Mechanically Stable and Biocompatible Polymer Brush Coated Dental Materials with Lubricious and Antifouling Properties

Surface modification plays a crucial role in enhancing the functionality of implanted interventional medical devices, offering added advantages to patients, particularly in terms of lubrication and prevention of undesired adsorption of biomolecules and microorganisms, such as proteins and bacteria, on the material surfaces. Utilizing polymer brushes for surface modification is currently a promising approach to maintaining the inherent properties of materials while introducing new functionalities to surfaces. Here, surface-initiated atom transfer radical polymerization (SI-ATRP) technology to effectively graft anionic, cationic, and neutral polymer brushes from a mixed silane initiating layer is employed. The presence of a polymer brush layer significantly enhances the lubrication performance of the substrates and ensures a consistently low coefficient of friction over thousands of friction cycles in aqueous environments. The antimicrobial efficacy of polymer brushes is evaluated against gram-positive Staphylococcus aureus (S. aureus) and gram-negative Escherichia coli (E. coli). It is observed that polym er brushes grafted to diverse substrate surfaces displays notable antibacterial properties, effectively inhibiting bacterial attachment. Furthermore, the polymer brush layer shows favorable biocompatibility and anti-inflammatory characteristics, which shows potential applications in dental materials, and other fields such as catheters and food packaging.

Long-Lasting Antibacterial PDMS Surfaces Constructed from Photocuring of End-Functionalized Polymers

A challenge remains in the development of anti-infectious coatings for the inert surfaces of biomedical devices that are prone to bacterial colonization and biofilm formation. Here, a facile photocuring method to construct functionalized polymeric coatings on inert polydimethylsiloxane (PDMS) surfaces, is developed. Using atom transfer radical polymerization (ATRP) initiator bearing thymol group, hydrophilic DMAEMA and benzophenone (BP)-containing monomers are copolymerized to form polymers with end functional groups. An end-functionalized biocidal coating is then constructed on the inert PDMS surface in one step using a photocuring reaction. The functionalized PDMS surfaces show excellent antibacterial and antifouling properties, are capable of completely eradiating MRSA within ≈6 h, and effectively inhibit the growth of biofilms. In addition, they have good stability and long-lasting antibacterial activity in body fluid environments such as 0.9% saline and urine. According to bladder model experiments, the catheter's lifespan can be extended from ≈7 to 35 days by inhibiting the growth and migration of bacteria along its inner surface. The photocuring technique is therefore very promising in terms of surface functionalization of inert biomedical devices in order to minimize the spread of infection.

Green Solvent-Based Antifouling Polymer Brushes Demonstrate Excellent Hemocompatibility

Medical devices are crucial for patient care, yet even the best biomaterials lead to infections and unwanted activation of blood coagulation, potentially being life-threatening. While hydrophilic polymer brushes are the best coatings to mitigate these issues, their reliance on fossil raw materials underscores the urgency of bio-based alternatives. In this work, we introduce polymer brushes of a green solvent-based monomer, prohibiting protein adsorption, bacterial colonization, and blood clot formation at the same level as fossil-based polymer brushes. The polymer brushes are composed of N,N-dimethyl lactamide acrylate (DMLA), can be polymerized in a controlled manner, and show strong hydrophilicity as determined by thermodynamic analysis of the surface tension components. The contact of various challenging protein solutions results in repellency on the poly(DMLA) brushes. Furthermore, the poly(DMLA) brushes completely prevent the adhesion and colonization of Escherichia coli. Remarkably, upon blood contact, the poly(DMLA) brushes successfully prevent the formation of a fibrin network and leukocyte adhesion on the surface. While showcasing excellent antifouling properties similar to those of N-hydroxypropyl methacrylamide (HPMA) polymer brushes as one of the best antifouling coatings, the absence of hydroxyl groups prevents activation of the complement system in blood. We envision the polymer brushes to contribute to the future of hemocompatible coatings.

Magnetic Soft Robot for Minimally Invasive Urethral Catheter Biofilm Eradication

Catheter-related biofilm infection remains the main problem for millions of people annually, affecting morbidity, mortality, and quality of life. Despite the recent advances in the prevention of biofilm formation, alternative methods for biofilm prevention or eradication still should be found to avoid traumatic and expensive removal or catheter replacement. Soft magnetic robots have drawn significant interest in favor of remote control, fast response, and wide space for design. In this work, we demonstrated magnetic soft robots as a minimally invasive, safe, and effective approach to eliminate biofilm from urethral catheters (20 Fr or 5.1 mm in diameter). Seven designs of the robot were fabricated (size 4.5 × 15 mm), characterized, and tested in the presence of a rotating magnetic field. As a proof-of-concept, we demonstrated the superior efficiency of biofilm removal on the model of a urethral catheter using a magnetic robot, reaching full eradication for the octagram-shaped robot (velocity 2.88 ± 0.6 mm/s) at a 15 Hz frequency and a 10 mT amplitude. These findings are helpful for the treatment of biofilm-associated catheter contamination, which allows an increase in the catheter wearing time without frequent replacement and treatment of catheter-associated infections.

Osteogenic and antibacterial PLLA membrane for bone tissue engineering

Insufficient bone regeneration and bacterial infection are two major concerns of bone repair materials. Poly-L-lactic acid (PLLA) have been widely used in bone tissue engineering (BTE), however, lack of osteogenic and antibacterial properties have greatly limit its clinical application. Herein, PLLA membrane was firstly treated with polydopamine (PDA), and then modified with ε-polylysine (ε-PL) and alginate (ALG) via layer-by-layer method. The (ε-PL/ALG)n composite layer coated PLLA (PLLA@(ε-PL/ALG)n) could facilitates the adhesion and osteoblast differentiation of MC3T3-E1 cells. Furthermore, PLLA@(ε-PL/ALG)n presents an effective antibacterial efficacy against S. aureus and E. coli, and the bacterial survival rates of S. aureus and E. coli on PLLA@(ε-PL/ALG)10 were 21.5 ± 3.5 % and 13 ± 2.1 %, respectively. This work provides a promising method to design PLLA materials with osteogenic and antibacterial activity simultaneously. Furthermore, the method is also an optional choice to construct multifunctional coatings on the other substrate.

Surface antimicrobial functionalization with polymers: fabrication, mechanisms and applications

Undesirable adhesion of microbes such as bacteria, fungi and viruses onto surfaces affects many industries such as marine, food, textile, and healthcare. In particular in healthcare and food packaging, the effects of unwanted microbial contamination can be life-threatening. With the current global COVID-19 pandemic, interest in the development of surfaces with superior anti-viral and anti-bacterial activities has multiplied. Polymers carrying anti-microbial properties are extensively used to functionalize material surfaces to inactivate infection-causing and biocide-resistant microbes including COVID-19. This review aims to introduce the fabrication of polymer-based antimicrobial surfaces through physical and chemical modifications, followed by the discussion of the inactivation mechanisms of conventional biocidal agents and new-generation antimicrobial macromolecules in polymer-modified antimicrobial surfaces. The advanced applications of polymer-based antimicrobial surfaces on personal protective equipment against COVID-19, food packaging materials, biomedical devices, marine vessels and textiles are also summarized to express the research trend in academia and industry.

Biofilms: Formation, Research Models, Potential Targets, and Methods for Prevention and Treatment

Due to the continuous rise in biofilm-related infections, biofilms seriously threaten human health. The formation of biofilms makes conventional antibiotics ineffective and dampens immune clearance. Therefore, it is important to understand the mechanisms of biofilm formation and develop novel strategies to treat biofilms more effectively. This review article begins with an introduction to biofilm formation in various clinical scenarios and their corresponding therapy. Established biofilm models used in research are then summarized. The potential targets which may assist in the development of new strategies for combating biofilms are further discussed. The novel technologies developed recently for the prevention and treatment of biofilms including antimicrobial surface coatings, physical removal of biofilms, development of new antimicrobial molecules, and delivery of antimicrobial agents are subsequently presented. Finally, directions for future studies are pointed out.

Polymers showing intrinsic antimicrobial activity

Pathogenic microorganisms are considered to a major threat to human health, impinging on multiple sectors including hospitals, dentistry, food storage and packaging, and water contamination. Due to the increasing levels of antimicrobial resistance shown by pathogens, often caused by long-term abuse or overuse of traditional antimicrobial drugs, new approaches and solutions are necessary. In this area, antimicrobial polymers are a viable solution to combat a variety of pathogens in a number of contexts. Indeed, polymers with intrinsic antimicrobial activities have long been an intriguing research area, in part, due to their widespread natural abundance in materials such as chitin, chitosan, carrageen, pectin, and the fact that they can be tethered to surfaces without losing their antimicrobial activities. In addition, since the discovery of the strong antimicrobial activity of some synthetic polymers, much work has focused on revealing the most effective structural elements that give rise to optimal antimicrobial properties. This has often been synthesis targeted, with the generation of either new polymers or the modification of natural antimicrobial polymers with the addition of antimicrobial enhancing modalities such as quaternary ammonium or guanidinium groups. In this review, the growing number of polymers showing intrinsic antimicrobial properties from the past decade are highlighted in terms of synthesis; often based on post-synthesis modification and their utilization. This includes as surface coatings, for example on medical devices, such as intravascular catheters, orthopaedic implants and contact lenses, or directly as antibacterial agents (specifically as eye drops). Surface functionalisation with inherently antimicrobial polymers is highlighted and has been achieved via various techniques, including surface-bound initiators allowing RAFT or ATRP surface-based polymerization, or via physical immobilization such as by layer-by-layer techniques. This article also covers the mechanistic modes of action of intrinsic antimicrobial polymers against bacteria, viruses, or fungi.

Contact-Active Layer-by-Layer Grafted TPU/PDMS Blends as an Antiencrustation and Antibacterial Platform for Next-Generation Urological Biomaterials: Validation in Artificial and Human Urine

Urinary tract infections and urinary encrustation impede the long-term clinical performance of urological implants and medical devices. Together, biofilm formation and encrustation constitute serious complications, driving the development of next-generation urological biomaterials. The currently available bioengineered solutions have limited success during long-term usage in the urinary environment. In addressing this unmet clinical challenge, contact-active, antiencrustation surface grafting were conceived onto a dynamically cross-linked polydimethylsiloxane (PDMS) modified thermoplastic polyurethane (TPU) blend using the layer-by-layer (LbL) assembly route. To the best of the authors' knowledge, the present study is the first to investigate the LbL grafting in developing an antiencrustation platform. These multilayered assemblies strategically employed covalent cross-linking and electrostatic interaction-assisted progressive depositions of branched polyethyleneimine and poly(2-ethyl-2-oxazoline). While polyethyleneimine conferred the contact-killing bactericidal activity, the much-coveted antiencrustation properties were rendered by incorporating a partially hydrolyzed derivative of poly(2-ethyl-2-oxazoline). The performance of the resultant surface-modified TPU/PDMS blends was benchmarked against the conventional urological alloplasts, in a customized lab-scale bioreactor-based dynamic encrustation study and in human urine. After 6 weeks of exposure to an artificial urine medium, simulating urease-positive bacterial infection, the surface-modified blends exhibited a remarkable ability to suppress Ca and Mg encrustation. In addition, these blends also displayed superior grafting stability and antibacterial efficacy against common uropathogens. As high as 4-fold log reduction in the planktonic growth of Gram-negative P. mirabilis and Gram-positive MRSA was recorded with the LbL platform vis-à-vis medical-grade TPU. In conjunction, the in vitro cellular assessment with human keratinocytes (HaCaT) and human embryonic kidney cells (HEK) established the uncompromised cytocompatibility of the multilayered grafted blends. Finally, the physiologically relevant functionality of the LbL grafting has been validated using clinical samples of human urine collected from 129 patients with a broad spectrum of disease conditions. The phase-I pre-clinical study, entailing 6 week-long incubation in human urine, demonstrated significantly improved encrustation resistance of the blends. The collective findings of the present work clearly establish the success of LbL strategies in the development of stable, multifunctional new-generation urological biomaterials.

The Bioanalytical and Biomedical Applications of Polymer Modified Substrates

Polymers with different structures and morphology have been extensively used to construct functionalized surfaces for a wide range of applications because the physicochemical properties of polymers can be finely adjusted by their molecular weights, polydispersity and configurations, as well as the chemical structures and natures of monomers. In particular, the specific functions of polymers can be easily achieved at post-synthesis by the attachment of different kinds of active molecules such as recognition ligand, peptides, aptamers and antibodies. In this review, the recent advances in the bioanalytical and biomedical applications of polymer modified substrates were summarized with subsections on functionalization using branched polymers, polymer brushes and polymer hydrogels. The review focuses on their applications as biosensors with excellent analytical performance and/or as nonfouling surfaces with efficient antibacterial activity. Finally, we discuss the perspectives and future directions of polymer modified substrates in the development of biodevices for the diagnosis, treatment and prevention of diseases.

Synthetic strategies to enhance the long-term stability of polymer brush coatings

High-density, end-anchored macromolecules that form so-called polymer brushes are popular components of bio-inspired surface coatings. In a bio-memetic approach, they have been utilized to reduce friction, repel contamination and control...

Cytocompatible, Soft and Thick Brush Modified Scaffolds with Prolonged Antibacterial Effect to Mitigate Wound Infections

Biomedical device or implant associated infections caused by pathogenic bacteria are one of the major leading clinical issues, prevention and/or treatment of which still remain a challenging task. Infection resistant...

Recent progress in Tannic Acid-driven antimicrobial/antifouling surface coating strategies

Medical devices and surgical implants are a necessary part of tissue engineering and regenerative medicines. However, the biofouling and microbial colonization on the implant surface continues to be a major...

Biocompatibility pathways and mechanisms for bioactive materials: The bioactivity zone

This essay analyzes the scientific evidence that forms the basis of bioactive materials, covering the fundamental understanding of bioactivity phenomena and correlation with the mechanisms of biocompatibility of biomaterials. This is a detailed assessment of performance in areas such as bone-induction, cell adhesion, immunomodulation, thrombogenicity and antimicrobial behavior. Bioactivity is the modulation of biological activity by characteristics of the interfacial region that incorporates the material surface and the immediate local host tissue. Although the term ‘bioactive material’ is widely used and has a well understood general meaning, it would be useful now to concentrate on this interfacial region, considered as ‘the bioactivity zone’. Bioactivity phenomena are either due to topographical/micromechanical characteristics, or to biologically active species that are presented in the bioactivity zone. Examples of topographical/micromechanical effects are the modulation of the osteoblast – osteoclast balance, nanotopographical regulation of cell adhesion, and bactericidal nanostructures. Regulation of bioactivity by biologically active species include their influence, especially of metal ions, on signaling pathways in bone formation, the role of cell adhesion molecules and bioactive peptides in cell attachment, macrophage polarization by immunoregulatory molecules and antimicrobial peptides. While much experimental data exists to demonstrate the potential of such phenomena, there are considerable barriers to their effective clinical translation. This essay shows that there is solid scientific evidence of the existence of bioactivity mechanisms that are associated with some types of biomaterials, especially when the material is modified in a manner designed to specifically induce that activity.

Martins MC, Costa F. Antimicrobial Peptides in the Battle against Orthopedic Implant-Related Infections: A Review

Prevention of orthopedic implant-related infections is a major medical challenge, particularly due to the involvement of biofilm-encased and multidrug-resistant bacteria. Current therapies, based on antibiotic administration, have proven to be insufficient, and infection prevalence may rise due to the dissemination of antibiotic resistance. Antimicrobial peptides (AMPs) have attracted attention as promising substitutes of conventional antibiotics, owing to their broad-spectrum of activity, high efficacy at very low concentrations, and, importantly, low propensity for inducing resistance. The aim of this review is to offer an updated perspective of the development of AMPs-based preventive strategies for orthopedic and dental implant-related infections. In this regard, two major research strategies are herein addressed, namely (i) AMP-releasing systems from titanium-modified surfaces and from bone cements or beads; and (ii) AMP immobilization strategies used to graft AMPs onto titanium or other model surfaces with potential translation as coatings. In overview, releasing strategies have evolved to guarantee higher loadings, prolonged and targeted delivery periods upon infection. In addition, avant-garde self-assembling strategies or polymer brushes allowed higher immobilized peptide surface densities, overcoming bioavailability issues. Future research efforts should focus on the regulatory demands for pre-clinical and clinical validation towards clinical translation.

Nisin-based antibacterial and antiadhesive layer-by-layer coatings

Some removable medical devices such as catheters and cardiovascular biomaterials require antiadhesive properties towards both prokaryotic and eukaryotic cells in order to prevent the tissues from infections upon implantation and, from alteration upon removal. In order to inhibit cell adhesion, we developed ultrathin hydrated Layer-by-Layer (LbL) coatings composed of biocompatible polyelectrolytes, namely chondroitin sulfate A (CSA) and poly-l-lysine (PLL). The coatings were crosslinked with genipin (GnP), a natural and biocompatible crosslinking agent, to increase their resistance against environmental changes. In order to confer antibacterial activity to the coatings, we proceeded to the electrostatically-driven immobilization of nisin Z, an antimicrobial peptide (AMP) active against gram-positive bacteria. The nisin-enriched coatings had a significantly increased anti-proliferative impact on fibroblasts, as well as a strong contact-killing activity against Staphylococcus aureus in the short and long term.

Enhanced osteogenic activity and antibacterial performance in vitro of polyetheretherketone by plasma-induced graft polymerization of acrylic acid and incorporation of zinc ions

Polyetheretherketone (PEEK) has been widely used in the fields of orthopedics and trauma, but weak osteointegration and bacterial infection affect its long-term stability and repair effects. Surface modification is an effective way to improve the osteogenic and antibacterial activity of PEEK implants. In the present study, a layer of acrylic acid (AA) polymer coating loaded with zinc ions (Zn²⁺) was constructed on the surface of PEEK (PEEK-AA-Zn) using a strategy of combining plasma-induced graft polymerization with a chemical immersion technique. Successful construction of the AA coating remarkably enhanced the hydrophilicity of PEEK, and effectively loaded and released Zn²⁺. In vitro cell culture using MC3T3-E1 preosteoblasts showed that the Zn²⁺ released from PEEK-AA-Zn promoted cell proliferation and elevated gene expression levels of alkaline phosphatase (ALP), osteocalcin (OCN) and bone sialoprotein (BSP). Antibacterial tests revealed that PEEK-AA-Zn efficiently inhibited the proliferation of Staphylococcus aureus (S. aureus). These results suggest that the combined method of graft polymerization and ion incorporation endows PEEK with excellent osteogenic and antibacterial activity, which provides a wide range of possibilities for developing PEEK implants with multifunctional properties for bone tissue repair.

A Synthetic Overview of Preparation Protocols of Nonmetallic, Contact-Active Antimicrobial Quaternary Surfaces on Polymer Substrates

Antibacterial surfaces have been researched for more than 30 years and remain highly desirable. In particular, there is an interest in providing antimicrobial properties to commodity plastics, because these, in their native state, are excellent substrates for pathogens to adhere and proliferate on. Therefore, efficient strategies for converting surfaces of commodity plastics into contact-active antimicrobial surfaces are of significant interest. Many systems have been prepared and tested for their efficacy. Here, the synthetic approaches to such active surfaces are reviewed, with the restriction to only include systems with tested antibacterial properties. The review focuses on the synthetic approach to surface functionalization of the most common materials used and tested for biomedical applications, which effectively has limited the study to quaternary materials. For future developments in the field, it is evident that there is a need for development of simple methods that permit scalable production of active surfaces. Furthermore, in terms of efficacy, there is an outstanding concern of a lack of universal antimicrobial action as well as rapid deactivation of the antibacterial effect through surface fouling.

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.

Synthesis of Polymer Brushes Via SI-PET-RAFT for Photodynamic Inactivation of Bacteria

Biofilms are a persistent issue in healthcare and industry. Once formed, the eradication of biofilms is challenging as the extracellular polymeric matrix provides protection against harsh environmental conditions and physically enhances resistance to antimicrobials. The fabrication of polymer brush coatings provides a versatile approach to modify the surface to resist the formation of biofilms. Herein, the authors report a facile synthetic route for the preparation of surface-tethered polymeric brushes with antifouling and visible light activated bactericidal properties using surface-initiated photoinduced electron transfer-reversible addition-fragmentation chain transfer polymerization (SI-PET-RAFT). Bactericidal property via the generation of singlet oxygen, which can be temporally and spatially controlled, is investigated against both Gram-positive and Gram-negative bacteria. In addition, the antibacterial properties of the surface can be recycled. This work paves the way for the preparation of polymer films that can resist and kill bacterial biofilms.

Robust Copper Metal-Organic Framework-Embedded Polysiloxanes for Biomedical Applications: Its Antibacterial Effects on MRSA and In Vitro Cytotoxicity

Polysiloxanes (PSs) have been widely utilized in the industry as lubricants, varnishes, paints, release agents, adhesives, and insulators. In addition, their applications have been expanded to include the development of new biomedical materials. To modify PS for application in therapeutic purposes, a flexible antibacterial Cu-MOF (metal-organic framework) consisting of glutarate and 1,2-bis(4-pyridyl)ethane ligands was embedded in PS via a hydrosilylation reaction of vinyl-terminated and H-terminated PSs at 25 °C. The bactericidal activities of the resulting Cu-MOF-embedded PS (PS@Cu-MOF) and the control polymer (PS) were tested against Escherichia coli, Staphylococcus aureus, and methicillin-resistant Staphylococcus aureus. PS@Cu-MOF exhibited more than 80% bactericidal activity toward the tested bacteria at a concentration of 100 μg⋅mL-1 and exhibited a negligible cytotoxicity toward mouse embryonic fibroblasts at the same concentration. Release tests of the Cu(II) ion showed PS@Cu-MOF to be particularly stable in a phosphate-buffered saline solution. Furthermore, its physical and thermal properties, including the phase transition, rheological measurements, swelling ratio, and thermogravimetric profile loss, were similar to those of the control polymer. Moreover, the low cytotoxicity and bactericidal activities of PS@Cu-MOF render it a promising candidate for use in medicinal applications, such as in implants, skin-disease treatment, wound healing, and drug delivery.

Self-Limiting Mussel Inspired Thin Antifouling Coating with Broad-Spectrum Resistance to Biofilm Formation to Prevent Catheter-Associated Infection in Mouse and Porcine Models

Catheter-associated urinary tract infections (CAUTIs) are one of the most commonly occurring hospital-acquired infections. Current coating strategies to prevent catheter-associated biofilm formation are limited by their poor long-term efficiency and limited applicability to diverse materials. Here, the authors report a highly effective non-fouling coating with long-term biofilm prevention activity and is applicable to diverse catheters. The thin coating is lubricous, stable, highly uniform, and shows broad spectrum prevention of biofilm formation of nine different bacterial strains and prevents the migration of bacteria on catheter surface. The coating method is adapted to human-sized catheters (both intraluminal and extraluminal) and demonstrates long-term biofilm prevention activity over 30 days in challenging conditions. The coated catheters are tested in a mouse CAUTI model and demonstrate high efficiency in preventing bacterial colonization of both Gram-positive and Gram-negative bacteria. Furthermore, the coated human-sized Foley catheters are evaluated in a porcine CAUTI model and show consistent efficiency in reducing biofilm formation by Escherichia coli (E. coli) over 95%. The simplicity of the coating method, the ability to apply this coating on diverse materials, and the high efficiency in preventing bacterial adhesion increase the potential of this method for the development of next generation infection resistant medical devices.

Which Are the Main Surface Disinfection Approaches at the Time of SARS-CoV-2?

Among many guidelines issued by the World Health Organization to prevent contagion from novel coronavirus (SARS-CoV-2), disinfection of animate and inanimate surfaces has emerged as a key issue. One effective approach to prevent its propagation can be achieved by disinfecting air, skin, or surfaces. A thorough and rational application of an Environmental Protection Agent for disinfection of surfaces, as well as a good personal hygiene, including cleaning hands with appropriate products (e.g., 60–90% alcohol-based product) should minimize transmission of viral respiratory pathogens such as SARS-CoV-2. Critical issues, associated with the potential health hazard of chemical disinfectants and the ineffective duration of most of the treatments, have fostered the introduction of innovative and alternative disinfection approaches. The present review aims to provide an outline of methods currently used for inanimate surface disinfection with a look to the future and a focus on the development of innovative and effective disinfection approaches (e.g., metal nanoparticles, photocatalysis, self-cleaning, and self-disinfection) with particular focus on SARS-CoV-2. The research reviews are, usually, focused on a specific category of disinfection methods, and therefore they are limited. On the contrary, a panoramic review with a wider focus, as the one here proposed, can be an added value for operators in the sector and generally for the scientific community.

Poly(l-lactide)-Based Anti-Inflammatory Responsive Surfaces for Surgical Implants

In the last few decades, surgical implants have been widely used to restore the function of damaged bones or joints. However, it is essential to receive antibiotic or anti-inflammatory treatment to circumvent significant problems associated, such as the colonization of the implanted surface by bacteria or other microorganisms and strong host inflammatory responses. This article presents the effectiveness of the copper catalyzed alkyne-azide cycloaddition (CuAAC) (“click”) reaction by the linkage of a fluorophore to the poly(L-lactide) (PLLA) surface. The results were analysed by means of X-ray photoelectron spectroscopy (XPS), contact angle and fluorescence microscopy. Moreover, this current work describes the covalent immobilization of the anti-inflammatory drug indomethacin on a PLLA surface. The CuAAC click reaction was selected to anchor the drug to the polymeric films. The successful bioconjugation of the drug was confirmed by XPS and the change on the contact angle.

A scope at antifouling strategies to prevent catheter-associated infections

The use of invasive medical devices is becoming more common nowadays, with catheters representing one of the most used medical devices. However, there is a risk of infection associated with the use of these devices, since they are made of materials that are prone to bacterial adhesion with biofilm formation, often requiring catheter removal as the only therapeutic option. Catheter-related urinary tract infections (CAUTIs) and central line-associated bloodstream infections (CLABSIs) are among the most common causes of healthcare-associated infections (HAIs) worldwide while endotracheal intubation is responsible for ventilator-associated pneumonia (VAP). Therefore, to avoid the use of biocides due to the potential risk of bacterial resistance development, antifouling strategies aiming at the prevention of bacterial adherence and colonization of catheter surfaces represent important alternative measures. This review is focused on the main strategies that are able to modify the physical or chemical properties of biomaterials, leading to the creation of antiadhesive surfaces. The most promising approaches include coating the surfaces with hydrophilic polymers, such as poly(ethylene glycol) (PEG), poly(acrylamide) and poly(acrylates), betaine-based zwitterionic polymers and amphiphilic polymers or the use of bulk-modified poly(urethanes). Natural polysaccharides and its modifications with heparin, have also been used to improve hemocompatibility. Recently developed bioinspired techniques yielding very promising results in the prevention of bacterial adhesion and colonization of surfaces include slippery liquid-infused porous surfaces (SLIPS) based on the superhydrophilic rim of the pitcher plant and the Sharklet topography inspired by the shark skin, which are potential candidates as surface-modifying approaches for biomedical devices. Concerning the potential application of most of these strategies in catheters, more in vivo studies and clinical trials are needed to assure their efficacy and safety for possible future use.

Immobilized random peptide mixtures exhibit broad antimicrobial activity with high selectivity

In the current study, we evaluated the antimicrobial activity of randomly-sequenced peptide mixtures (RPMs) bearing hydrophobic and cationic residues that were immobilized on beads. We showed that these beads exhibit high and broad bactericidal activity against various pathogenic bacteria while possessing minimal hemolytic activity.

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.

UV-Curable Surface-Attached Antimicrobial Polymeric Onium Coatings: Designing Effective, Solvent-Resistant Coatings for Plastic Surfaces

Contact-active ammonium and phosphonium antimicrobial polymeric coatings grafted to plastic surfaces by UV treatment are described. Robust, antimicrobial styrenic polymeric scaffolds copolymerized with a low loading of UV-curable benzophenone were prepared by nitroxide-mediated polymerization (NMP). Similar reversible addition-fragmentation chain-transfer (RAFT)-controlled radical polymerizations were attempted for comparison. These random styrenics were further functionalized into partially quaternarized water-soluble cationic polymers. UV-cured polymeric thin film coatings possessing cationic groups with n-alkyl substituents of n ≤ 2 demonstrate antimicrobial properties against both Gram-positive and Gram-negative bacteria, while species containing bulkier or longer substituents were biologically inactive. The UV-cured cationic antimicrobial polymeric onium thin films also demonstrate enhanced abrasion and chemical resistance.

Recent Advances in Surface Nanoengineering for Biofilm Prevention and Control. Part I: Molecular Basis of Biofilm Recalcitrance. Passive Anti-Biofouling Nanocoatings

Medical device-associated infections are becoming a leading cause of morbidity and mortality worldwide, prompting researchers to find new, more effective ways to control the bacterial colonisation of surfaces and biofilm development. Bacteria in biofilms exhibit a set of "emergent properties", meaning those properties that are not predictable from the study of free-living bacterial cells. The social coordinated behaviour in the biofilm lifestyle involves intricate signaling pathways and molecular mechanisms underlying the gain in resistance and tolerance (recalcitrance) towards antimicrobial agents as compared to free-floating bacteria. Nanotechnology provides powerful tools to disrupt the processes responsible for recalcitrance development in all stages of the biofilm life cycle. The present paper is a state-of-the-art review of the surface nanoengineering strategies currently used to design antibiofilm coatings. The review is structurally organised in two parts according to the targeted biofilm life cycle stages and molecular mechanisms intervening in recalcitrance development. Therefore, in the present first part, we begin with a presentation of the current knowledge of the molecular mechanisms responsible for increased recalcitrance that have to be disrupted. Further, we deal with passive surface nanoengineering strategies that aim to prevent bacterial cells from settling onto a biotic or abiotic surface. Both "fouling-resistant" and "fouling release" strategies are addressed as well as their synergic combination in a single unique nanoplatform.

Renewable Fabric Surface-Initiated ATRP Polymerizations: Towards Mixed Polymer Brushes

A totally new approach in the synthesis of mixed polymer brushes tethered on polyamide (PA) surfaces is presented herein. As a proof of concept, two types of homopolymers were synthesized in sequential surface-initiated atom transfer radical polymerization (SI-ATRP) reactions: poly(methyl methacrylate)/poly((2-dimethylamino)ethyl methacrylate) and polystyrene /poly((2-dimethylamino)ethyl methacrylate). The ATRP initiator was immobilized on the surface through PA chain-end groups in two subsequent steps, separated by homo-polymerizations. The amount of the PA chains' end groups available on the modified surface was tuned by the thermal rearrangement of the surface.

Antibacterial Coatings for Improving the Performance of Biomaterials

Biomedical devices have become essential in the health care. Every day, an enormous number of these devices are used or implanted in humans. In this context, the bacterial contamination that could be developed in implanted devices is critical since it is estimated that infections kill more people than other medical causes. Commonly, these infections are treated with antibiotics, but the biofilm formation on implant surfaces could significantly reduce the effectiveness of these antibiotics since bacteria inside the biofilm is protected from the drug. In some cases, a complete removal of the implant is necessary in order to overcome the infection. In this context, antibacterial coatings are considered an excellent strategy to avoid biofilm formation and, therefore, mitigate the derived complications. In this review, the main biomaterials used in biomedical devices, the mechanism of biofilm formation, and the main strategies for the development of antibacterial coatings, are reviewed. Finally, the main polymer-based strategies to develop antibacterial coatings are summarized, with the aim of these coatings being to avoid the bacteria proliferation by controlling the antibacterial mechanisms involved and enhancing long-term stability.

Boronate sol-gel method for one-step fabrication of polyvinyl alcohol hydrogel coatings by simple cast- and dip-coating techniques

The self-assembly of polyvinyl alcohol (PVA) and benzene-1,4-diboronic acid (DBA) is employed as a sol–gel method for one-step fabrication of hydrogel coatings with versatile functionalities. A mixture of PVA and DBA in aqueous ethanol is prepared as a coating agent. The long pot life of the mixture allows for the coating of a wide range of materials with hydrogel films by simple cast- and dip-coating techniques. The resultant films show negligible dissolution in water and the intrinsic hydrophilicity of PVA provides the films with functional properties, such as improved antifogging property and resistance to protein and cell fouling. The self-assembling process shows adaptive inclusion properties toward nanoscale materials, such as metal–organic coordination polymers and inorganic nanoparticles, affording composite films. Furthermore, the coating film exhibits a unique secondary functionalization reactivity toward boronic acid-appended fluorescent dyes, through which a variety of materials are converted into fluorescent materials.

The self-assembly of polyvinyl alcohol (PVA) and benzene-1,4-diboronic acid (DBA) is employed as a sol–gel method for one-step fabrication of hydrogel coatings with versatile functionalities.

Bioinert and Lubricious Surfaces by Macromolecular Design

The modification of a variety of biomaterials and medical devices often encompasses the generation of biopassive and lubricious layers on their exposed surfaces. This is valid when the synthetic supports are required to integrate within physiological media without altering their interfacial composition and when the minimization of shear stress prevents or reduces damage to the surrounding environment. In many of these cases, hydrophilic polymer brushes assembled from surface-interacting polymer adsorbates or directly grown by surface-initiated polymerizations (SIP) are chosen. Although growing efforts by polymer chemists have been focusing on varying the composition of polymer brushes in order to attain increasingly bioinert and lubricious surfaces, the precise modulation of polymer architecture has simultaneously enabled us to substantially broaden the tuning potential for the above-mentioned properties. This feature article concentrates on reviewing this latter strategy, comparatively analyzing how polymer brush parameters such as molecular weight and grafting density, the application of block copolymers, the introduction of branching and cross-links, or the variation of polymer topology beyond the simple, linear chains determine highly technologically relevant properties, such as biopassivity and lubrication.

Formation of Hydrophobic Domains on the poly(MPC-co-Dodecyl Methacrylate)-Coated Surface Recognized by Macrophage-like Cells

Copolymers comprising 2-methacryloyloxyethyl phosphorylcholine (MPC) and hydrophobic methacrylic esters were used as biomembrane-mimetic polymers to provide blood compatibility. In the present study, we compared the surfaces coated with two MPC polymers with different alkyl groups, namely, poly(MPC-co-butyl methacrylate) (PMB) and poly(MPC-co-dodecyl methacrylate) (PMD), to clarify the effect of their hydrophobic units. Various substrates, such as poly(ethylene terephthalate), polycarbonate, polypropylene, acrylonitrile-butadiene-styrene copolymer, and stainless steel, were coated with ethanol solutions containing various concentrations of PMD or PMB. The solubility of PMD in ethanol changed depending on the water content. Scanning probe microscopy and rhodamine 6G staining revealed heterogeneous microstructures on the PMD-coated surface but not on the PMB-coated surface. Adhesion of various cells was efficiently suppressed by the PMD coating at lower concentration than the PMB coating, except regarding the adhesion of macrophage-like RAW264.7 cells. Our results suggest that the dodecyl groups in PMD increased its affinity for the substrates and simultaneously induced the formation of hydrophobic domains recognized by RAW264.7 cells.

Self-disinfecting surfaces and infection control

According to World Health Organization, every year in the European Union, 4 million patients acquire a healthcare associated infection. Even though some microorganisms represent no threat to healthy people, hospitals harbor different levels of immunocompetent individuals, namely patients receiving immunosuppressors, with previous infections, or those with extremes of age (young children and elderly), requiring the implementation of effective control measures. Public spaces have also been found an important source of infectious disease outbreaks due to poor or none infection control measures applied. In both places, surfaces play a major role on microorganisms' propagation, yet they are very often neglected, with very few guidelines about efficient cleaning measures and microbiological assessment available. To overcome surface contamination problems, new strategies are being designed to limit the microorganisms' ability to survive over surfaces and materials. Surface modification and/or functionalization to prevent contamination is a hot-topic of research and several different approaches have been developed lately. Surfaces with anti-adhesive properties, with incorporated antimicrobial substances or modified with biological active metals are some of the strategies recently proposed. This review intends to summarize the problems associated with contaminated surfaces and their importance on infection spreading, and to present some of the strategies developed to prevent this public health problem, namely some already being commercialized.

Zwitterion Functionalized Silica Nanoparticle Coatings: The Effect of Particle Size on Protein, Bacteria, and Fungal Spore Adhesion

The negative impacts that arise from biological fouling of surfaces have driven the development of coatings with unique physical and chemical properties that are able to prevent interactions with fouling species. Here, we report on low-fouling hydrophilic coatings presenting nanoscaled features prepared from different size silica nanoparticles (SiNPs) functionalized with zwitterionic chemistries. Zwitterionic sulfobetaine siloxane (SB) was reacted to SiNPs ranging in size from 7 to 75 nm. Particle stability and grafting density were confirmed using dynamic light scattering and thermogravimetric analysis. Thin coatings of nanoparticles were prepared by spin-coating aqueous particle suspensions. The resulting coatings were characterized using scanning electron microscopy, atomic force microscopy, and contact angle goniometry. SB functionalized particle coatings displayed increased hydrophilicity compared to unmodified particle coating controls while increasing particle size correlated with increased coating roughness and increased surface area. Coatings of zwitterated particles demonstrated a high degree of nonspecific protein resistance, as measured by quartz crystal microgravimetry. Adsorption of bovine serum albumin and hydrophobin proteins were reduced by up to 91 and 94%, respectively. Adhesion of bacteria ( Escherichia coli) to zwitterion modified particle coatings were also significantly reduced over both short and long-term assays. Maximum reductions of 97% and 94% were achieved over 2 and 24 h assay periods, respectively. For unmodified particle coatings, protein adsorption and bacterial adhesion were generally reduced with increasing particle size. Adhesion of fungal spores to SB modified SiNP coatings was also reduced, however no clear trends in relation to particle size were demonstrated.

Biologically Functional Ultrathin Films Made of Zwitterionic Block Copolymer Micelles

We report the preparation of ultrathin coatings of zwitterionic block copolymer micelles and a comparison of their protein adsorption, adhesiveness, and antibacterial properties. Zwitterionic block copolymer micelles were obtained through pH-induced self-assembly of poly[3-dimethyl(methacryloyloxyethyl)ammonium propanesulfonate- b-2-(diisopropylamino)ethyl methacrylate] (βPDMA- b-PDPA) at pH 7.5. βPDMA- b-PDPA micelles with zwitterionic βPDMA-corona and pH-responsive PDPA-core were then used as building blocks to prepare layer-by-layer (LbL) assembled multilayer films together with hyaluronic acid (HA), tannic acid (TA), or poly(sodium 4-styrenesulfonate) (PSS). Protein adsorption tests showed that 3-layer βPDMA- b-PDPA micelles/HA films were the most effective to reduce the adhesion of BSA, lysozyme, ferritin, and casein. In contrast, βPDMA- b-PDPA micelles/TA films were the most attractive surfaces for protein adsorption. Bacterial antiadhesive tests against a model Gram-negative bacterium, Escherichia coli, and a model Gram-positive bacterium, Staphylococcus aureus, were in good agreement with the protein adsorption properties of the films. The differences in the antiadhesive properties between these three different film systems are discussed within the context of chemical nature and the functional chemical groups of the polyanions, layer number, and surface morphology of the films. Multilayers were found to lose their antiadhesiveness in the long term. However, by taking advantage of the pH-responsive hydrophobic micellar cores, we show that an antibacterial agent could be loaded into the micelles and multilayers could exhibit antibacterial activity in the long term especially at moderately acidic conditions. In contrast to antiadhesive properties, no significant differences were recorded in the antibacterial properties between the different film types.

Surface-attached sulfonamide containing quaternary ammonium antimicrobials for textiles and plastics

With the risks associated with healthcare-associated infections and the rise of antibiotic resistant microorganisms, there is an important need to control the proliferation of these factors in hospitals, retirement homes and other institutions. This work explores the development and application of a novel class of sulfonamide-based quaternary ammonium antimicrobial coatings, anchored to commercially and clinically relevant material surfaces. Synthesized in high yields (60–97%), benzophenone-anchored antimicrobials were spray-coated and UV grafted onto plastic surfaces, while silane-anchored variants were adhered to select textiles via dip-coating. Surface modified samples were characterised by advancing contact angle, anionic dye staining, X-ray photoelectron spectroscopy and atomic force microscopy. After verifying coating quality through the above characterization methods, microbiological testing was performed on batch samples in conditions that simulate the natural inoculation of surfaces and objects (solid/air) and water containers (solid/liquid). Using the previously established Large Drop Inoculum (LDI) protocol at solid/air interfaces, all treated samples showed a full reduction (10⁵–10⁷ CFU) of viable Arthrobacter sp., S. aureus, and E. coli after 3 h of contact time. Additional testing of the walls of plastic LDPE vials treated with a UV-cured sulfonamide antimicrobial at a solid/liquid interface using the newly developed Large Reservoir Inoculum (LRI) protocol under static conditions revealed a complete kill (>10⁶ reduction) of Gram-positive Arthrobacter sp., and a partial kill (>10⁴ reduction) of Gram-negative E. coli within 24–48 h of contact.

A series of surface attached silane or benzophenone sulfonamide quaternary ammonium antimicrobials show potent efficacy at solid/air and solid/liquid interfaces.

Reduced fibrous capsule formation at nano-engineered silicone surfaces via tantalum ion implantation

Nano-engineered surface of silicone implant improves the biocompatibility and suppresses the fibrous capsule formation which is the most common side effect of polymeric implants.