high quality, and high repeatability, and the new multifunctional 3D micro-nanostructures can effectively prevent thrombosis and bacterial infection, which can be widely applied to various clinical needs such as biomedical devices and implants.

Anti-Methicillin-Resistant Staphylococcus aureus Nanoantibiotics

Nanoparticle-based antibiotic constructs have become a popular area of investigation in the biomedical sciences. Much of this work has pertained to human diseases, largely in the cancer therapy arena. However, considerable research has also been devoted to the nanochemistry for controlling infectious diseases. Among these are ones due to bacterial infections, which can cause serious illnesses leading to death. The onset of multi-drug-resistant (MDR) infections such as those caused by the human pathogen Staphylococcus aureus has created a dearth of problems such as surgical complications, persistent infections, and lack of available treatments. In this article, we set out to review the primary literature on the design and development of new nanoparticle materials for the potential treatment of S. aureus infections, and areas that could be further expanded upon to make nanoparticle antibiotics a mainstay in clinical settings.

Biogenic synthesis of biopolymer-based Ag-Au bimetallic nanoparticle constructs and their anti-proliferative assessment

This study reports an eco-friendly-based method for the preparation of biopolymer Ag-Au nanoparticles (NPs) by using gum kondagogu (GK; Cochlospermum gossypium), as both reducing and protecting agent. The formation of GK-(Ag-Au) NPs was confirmed by UV-absorption, fourier transformed infrared (FTIR), atomic force microscopy (AFM), scanning electron microscope (SEM) and transmission electron microscope (TEM). The GK-(Ag-Au) NPs were of 1-12 nm in size. The anti-proliferative activity of nanoparticle constructs was assessed by MTT assay, confocal microscopy, flow cytometry and quantitative real-time polymerase chain reaction (PCR) techniques. Expression studies revealed up-regulation of p53, caspase-3, caspase-9, peroxisome proliferator-activated receptors (PPAR) PPARa and PPARb, genes and down-regulation of Bcl-2 and Bcl-x(K) genes, in B16F10 cells treated with GK-(Ag-Au) NPs confirming the anti-proliferative properties of the nanoparticles.

Biogenic Nanoparticle‒Chitosan Conjugates with Antimicrobial, Antibiofilm, and Anticancer Potentialities: Development and Characterization

In the 21st century, with ever-increasing consciousness and social awareness, researchers must tackle the microbial infections that pose a major threat to human safety. For many reasons, the emergence/re-emergence of threatening pathogens has increased and poses a serious challenge to health care services. Considering the changing dynamics of 21st-century materials with medical potentialities, the integration of bioactive agents into materials to engineer antibacterial matrices has received limited attention so far. Thus, antimicrobial active conjugates are considered potential candidates to eradicate infections and reduce microbial contaminations in healthcare facilities. In this context, eco-friendly and novel conjugates with antimicrobial, antibiofilm, and anticancer potentialities were developed using biogenic silver nanoparticles (AgNPs) from Convolvulus arvensis (C. arvensis) extract and chitosan (CHI). A range of instrumental and imaging tools, i.e., UV-Vis and FTIR spectroscopy, scanning electron microscopy (SEM), transmission electron microscopy (TEM), energy-dispersive spectroscopy (EDX), and X-ray diffraction (XRD), were employed to characterize the freshly extracted C. arvensis AgNPs. Biogenic AgNPs obtained after a 24-h reaction period were used to engineer CHI-based conjugates and designated as CHI‒AgNPs1 to CHI‒AgNPs5, subject to the C. arvensis AgNPs concentration. After the stipulated loading period, 92% loading efficiency (LE) was recorded for a CHI‒AgNPs3 conjugate. Gram+ and Gram- bacterial isolates, i.e., Staphylococcus aureus, and Escherichia coli, were used to test the antibacterial activities of newly developed CHI‒AgNPs conjugates. In comparison to the control sample with bacterial cell count 1.5 × 10⁸ CFU/mL, a notable reduction in the log values was recorded for the CHI‒AgNPs3 conjugate. The antibiofilm potential of CHI‒AgNPs conjugates was tested against Pseudomonas aeruginosa. Moreover, the CHI‒AgNPs3 conjugate also showed substantial cytotoxicity against the MCF-7 (breast cancer) cell line. In summary, the newly engineered CHI‒AgNPs conjugates with antibacterial, antibiofilm, and anticancer potentialities are potential candidate materials for biomedical applications.

TC4/Ag Metal Matrix Nanocomposites Modified by Friction Stir Processing: Surface Characterization, Antibacterial Property, and Cytotoxicity in Vitro

Numerous antibacterial biomaterials have been developed, but a majority of them suffer from poor biocompatibility. With the purpose of reducing biomaterial-related infection and cytotoxicity, friction stir processing (FSP) was employed to embed silver nanoparticles (Ag NPs) in a Ti-6Al-4V (TC4) substrate. Characterization using scanning electron microscopy, transmission electron microscopy, and three-dimensional atom probe tomography illustrates that NPs are distributed more homogeneously on the surface of TC4 as the groove depth increases, and silver-rich NPs with a size from 10 to 20 nm exist as metallic silver diffused into the substrate, where the silver content is 4.3-5.6%. Electrochemical impedance spectroscopy shows that both FSP and the addition of silver have positive effects on corrosion resistance. The modified samples effectively inhibit both Staphylococcus aureus and Escherichia coli strains and slightly reduce their adhesion while not displaying any cytotoxicity to bone mesenchymal stem cells in vitro. The antibacterial effect is independent of Ag-ion release and is likely due to the number of embedded silver NPs on the surface, which directly contact and subsequently destroy the cell membrane. Our study shows that the TC4/Ag metal matrix nanocomposite is a potential infection-related biomaterial and that embedding Ag NPs tightly on a biomaterial surface is an effective strategy for striking a balance between the antibacterial effect and biocompatibility, providing an innovative approach for accurately controlling the cytotoxicity of infection-related biomaterials.

Tailored antimicrobial activity and long-term cytocompatibility of plasma polymer silver nanocomposites

The deposition of coatings enabling antibacterial properties in combination with cytocompatibility remains a challenge for biomaterial applications, such as in medical devices. Silver is one of the most utilized antibacterial surface components, due to its efficacy and extensive applicability. In this work, silver-containing plasma polymer nanocomposites (single layer and multilayers) were developed and tested, with a focus on cytotoxicity and bactericidal function, on the NIH3T3 mammalian cell line as well as Gram-negative ( Pseudomonas aeruginosa) and Gram-positive ( Staphylococcus aureus) bacterial strains. The data demonstrate that a tuneable Ag⁺ release is required, allowing sufficient antimicrobial activity while retaining appropriate cytocompatibility over the entire testing period of up to eight days.

Biomedical Applications of Silver Nanoparticles: An Up-to-Date Overview

During the past few years, silver nanoparticles (AgNPs) became one of the most investigated and explored nanotechnology-derived nanostructures, given the fact that nanosilver-based materials proved to have interesting, challenging, and promising characteristics suitable for various biomedical applications. Among modern biomedical potential of AgNPs, tremendous interest is oriented toward the therapeutically enhanced personalized healthcare practice. AgNPs proved to have genuine features and impressive potential for the development of novel antimicrobial agents, drug-delivery formulations, detection and diagnosis platforms, biomaterial and medical device coatings, tissue restoration and regeneration materials, complex healthcare condition strategies, and performance-enhanced therapeutic alternatives. Given the impressive biomedical-related potential applications of AgNPs, impressive efforts were undertaken on understanding the intricate mechanisms of their biological interactions and possible toxic effects. Within this review, we focused on the latest data regarding the biomedical use of AgNP-based nanostructures, including aspects related to their potential toxicity, unique physiochemical properties, and biofunctional behaviors, discussing herein the intrinsic anti-inflammatory, antibacterial, antiviral, and antifungal activities of silver-based nanostructures.

Clavanin A-bioconjugated Fe3O4/Silane core-shell nanoparticles for thermal ablation of bacterial biofilms

The use of central venous catheters (CVC) is highly associated with nosocomial blood infections and its use largely requires a systematic assessment of benefits and risks. Bacterial contamination of these tubes is frequent and may result in development of microbial consortia also known as biofilm. The woven nature of biofilm provides a practical defense against antimicrobial agents, facilitating bacterial dissemination through the patient's body and development of antimicrobial resistance. In this work, the authors describe the modification of CVC tubing by immobilizing Fe₃O₄-aminosilane core-shell nanoparticles functionalized with antimicrobial peptide clavanin A (clavA) as an antimicrobial prophylactic towards Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa and Klebsiella pneumoniae. Its anti-biofilm-attachment characteristic relies in clavA natural activity to disrupt the bacterial lipidic membrane. The aminosilane shell prevents iron leaching, which is an important nutrient for bacterial growth. Fe₃O₄-clavA-modified CVCs showed to decrease Gram-negative bacteria attachment up to 90% when compared to control clean CVC. Additionally, when hyperthermal treatment is triggered for 5 min at 80 °C in a tubing that already presents bacterial biofilm (CVC-BF), the viability of attached bacteria reduces up to 88%, providing an efficient solution to avoid changing catheter.

Antimicrobial and Antifouling Strategies for Polymeric Medical Devices

Hospital-acquired infections arising from implanted polymeric medical devices continue to pose a significant challenge for medical professionals and patients. Often times, these infections arise from biofilm accumulation on the device, which is difficult to eradicate and usually requires antibiotic treatment and device removal. In response, significant efforts have been made to design functional polymeric devices or coatings that possess antimicrobial or antifouling properties that limit biofilm formation and subsequent infection by inhibiting or eliminating bacteria near the device surface or by limiting the initial attachment of proteins and bacteria. In this Viewpoint, we highlight the magnitude of device-associated infections, the role of biofilm formation in human pathogenesis, and recent advances in antimicrobial and antifouling polymers, as well as current strategies employed in commercial devices for preventing infection.

Designing polymeric adhesives for antimicrobial materials: poly(ethylene imine) polymer, graphene, graphene oxide and molybdenum trioxide - a biomimetic approach

The synthesis of biocompatible polymers for coating applications has gained significant attention in recent years due to the increasing spread of infectious diseases via contaminated surfaces. One strategy to combat this problem is to apply antimicrobial coatings to surfaces prone to microbial contamination. This study presents a series of biomimetic polymers that can be used as adhesives to immobilize known antimicrobial agents on the surfaces as coatings. Several polymers containing dopamine methacrylate as co-polymers were synthesized and investigated as adhesives for the deposition of an antimicrobial polymer (polyethyleneimine) and antimicrobial nanoparticles (graphene, graphene oxide and molybdenum trioxide) onto glass surfaces. The results showed that different antimicrobials required different types of adhesives for effective coating. Overall, the coatings fabricated from these composites were shown to inactivate E. coli and B. subtilis within 1 h. These coatings were also effective to prevent biofilm growth and demonstrated to be non-toxic to the human corneal epithelial cell line (htCEpi). Leaching tests of the coatings proved that the coatings were stable under biological conditions.

Antifouling and antimicrobial biomaterials: an overview

The use of implantable medical devices is a common and indispensable part of medical care for both diagnostic and therapeutic purposes. However, as side effect, the implant of medical devices quite often leads to the occurrence of difficult-to-treat infections, as a consequence of the colonization of their abiotic surfaces by biofilm-growing microorganisms increasingly resistant to antimicrobial therapies. A promising strategy to combat device-related infections is based on anti-infective biomaterials that either repel microbes, so they cannot attach to the device surfaces, or kill them in the surrounding areas. In general, such biomaterials are characterized by antifouling coatings, exhibiting low adhesion or even repellent properties towards microorganisms, or antimicrobial coatings, able to kill microbes approaching the surface. In this light, the present overview will address the development in the last two decades of antifouling and antimicrobial biomaterials designed to potentially limit the initial stages of microbial adhesion, as well as the microbial growth and biofilm formation on medical device surfaces.

Drug eluting antimicrobial vascular catheters: Progress and promise

Vascular catheters are critical tools in modern healthcare yet present substantial risks of serious bloodstream infections that exact significant health and economic burdens. Drug-eluting antimicrobial vascular catheters have become important tools in preventing catheter-related bloodstream infections and their importance is expected to increase as significant initiatives are expanded to eliminate and make the occurrence of these infections unacceptable. Here we review clinically significant and emerging drug-eluting antimicrobial catheters within the categories of antibiotic, antiseptic, novel bioactive agents and energy-enhanced drug eluting antimicrobial catheters. Important representatives of each category are reviewed from the standpoints of mechanisms of action, physical-chemical properties, safety, in vitro and clinical effectiveness.

A novel in situ silver/hyaluronan bio-nanocomposite fabrics for wound and chronic ulcer dressing: In vitro and in vivo evaluations

In-situ formed hyaluronan/silver (HA/Ag) nanoparticles (NPs) were used to prepare composite fibers/fabrics for the first time. Different concentrations of silver nitrate (1, 2mg/100ml) were added at ambient temperature to sodium hyaluronate solution (40mg/ml), then the pH was increased to 8 by adding sodium hydroxide. The in-situ formed HA/Ag-NPs were used to prepare fibers/nonwoven fabrics by wet-dry-spinning technique (WDST). UV/vis spectroscopy, SEM, TEM, DLS, XPS, XRD and TGA were employed to characterize the structure and composition of the nanocomposite, surface morphology of fiber/fabrics, particle size of Ag-NPs, chemical interactions of Ag⁰ and HA functional groups, crystallinity and thermal stability of the wound dressing, respectively. The resultant HA/Ag-NPs1 and HA/Ag-NPs2 composite showed uniformly dispersed throughout HA fiber/fabrics (SEM), an excellent distribution of Ag-NPs with 25±2, nm size (TEM, DLS) and acceptable mechanical properties. The XRD analysis showed that the in-situ preparation of Ag-NPs increased the crystallinity of the resultant fabrics as well as the thermal stability. The antibacterial performance of medical HA/Ag-NPs fabrics was evaluated against gram negative bacteria E. coli K12, exhibiting significant bactericidal activity. The fibers did not show any cytotoxicity against human keratinocyte cell line (HaCaT). In-vivo animal tests indicated that the prepared wound dressing has strong healing efficacy (non-diabetics/diabetics rat model) compared to the plain HA fabrics and greatly accelerated the healing process. Based on our results, the new HA/Ag-NPs-2mg nonwoven wound dressing fabrics can be used in treating wounds and chronic ulcers as well as cell carrier in different biological research and tissue engineering.

Effect of gelatin sponge with colloid silver on bone healing in infected cranial defects

Oral infectious diseases may lead to bone loss, which makes it difficult to achieve satisfactory restoration. The rise of multidrug resistant bacteria has put forward severe challenges to the use of antibiotics. Silver (Ag) has long been known as a strong antibacterial agent. In clinic, gelatin sponge with colloid silver is used to reduce tooth extraction complication. To investigate how this material affect infected bone defects, methicillin-resistant Staphylococcus aureus (MRSA) infected 3-mm-diameter cranial defects were created in adult female Sprague-Dawley rats. One week after infection, the defects were debrided of all nonviable tissue and then implanted with gelatin sponge with colloid silver (gelatin/Ag group) or gelatin alone (gelatin group). At 2 and 3days after debridement, significantly lower mRNA expression levels of IL-6 and TNF-α and lower plate colony count value were detected in gelatin/Ag group than control. Micro-CT analysis showed a significant increase of newly formed bone volume fraction (BV/TV) in gelatin/Ag treated defects. The HE stained cranium sections also showed a faster rate of defect closure in gelatin/Ag group than control. These findings demonstrated that gelatin sponge with colloid silver can effectively reduce the infection caused by MRSA in cranial defects and accelerate bone healing process.

In vitro and in vivo antimicrobial activity of combined therapy of silver nanoparticles and visible blue light against Pseudomonas aeruginosa

Silver nanoparticles (AgNPs) have been used as potential antimicrobial agents against resistant pathogens. We investigated the possible therapeutic use of AgNPs in combination with visible blue light against a multidrug resistant clinical isolate of Pseudomonas aeruginosa in vitro and in vivo. The antibacterial activity of AgNPs against P. aeruginosa (1×10(5) colony forming unit/mL) was investigated at its minimal inhibitory concentration (MIC) and sub-MIC, alone and in combination with blue light at 460 nm and 250 mW for 2 hours. The effect of this combined therapy on the treated bacteria was then visualized using transmission electron microscope. The therapy was also assessed in the prevention of biofilm formation by P. aeruginosa on AgNP-impregnated gelatin biopolymer discs. Further, in vivo investigations were performed to evaluate the efficacy of the combined therapy to prevent burn-wound colonization and sepsis in mice and, finally, to treat a real infected horse with antibiotic-unresponsive chronic wound. The antimicrobial activity of AgNPs and visible blue light was significantly enhanced (P<0.001) when both agents were combined compared to each agent alone when AgNPs were tested at MIC, 1/2, or 1/4 MIC. Transmission electron microscope showed significant damage to the cells that were treated with the combined therapy compared to other cells that received either the AgNPs or blue light. In addition, the combined treatment significantly (P<0.001) inhibited biofilm formation by P. aeruginosa on gelatin discs compared to each agent individually. Finally, the combined therapy effectively treated a horse suffering from a chronic wound caused by mixed infection, where signs of improvement were observed after 1 week, and the wound completely healed after 4 weeks. To our knowledge, this combinatorial therapy has not been investigated before. It was proved efficient and promising in managing infections caused by multidrug resistant bacteria and could be used as an alternative to conventional antibiotic therapy.

Dual-functional anticoagulant and antibacterial blend coatings based on gemini quaternary ammonium salt waterborne polyurethane and heparin

A simple design of the dual-functional anticoagulant and antibacterial blend coatings with controlled release of heparin.

Silver nanoparticles with different size and shape: equal cytotoxicity, but different antibacterial effects

The influence of silver nanoparticle morphology on their dissolution kinetics in ultrapure water as well as their biological effect on eukaryotic and prokaryotic cells was examined.

Antimicrobial-impregnated central venous catheters for prevention of catheter-related bloodstream infection in newborn infants

BACKGROUND

Central venous catheter-related bloodstream infection is an important cause of mortality and morbidity in newborn infants cared for in neonatal units. Potential strategies to prevent these infections include the use of central venous catheters impregnated with antimicrobial agents.

OBJECTIVES

To determine the effect of antimicrobial-impregnated central venous catheters in preventing catheter-related bloodstream infection in newborn infants.

SEARCH METHODS

We searched the Cochrane Central Register of Controlled Trials (CENTRAL 2015, Issue 8), MEDLINE (1966 to September 2015), EMBASE (1980 to September 2015), CINAHL (1982 to September 2015), conference proceedings and previous reviews.

SELECTION CRITERIA

Randomised or quasi-randomised controlled trials comparing central venous catheters impregnated or coated with any antibiotic or antiseptic versus central venous catheters without antibiotic or antiseptic coating or impregnation in newborn infants.

DATA COLLECTION AND ANALYSIS

We extracted data using the standard methods of the Cochrane Neonatal Group, with independent evaluation of risk of bias and data extraction by two review authors.

MAIN RESULTS

We found only one small trial (N = 98). This trial found that silver zeolite-impregnated umbilical venous catheters reduced the incidence of bloodstream infection in very preterm infants (risk ratio 0.11, 95% confidence interval 0.01 to 0.87; risk difference -0.17, 95% CI -0.30 to -0.04; number needed to treat for benefit 6, 95% CI 3 to 25].

AUTHORS' CONCLUSIONS

Although the data from one small trial indicates that antimicrobial-impregnated central venous catheters might prevent catheter-related bloodstream infection in newborn infants, the available evidence is insufficient to guide clinical practice. A large, simple and pragmatic randomised controlled trial is needed to resolve on-going uncertainty.

Green synthesis of silver nanoparticles: Advantages of the yeast Saccharomyces cerevisiae model

Background and Purpose:

Microorganism-based synthesis of nanostructures has recently been noted as a green method for the sustainable development of nanotechnology. Nowadays, there have been numerous studies on the emerging resistant pathogenic bacteria and fungal isolates, the probable inability of bacteria and fungi to develop resistance against silver nanoparticles’ (SNPs) antibacterial, antifungal, antiviral and, particularly antibacterial activities. In this study, we aim to use the yeast Saccharomycescerevisiae model for synthesis of SNPs and to investigate its antifungal activity against some isolates of Candidaalbicans.

Materials and Methods:

A standard strain of S.cerevisiae was grown in liquid medium containing mineral salt; then, it was exposed to 2 mM AgNO₃. The reduction of Ag⁺ ions to metal nanoparticles was virtually investigated by tracing the color of the solution, which turned into reddish-brown after 72 hours. Further characterization of synthesized SNPs was performed afterwards. In addition, antifungal activity of synthesized SNPs was evaluated against fluconazole-susceptible and fluconazole-resistant isolates of Candidaalbicans.

Results:

The UV-vis spectra demonstrated a broad peak centering at 410 nm, which is associated with the particle sizes much less than 70 nm. The results of TEM demonstrated fairly uniform, spherical and small in size particles with almost 83.6% ranging between 5 and 20 nm. The zeta potential of SNPs was negative and equal to -25.0 (minus 25) mv suggesting that there was not much aggregation. Silver nanoparticles synthesized by S.cerevisiae, showed antifungal activity against fluconazole-susceptible and fluconazole-resistant Candida albicans isolates, and exhibited MIC₉₀ values of 2 and 4 μg/ml, respectively.

Conclusion:

The yeast S. cerevisiae model demonstrated the potential for extracellular synthesis of fairly monodisperse silver nanoparticles.

Silver nanoparticles as potential antibacterial agents

Multi-drug resistance is a growing problem in the treatment of infectious diseases and the widespread use of broad-spectrum antibiotics has produced antibiotic resistance for many human bacterial pathogens. Advances in nanotechnology have opened new horizons in nanomedicine, allowing the synthesis of nanoparticles that can be assembled into complex architectures. Novel studies and technologies are devoted to understanding the mechanisms of disease for the design of new drugs, but unfortunately infectious diseases continue to be a major health burden worldwide. Since ancient times, silver was known for its anti-bacterial effects and for centuries it has been used for prevention and control of disparate infections. Currently nanotechnology and nanomaterials are fully integrated in common applications and objects that we use every day. In addition, the silver nanoparticles are attracting much interest because of their potent antibacterial activity. Many studies have also shown an important activity of silver nanoparticles against bacterial biofilms. This review aims to summarize the emerging efforts to address current challenges and solutions in the treatment of infectious diseases, particularly the use of nanosilver antimicrobials.

Silver nanoparticles: correlating nanoparticle size and cellular uptake with genotoxicity

The focus of this research was to develop a better understanding of the pertinent physico-chemical properties of silver nanoparticles (AgNPs) that affect genotoxicity, specifically how cellular uptake influences a genotoxic cell response. The genotoxicity of AgNPs was assessed for three potential mechanisms: mutagenicity, clastogenicity and DNA strand-break-based DNA damage. Mutagenicity (reverse mutation assay) was assessed in five bacterial strains of Salmonella typhimurium and Echerichia coli, including TA102 that is sensitive to oxidative DNA damage. AgNPs of all sizes tested (10, 20, 50 and 100nm), along with silver nitrate (AgNO3), were negative for mutagenicity in bacteria. No AgNPs could be identified within the bacteria cells using transmission electron microscopy (TEM), indicating these bacteria lack the ability to actively uptake AgNPs 10nm or larger. Clastogenicity (flow cytometry-based micronucleus assay) and intermediate DNA damage (DNA strand breaks as measured in the Comet assay) were assessed in two mammalian white blood cell lines: Jurkat Clone E6-1 and THP-1. It was observed that micronucleus and Comet assay end points were inversely correlated with AgNP size, with smaller NPs inducing a more genotoxic response. TEM results indicated that AgNPs were confined within intracellular vesicles of mammalian cells and did not penetrate the nucleus. The genotoxicity test results and the effect of AgNO3 controls suggest that silver ions may be the primary, and perhaps only, cause of genotoxicity. Furthermore, since AgNO3 was not mutagenic in the gram-negative bacterial Ames strains tested, the lack of bacterial uptake of the AgNPs may not be the major reason for the lack of genotoxicity observed.

Polysaccharide-based nanocomposites and their applications

Polysaccharide nanocomposites have become increasingly important materials over the past decade. Polysaccharides offer a green alternative to synthetic polymers in the preparation of soft nanomaterials. They have also been used in composites with hard nanomaterials, such as metal nanoparticles and carbon-based nanomaterials. This mini review describes methods for polysaccharide nanocomposite preparation and reviews the various types and diverse applications for these novel materials.

Comparative study of antimicrobial activity of AgBr and Ag nanoparticles (NPs)

The diverse mechanism of antimicrobial activity of Ag and AgBr nanoparticles against gram-positive and gram-negative bacteria and also against several strains of candida was explored in this study. The AgBr nanoparticles (NPs) were prepared by simple precipitation of silver nitrate by potassium bromide in the presence of stabilizing polymers. The used polymers (PEG, PVP, PVA, and HEC) influence significantly the size of the prepared AgBr NPs dependently on the mode of interaction of polymer with Ag⁺ ions. Small NPs (diameter of about 60–70 nm) were formed in the presence of the polymer with low interaction as are PEG and HEC, the polymers which interact with Ag⁺ strongly produce nearly two times bigger NPs (120–130 nm). The prepared AgBr NPs were transformed to Ag NPs by the reduction using NaBH₄. The sizes of the produced Ag NPs followed the same trends – the smallest NPs were produced in the presence of PEG and HEC polymers. Prepared AgBr and Ag NPs dispersions were tested for their biological activity. The obtained results of antimicrobial activity of AgBr and Ag NPs are discussed in terms of possible mechanism of the action of these NPs against tested microbial strains. The AgBr NPs are more effective against gram-negative bacteria and tested yeast strains while Ag NPs show the best antibacterial action against gram-positive bacteria strains.

Anticoagulation treatments related different types of vascular access on maintenance hemodialysis patient: A multicenter epidemiological investigation

Objective

The objective was to increase the understanding of vascular access in hemodialysis and evaluate hemodialysis-related anticoagulation treatments and the associated hemorrhagic or thrombotic complications.

Materials and Methods

In this study, an epidemiological investigation was conducted in 1175 patients who underwent hemodialysis in seven blood purification centers in northern Chinese. The patients were divided into two groups based on the vascular access they used: Arteriovenous fistula (AVF) group and central venous catheter (CVC) group. The similarities and differences of anticoagulation and hemorrhagic, thrombotic complications were compared between two groups.

Results

Arteriovenous fistula was the most frequently used vascular access, and heparin was the most commonly used anticoagulant. Patients in CVC group experienced significantly greater rates of low molecular weight heparin (LMWH) administration and had a higher rate in achieving thrombotic complications than those in AVF group. There were no significant differences in LMWH dosages in patients with thrombotic complications, as well as the proportion of patients who received anti-platelet drugs. Heparinized catheter lock solutions were excessively high in this study, which may lead to a risk of hemorrhage.

Conclusion

Hemodialysis-related anticoagulation treatments in China require additional improvements, especially for the patients using CVC as vascular access. There is an urgent need to develop clinical evaluation studies of anticoagulation treatments for achieving more standardized and targeted treatments.

Polydopamine-induced nanocomposite Ag/CaP coatings on the surface of titania nanotubes for antibacterial and osteointegration functions

A mussel-inspired novel nano silver/calcium phosphate (CaP) composite coating was prepared on anodized Ti, with its surface maintaining preferable biological performance and possessing long-term antibacterial ability.

Cytotoxicity, genotoxicity and alteration of cellular antioxidant enzymes in silver nanoparticles exposed CHO cells

The broad applications of silver nanoparticles (Ag NPs) increase human exposure, thus potential risk associated with their toxicity; therefore, the toxicity of Ag NPs, synthesized by chemical route was studied using Chinese Hamster Ovary (CHO) cells.

Brush-like polycarbonates containing dopamine, cations, and PEG providing a broad-spectrum, antibacterial, and antifouling surface via one-step coating

An antibacterial and antifouling surface is obtained by simple one-step immersion of a catheter surface with brush-like polycarbonates containing pendent adhesive dopamine, antifouling polyethylene glycol (PEG), and antibacterial cations. This coating demonstrates excellent antibacterial and antifouling activities against both Gram-positive (S. aureus) and Gram-negative (E. coli) bacteria, proteins, and platelets, good stability under simulated blood-flow conditions, and no toxicity.