Medical Device-Associated Infections Caused by Biofilm-Forming Microbial Pathogens and Controlling Strategies

Hospital-acquired infections, also known as nosocomial infections, include bloodstream infections, surgical site infections, skin and soft tissue infections, respiratory tract infections, and urinary tract infections. According to reports, Gram-positive and Gram-negative pathogenic bacteria account for up to 70% of nosocomial infections in intensive care unit (ICU) patients. Biofilm production is a main virulence mechanism and a distinguishing feature of bacterial pathogens. Most bacterial pathogens develop biofilms at the solid-liquid and air-liquid interfaces. An essential requirement for biofilm production is the presence of a conditioning film. A conditioning film provides the first surface on which bacteria can adhere and fosters the growth of biofilms by creating a favorable environment. The conditioning film improves microbial adherence by delivering chemical signals or generating microenvironments. Microorganisms use this coating as a nutrient source. The film gathers both inorganic and organic substances from its surroundings, or these substances are generated by microbes in the film. These nutrients boost the initial growth of the adhering bacteria and facilitate biofilm formation by acting as a food source. Coatings with combined antibacterial efficacy and antifouling properties provide further benefits by preventing dead cells and debris from adhering to the surfaces. In the present review, we address numerous pathogenic microbes that form biofilms on the surfaces of biomedical devices. In addition, we explore several efficient smart antiadhesive coatings on the surfaces of biomedical device-relevant materials that manage nosocomial infections caused by biofilm-forming microbial pathogens.

Dual Self-Assembly of Puerarin and Silk Fibroin into Supramolecular Nanofibrillar Hydrogel for Infected Wound Treatment

The treatment of infected wounds remains a challenging biomedical problem. Some bioactive small-molecule hydrogelators with unique rigid structures can self-assemble into supramolecular hydrogels for wound healing. However, they are still suffered from low structural stability and bio-functionality. Herein, a supramolecular hydrogel antibacterial dressing with a dual nanofibrillar network structure is proposed. A nanofibrillar network created by a small-molecule hydrogelator, puerarin extracted from the traditional Chinese medicine Pueraria, is interconnected with a secondary macromolecular silk fibroin nanofibrillar network induced by Ga ions via charge-induced supramolecular self-assembly. The resulting hydrogel features adequate mechanical strength for sustainable retention at wounds. Good biocompatibility and efficient bacterial inhibition are obtained when the Ga ion concentration is 0.05%. Otherwise, the substantial release of Ga ions and puerarin endows the hydrogel with excellent hemostatic and antioxidative properties. In vivo, evaluation of a mouse-infected wound model demonstrates that its healing effect outperformed that of a commercially available silver-containing wound dressing. The experimental group successfully achieves a 100% wound closure rate on day 10. This study sheds new light on the design of nanofibrillar hydrogels based on supramolecular self-assembly of naturally derived bioactive molecules as well as their clinical use for treating chronic infected wounds.

Nanomaterials for Photothermal Antimicrobial Surfaces

Microbial infection diseases are a major threat to human health and have become one of the main causes of mortality. The search for novel antimicrobial strategies is an important challenge for the scientific community, considering also the constant increase of antimicrobial resistance and the rise of new diseases. Among the new strategies to combat microbial infections, the photothermal effect seems to be one of the most promising. Hyperthermia is an effective and broad spectrum strategy for the removal of microbial infections. Among all of the strategies to reduce the diffusion of microbial infections, the preparation of antimicrobial surfaces seems of primary importance. In many cases, in fact, an infection can be diffused through surfaces just by touching them, or by inoculating microbes through an internalizable device, such as an implant, a prosthesis, or a catheter. In this review, we will summarize the recent advances in the preparation of photothermal antibacterial surfaces.

Dynamic Antimicrobial Poly(disulfide) Coatings Exfoliate Biofilms On Demand Via Triggered Depolymerization

Bacterial biofilms are notoriously problematic in applications ranging from biomedical implants to ship hulls. Cationic, amphiphilic antibacterial surface coatings delay the onset of biofilm formation by killing microbes on contact, but they lose effectiveness over time due to non-specific binding of biomass and biofilm formation. Harsh treatment methods are required to forcibly expel the biomass and regenerate a clean surface. Here, a simple, dynamically reversible method of polymer surface coating that enables both chemical killing on contact, and on-demand mechanical delamination of surface-bound biofilms, by triggered depolymerization of the underlying antimicrobial coating layer, is developed. Antimicrobial polymer derivatives based on α-lipoic acid (LA) undergo dynamic and reversible polymerization into polydisulfides functionalized with biocidal quaternary ammonium salt groups. These coatings kill >99.9% of Staphylococcus aureus cells, repeatedly for 15 cycles without loss of activity, for moderate microbial challenges (≈105 colony-forming units (CFU) mL-1, 1 h), but they ultimately foul under intense challenges (≈107 CFU mL-1, 5 days). The attached biofilms are then exfoliated from the polymer surface by UV-triggered degradation in an aqueous solution at neutral pH. This work provides a simple strategy for antimicrobial coatings that can kill bacteria on contact for extended timescales, followed by triggered biofilm removal under mild conditions.

Interdisciplinary-Inspired Smart Antibacterial Materials and Their Biomedical Applications

The discovery of antibiotics has saved millions of lives, but the emergence of antibiotic-resistant bacteria has become another problem in modern medicine. To avoid or reduce the overuse of antibiotics in antibacterial treatments, stimuli-responsive materials, pathogen-targeting nanoparticles, immunogenic nano-toxoids, and biomimetic materials are being developed to make sterilization better and smarter than conventional therapies. The common goal of smart antibacterial materials (SAMs) is to increase the antibiotic efficacy or function via an antibacterial mechanism different from that of antibiotics in order to increase the antibacterial and biological properties while reducing the risk of drug resistance. The research and development of SAMs are increasingly interdisciplinary because new designs require the knowledge of different fields and input/collaboration from scientists in different fields. A good understanding of energy conversion in materials, physiological characteristics in cells and bacteria, and bactericidal structures and components in nature are expected to promote the development of SAMs. In this review, the importance of multidisciplinary insights for SAMs is emphasized, and the latest advances in SAMs are categorized and discussed according to the pertinent disciplines including materials science, physiology, and biomimicry.

Disruption of Communication: Recent Advances in Antibiofilm Materials with Anti-Quorum Sensing Properties

Biofilm contamination presents a significant threat to public health, the food industry, and aquatic/marine-related applications. In recent decades, although various methods have emerged to combat biofilm contamination, the intricate and persistent nature of biofilms makes complete eradication challenging. Therefore, innovative alternative solutions are imperative for addressing biofilm formation. Instead of solely focusing on the eradication of mature biofilms, strategically advantageous measures involve the delay or prevention of biofilm formation on surfaces. Quorum sensing, a communication system enabling bacteria to coordinate their behavior based on population density, plays a pivotal role in biofilm formation for numerous microbial species. Materials possessing antibiofilm properties that target quorum sensing have gained considerable attention for their potential to prevent biofilm formation. This Review consolidates recent research progress on the utilization of materials with antiquorum sensing properties for combating biofilm formation. These materials can be categorized into three distinct types: (i) antibiofilm nanomaterials, (ii) antibiofilm surfaces, and (iii) antibiofilm hydrogels with antiquorum sensing capabilities. Finally, the Review concludes with a brief discussion of current challenges and outlines potential avenues for future research.

Fabrication of reversible bacteria-killing and bacteria-releasing cotton fabrics with anti-bacteria adhesion capacity for potential application in reusable medical materials

Nowadays, more and more smart antibacterial materials have been prepared to meet some specific application area, and most of these materials have complex fabrication processes or incompatible biocompatibility. In this paper, a smart monomer that can switch between the form of quaternary ammonium salt and zwitterionic betaine was prepared and grafted onto cotton fabric. This finished cotton was smart too, it had nice antibacterial performance (99.89 % for E. coli and 99.97 % for S. aureus) in the form of quaternary ammonium salt, and it could release most of the attached bacteria when transferred to the form of zwitterionic betaine in PBS, and the form of zwitterionic betaine could converse back to the state of quaternary ammonium salt in HAC. Simultaneously, it was biocompatible in the form of zwitterionic betaine form. Furthermore, this smart material had nice function reproducibility after repeated transformations. In general, the smart antibacterial cotton could switch between bacteria-killing and bacteria-releasing reversibly, and had good biocompatibility and nice reproducibility, showing a potential application in reusable medical protective materials.

Strategies and materials for the prevention and treatment of biofilms

Biofilms are aggregates of organized microbial growth that function as barriers and create a stable internal environment for cell survival. The bacteria in the biofilms exhibit characteristics that are quite different from the planktonic bacteria, such as strong resistance to antibiotics and other bactericides, getting out of host immunity, and developing in harsh environments, which all contribute to the persistent and intractable treatment. Hence, there is an urgent need to develop novel materials and strategies to combat biofilms. However, most of the reviews on anti-biofilms published in recent years are based on specific fields or materials. Microorganisms are ubiquitous, except in the context of medical and health issues; however, biofilms exert detrimental effects on the advancement and progress of various fields. Therefore, this review aims to provide a comprehensive summary of effective strategies and methodologies applicable across all industries. Firstly, the process of biofilms formation was introduced to enhance our comprehension of the "enemy". Secondly, strategies to intervene in the important links of biofilms formation were discussed, taking timely action during the early weak stages of the "enemy". Thirdly, treatment strategies for mature biofilms were summarized to deal with biofilms that break through the defense line. Finally, several substances with antibacterial properties were presented. The review concludes with the standpoint of the author about potential developments of anti-biofilms strategies. This review may help researchers quickly understand the research progress and challenges in the field of anti-biofilms to design more efficient methods and strategies to combat biofilms.

Nanocellulose aerogels as 3D amyloid templates

Proteins in solution tend to coat solid surfaces upon exposure. Depending on the nature of the surface, the environmental conditions, and the nature of the protein these adsorbed proteins may self-assemble into ordered, fibre-like structures called amyloids. Nanoparticulate surfaces, with their high surface to volume ratio, are particularly favourable to amyloid formation. Most prior research has focussed on either inorganic or organic nanoparticles in solution. In this research, we instead focus on aerogels created from TEMPO-oxidized cellulose nanofibers (TO-CNF) to serve as bio-based, three-dimensional amyloid templates with a tuneable surface chemistry. Previous research on the use of cellulose as a protein adsorption template has shown no evidence of a change in the secondary protein structure. Herein, however, with the aid of the reducing agent TCEP, we were able to induce the formation of amyloid-like 'worms' on the surface of TO-CNF aerogels. Furthermore, we demonstrate that the addition of the TO-CNF aerogel can also induce bulk aggregation under conditions where it previously did not exist. Finally, we show that the addition of the aerogel increases the rate of 'worm' formation in conditions where previous research has found a long lag-phase. Therefore, TO-CNF aerogels are shown to be excellent templates for inducing ordered protein aggregation.

Amyloid-like protein bridged nano-materials and fabrics for preparing rapid and long lasting antibacterial, UV-resistant and personal thermal management textiles

Textiles with efficient and long-lasting antibacterial properties have attracted significant attention. However, a single antibacterial model is insufficient to with variable environments and achieve higher antibacterial activity. In this study, lysozyme was used as assistant and stabilizer, and the efficient peeling and functional modification of molybdenum disulfide nanosheets were realized by ultrasonic. Additionally, lysozyme in the presence of reducing agents to form amyloid-like phase-transited lysozyme (PTL) and self-assembling on the wool fabric. Finally, the AgNPs are reduced in situ by PTL and anchored onto the fabric. It has been demonstrated that Ag-MoS2/PTL@wool generates ROS under light irradiation, rapidly converts photothermal heat into generate hyperthermia, and promotes the release of Ag+. The aforementioned "four-in-one" approach resulted in bactericidal rates of 99.996 % (4.4 log, P < 0.0005) and 99.998 % (4.7 log, P < 0.0005) for S.aureus and E.coli, respectively. Even after 50 washing cycles, the inactivation rates remained at 99.813 % and 99.792 % for E.coli and S.aureus, respectively. In the absence of sunlight, AgNPs and PTL continue to provide continuous antibacterial activity. This work emphasizes the importance of amyloid protein in the synthesis and application of high-performance nanomaterials and provides a new direction for the safe and effective application of multiple synergistic antibacterial modes for microbial inactivation.

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

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

Antibacterial Designs for Implantable Medical Devices: Evolutions and Challenges

The uses of implantable medical devices are safer and more common since sterilization methods and techniques were established a century ago; however, device-associated infections (DAIs) are still frequent and becoming a leading complication as the number of medical device implantations keeps increasing. This urges the world to develop instructive prevention and treatment strategies for DAIs, boosting the studies on the design of antibacterial surfaces. Every year, studies associated with DAIs yield thousands of publications, which here are categorized into four groups, i.e., antibacterial surfaces with long-term efficacy, cell-selective capability, tailored responsiveness, and immune-instructive actions. These innovations are promising in advancing the solution to DAIs; whereas most of these are normally quite preliminary “proof of concept” studies lacking exact clinical scopes. To help identify the flaws of our current antibacterial designs, clinical features of DAIs are highlighted. These include unpredictable onset, site-specific incidence, and possibly involving multiple and resistant pathogenic strains. The key point we delivered is antibacterial designs should meet the specific requirements of the primary functions defined by the “intended use” of an implantable medical device. This review intends to help comprehend the complex relationship between the device, pathogens, and the host, and figure out future directions for improving the quality of antibacterial designs and promoting clinical translations.

Bioinspired nanopillar surface for switchable mechano-bactericidal and releasing actions

Constructing safe and effective antibacterial surfaces has continuously received great attention, especially in healthcare-related fields. Bioinspired mechano-bactericidal nanostructure surfaces could serve as a promising strategy to reduce surface bacterial contamination while avoiding the development of antibiotic resistance. Although effective, these nanostructure surfaces are prone to be contaminated by the accumulation of dead bacteria, inevitably compromising their long-term antibacterial activity. Herein, a bioinspired nanopillar surface with both mechano-bactericidal and releasing actions is developed, via grafting zwitterionic polymer (poly(sulfobetaine methacrylate) (PSBMA)) on ZnO nanopillars. Under dry conditions, this nanopillar surface displays remarkable mechano-bactericidal activity, because the collapsed zwitterionic polymer layer makes no essential influence on nanopillar structure. Once being incubated with aqueous solution, the surface could readily detach the killed bacteria and debris, owing to the swelling of the zwitterionic layer. Consequentially, the surface antibacterial performances can be rapidly and controllably switched between mechano-bactericidal action and bacteria-releasing activity, guaranteeing a long-lasting antibacterial performance. Notably, these collaborative antibacterial behaviors are solely based on physical actions, avoiding the risk of triggering bacteria resistance. The resultant nanopillar surface also enjoys the advantages of substrate-independency and good biocompatibility, offering potential antibacterial applications for biomedical devices and hospital surfaces.

Photothermal scaffolds/surfaces for regulation of cell behaviors

Regulation of cell behaviors and even cell fates is of great significance in diverse biomedical applications such as cancer treatment, cell-based therapy, and tissue engineering. During the past decades, diverse methods have been developed to regulate cell behaviors such as applying external stimuli, delivering exogenous molecules into cell interior and changing the physicochemical properties of the substrates where cells adhere. Photothermal scaffolds/surfaces refer to a kind of materials embedded or coated with photothermal agents that can absorb light with proper wavelength (usually in near infrared region) and convert light energy to heat; the generated heat shows great potential for regulation of cell behaviors in different ways. In the current review, we summarize the recent research progress, especially over the past decade, of using photothermal scaffolds/surfaces to regulate cell behaviors, which could be further categorized into three types: (i) killing the tumor cells via hyperthermia or thermal ablation, (ii) engineering cells by intracellular delivery of exogenous molecules via photothermal poration of cell membranes, and (iii) releasing a single cell or an intact cell sheet via modulation of surface physicochemical properties in response to heat. In the end, challenges and perspectives in these areas are commented.

Versatile polymer-based strategies for antibacterial drug delivery systems and antibacterial coatings

Human health damage and economic losses due to bacterial infections are very serious worldwide. Excessive use of antibiotics has caused an increase in bacterial resistance. Fortunately, various non-antibiotic antibacterial materials...

Applications of Lysozyme, an Innate Immune Defense Factor, as an Alternative Antibiotic

Lysozyme is a ~14 kDa protein present in many mucosal secretions (tears, saliva, and mucus) and tissues of animals and plants, and plays an important role in the innate immunity, providing protection against bacteria, viruses, and fungi. Three main different types of lysozymes are known: the c-type (chicken or conventional type), the g-type (goose type), and the i-type (invertebrate type). It has long been the subject of several applications due to its antimicrobial properties. The problem of antibiotic resistance has stimulated the search for new molecules or new applications of known compounds. The use of lysozyme as an alternative antibiotic is the subject of this review, which covers the results published over the past two decades. This review is focused on the applications of lysozyme in medicine, (the treatment of infectious diseases, wound healing, and anti-biofilm), veterinary, feed, food preservation, and crop protection. It is available from a wide range of sources, in addition to the well-known chicken egg white, and its synergism with other compounds, endowed with antimicrobial activity, are also summarized. An overview of the modified lysozyme applications is provided in the form of tables.

Phototherapy and optical waveguides for the treatment of infection

With rapid emergence of multi-drug resistant microbes, it is imperative to seek alternative means for infection control. Optical waveguides are an auspicious delivery method for precise administration of phototherapy. Studies have shown that phototherapy is promising in fighting against a myriad of infectious pathogens (i.e. viruses, bacteria, fungi, and protozoa) including biofilm-forming species and drug-resistant strains while evading treatment resistance. When administered via optical waveguides, phototherapy can treat both superficial and deep-tissue infections while minimizing off-site effects that afflict conventional phototherapy and pharmacotherapy. Despite great therapeutic potential, exact mechanisms, materials, and fabrication designs to optimize this promising treatment option are underexplored. This review outlines principles and applications of phototherapy and optical waveguides for infection control. Research advances, challenges, and outlook regarding this delivery system are rigorously discussed in a hope to inspire future developments of optical waveguide-mediated phototherapy for the management of infection and beyond.

Harvesting Light To Produce Heat: Photothermal Nanoparticles for Technological Applications and Biomedical Devices

The photothermal properties of nanoparticles (NPs), that is, their ability to convert absorbed light into heat, have been studied since the end of the last century, mainly on gold NPs. In the new millennium, these studies have developed into a burst of research dedicated to the photothermal ablation of tumors. However, beside this strictly medical theme, research has also flourished in the connected areas of photothermal antibacterial surface coatings, gels and polymers, of photothermal surfaces for cell stimulation, as well as in purely technological areas that do not involve medical biotechnology. These include the direct conversion of solar light into heat, a more efficient sun-powered generation of steam and the use of inkjet-printed patterns of photothermal NPs for anticounterfeit printing based on temperature reading, to cite but a few. After an analysis of the photothermal effect (PTE) and its mechanism, this minireview briefly considers the antitumor-therapy theme and takes an in-depth look at all the other technological and biomedical applications of the PTE, paying particular attention to photothermal materials whose NPs have joined those based on Au.

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

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

Self-Assembly Pathways and Antimicrobial Properties of Lysozyme in Different Aggregation States

Antimicrobial resistance in microorganisms will cause millions of deaths and pose a vast burden on health systems; therefore, alternatives to existing small-molecule antibiotics have to be developed. Lysozyme is an antimicrobial enzyme and has broad-spectrum antimicrobial activity in different aggregated forms. Here, we propose a reductive pathway to obtain colloidally stable amyloid-like worm-shaped lysozyme nanoparticles (worms) from hen egg white lysozyme (HEWL) and compare them to amyloid fibrils made in an acid hydrolysis pathway. The aggregation of HEWL into worms follows strongly pH-dependent kinetics and induces a structural transition from α-helices to β-sheets. Both HEWL worms and amyloid fibrils show broad-spectrum antimicrobial activity against the bacteria Staphylococcus aureus (Gram-positive), Escherichia coli (Gram-negative), and the fungus Candida albicans. The colloidal stability of the worms allows the determination of minimum inhibitory concentrations, which are lower than that for native HEWL in the case of S. aureus. Overall, amyloid fibrils have the strongest antimicrobial effect, likely due to the increased positive charge compared to native HEWL. The structural and functional characterizations of HEWL worms and amyloids investigated herein are critical for understanding the detailed mechanisms of antimicrobial activity and opens up new avenues for the design of broad-spectrum antimicrobial materials for use in various applications.

Antimicrobial surfaces: a review of synthetic approaches, applicability and outlook

The rapid spread of microorganisms such as bacteria, fungi, and viruses can be extremely detrimental and can lead to seasonal epidemics or even pandemic situations. In addition, these microorganisms may bring about fouling of food and essential materials resulting in substantial economic losses. Typically, the microorganisms get transmitted by their attachment and growth on various household and high contact surfaces such as doors, switches, currency. To prevent the rapid spread of microorganisms, it is essential to understand the interaction between various microbes and surfaces which result in their attachment and growth. Such understanding is crucial in the development of antimicrobial surfaces. Here, we have reviewed different approaches to make antimicrobial surfaces and correlated surface properties with antimicrobial activities. This review concentrates on physical and chemical modification of the surfaces to modulate wettability, surface topography, and surface charge to inhibit microbial adhesion, growth, and proliferation. Based on these aspects, antimicrobial surfaces are classified into patterned surfaces, functionalized surfaces, superwettable surfaces, and smart surfaces. We have critically discussed the important findings from systems of developing antimicrobial surfaces along with the limitations of the current research and the gap that needs to be bridged before these approaches are put into practice.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s10853-021-06404-0.

The recent progress on metal-organic frameworks for phototherapy

Some infectious or malignant diseases such as cancers are seriously threatening the health of human beings all over the world. The commonly used antibiotic therapy cannot effectively treat these diseases within a short time, and also bring about adverse effects such as drug resistance and immune system damage during long-term systemic treatment. Phototherapy is an emerging antibiotic-free strategy to treat these diseases. Upon light irradiation, phototherapeutic agents can generate cytotoxic reactive oxygen species (ROS) or induce a temperature increase, which leads to the death of targeted cells. These two kinds of killing strategies are referred to as photodynamic therapy (PDT) and photothermal therapy (PTT), respectively. So far, many photo-responsive agents have been developed. Among them, the metal-organic framework (MOF) is becoming one of the most promising photo-responsive materials because its structure and chemical compositions can be easily modulated to achieve specific functions. MOFs can have intrinsic photodynamic or photothermal ability under the rational design of MOF construction, or serve as the carrier of therapeutic agents, owing to its tunable porosity. MOFs also provide feasibility for various combined therapies and targeting methods, which improves the efficiency of phototherapy. In this review, we firstly investigated the principles of phototherapy, and comprehensively summarized recent advances of MOF in PDT, PTT and synergistic therapy, from construction to modification. We expect that our demonstration will shed light on the future development of this field, and bring it one step closer to clinical trials.

Vascular cell behavior on heparin-like polymers modified silicone surfaces: The prominent role of the lotus leaf-like topography

Vascular cell behavior on material surfaces, such as heparin-like polymers, can be affected by the surface chemical composition and surface topological structure. In this study, the effects of heparin-like polymers and lotus leaf-like topography on surface vascular cell behavior are considered. By combining multicomponent thermo-curing and replica molding, a polydimethylsiloxane surface containing bromine (PDMS-Br) with lotus leaf-like topography is obtained. Heparin-like polymers with different chemical compositions are grafted onto PDMS-Br surfaces using visible-light-induced graft polymerization. Compared with unmodified PDMS-Br, surfaces modified by sulfonate-containing polymers are more friendly to vascular cells, while those modified by a glyco-polymer are much more resistant to vascular cells. The introduction of lotus leaf-like topography results in different degrees of decrease in cell density on different heparin-like polymer-modified surfaces. In addition, the combination of heparin-like polymers and lotus leaf-like topography results in the change in protein adsorption, indicating that the two factors may affect the surface vascular cell behavior by affecting the adsorption of relative proteins. The combination of bionic surface topography and different chemical components of heparin-like polymers on material surfaces suggests a new way of engineering cell-material interactions.

Design of nanoengineered antibacterial polymers for biomedical applications

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

Antimicrobial Hybrid Coatings Combining Enhanced Biocidal Activity under Visible-Light Irradiation with Stimuli-Renewable Properties

Hybrid, organic-inorganic, biocidal films exhibiting polishing properties were developed as effective long-lasting antimicrobial surface coatings. The films were prepared using cationically modified chitosan, synthesized by the reaction with 3-bromo-N,N,N-trimethylpropan-1-aminium bromide, to introduce permanent biocidal quaternary ammonium salt (QAS) groups along the polymer backbone and were cross-linked by a novel, pH-cleavable acetal cross-linker, which allowed polishing the hybrid coatings with the solution pH. TiO₂ nanoparticles, modified with reduced graphene oxide (rGO) sheets, to narrow their band gap energy value and shift their photocatalytic activity in the visible light regime, were introduced within the polymer film to enhance its antibacterial activity. The hybrid coatings exhibited an effective biocidal activity in the dark (∼2 Log and ∼3 Log reduction for Gram-negative and Gram-positive bacteria, respectively), when only the QAS sites interacted with the bacteria membrane, and an excellent biocidal action upon visible-light irradiation (∼5 Log and ∼6 Log reduction for Gram-negative and Gram-positive bacteria, respectively) due to the synergistic antimicrobial effect of the QAS moieties and the rGO-modified TiO₂ nanoparticles. The gradual decrease in the film thickness, upon immersion of the coatings in mildly basic (pH 8), neutral (pH 7), and acidic (pH 6) media, reaching 10, 20, and 70% reduction, respectively, after 60 days of immersion time, confirmed the polishing behavior of the films, whereas their effective antimicrobial action was retained. The biocompatibility of the hybrid films was verified in human cell culture studies. The proposed approach enables the facile development of highly functional coatings, combining biocompatibility and bactericidal action with a "kill and self-clean" mechanism that allows the regeneration of the outer surface of the coating leading to a strong and prolonged antimicrobial action.

Photothermal bactericidal surfaces: killing bacteria using light instead of biocides

Recent developments of photothermal bactericidal surfaces based on immobilized photothermal agents to kill bacteria through hyperthermia effects are reviewed.

Surface-Mediated Intracellular Delivery by Physical Membrane Disruption

Effective and nondestructive intracellular delivery of exogenous molecules and other functional materials into living cells is of importance for diverse biological fundamental research and therapeutic applications, such as gene editing and cell-based therapies. However, for most exogenous molecules, the cell plasma membrane is effectively impermeable and thus remains the greatest barrier to intracellular delivery. In recent years, methods based on surface-mediated physical membrane disruption have attracted considerable attention. These methods exploit the physical properties of the surface to transiently increase the membrane permeability of cells come in contact thereto, thereby facilitating the efficient intracellular delivery of molecules regardless of molecule or target cell type. In this Review, we focus on recent progress, particularly over the past decade, on these surface-mediated membrane disruption-based delivery systems. According to the membrane disruption mechanism, three categories can be recognized: (i) mechanical penetration, (ii) electroporation, and (iii) photothermal poration. Each of these is discussed in turn and a brief perspective on future developments in this promising area is presented.

Visible light responsive CuS/ protonated g-C3N4 heterostructure for rapid sterilization

As the environment deterioration is becoming more serious, bacterial pollution is threatening the health of human beings. Hence, it is vital to develop rapid and safe sterilization strategy. Herein, CuS/protonated g-C₃N₄(CuS/PCN) composites were synthesized by simple hydrothermal method and electrostatic adsorption. This heterostructured system exhibited enhanced photocatalytic properties under visible light compared with CuS or g-C₃N₄ alone, ascribing to the rapid separation of photogenerated electron-hole pairs. Meanwhile, the obvious photothermal effects of CuS/PCN were achieved and the temperature increased with the increased amount of CuS in the composites due to the more light absorption. However, when the CuS content is more than 10 %, photocurrent density is decreased with increasing the amount of CuS, indicating the increased recombination of photogenerated electron-hole pairs. When the CuS content is 20 %, the composite can perform the optimized synergistic effects of both photothermal action and photocatalysis under light irradiation for 20 min. The corresponding bacteria-killing efficiency against Staphylococcus aureus and Escherichia coli is 98.23 % and 99.16 %, respectively. The underlying mechanism is that the bacterial membrane can be weakened by reactive oxygen species and bacterial activities are inhibited by hyperthermia. This CuS/PCN heterojunction is promising for environmental disinfection including water and public facilities sterilization.

Universal Antifogging and Antimicrobial Thin Coating Based on Dopamine-Containing Glycopolymers

A novel strategy for preparing universal antifogging and antimicrobial coating is reported by the means of one-step coating and Ag nanoparticle (AgNP) formation in situ. A series of hydrophilic glycopolymers including poly(N-3,4-dihydroxybenzenethyl methacrylamide-co-2-deoxy-2-(methacrylamido)glucopyranose) (P1s) and poly(N-3,4-dihydroxybenzenethyl methacrylamide-co-methacrylic acid-co-2-deoxy-2-(methacrylamido)glucopyranose) (P2s) were synthesized by sunlight-induced reverse addition-fragmentation chain transfer (RAFT) polymerization. With the ability to strongly immobilize onto organic and inorganic surfaces (i.e., glass slide, silicon wafer, and polycarbonate) via catechol groups, P1s are very convenient to form superhydrophilic and transparent thin coatings, which result in a unique antifogging property. Additionally, the antimicrobial property is realized by in situ AgNPs forming P2 coatings, facilitated by the presence of carboxyl groups and catechol groups in the polymer chain, rendering it superior antimicrobial activity against both Gram-negative Escherichia coli and Gram-positive Staphylococcus aureus microorganisms. This antifogging and antimicrobial thin coating shows strong prospects in medical and optical devices, with the extra benefits of avoiding potential pathogen infection in vitro or while in storage.

Smart, Photothermally Activated, Antibacterial Surfaces with Thermally Triggered Bacteria-Releasing Properties

The development of effective antibacterial surfaces to prevent the attachment of pathogenic bacteria and subsequent bacterial colonization and biofilm formation is critically important for medical devices and public hygiene products. In the work reported herein, a smart antibacterial hybrid film based on tannic acid/Fe³⁺ ion (TA/Fe) complex and poly(N-isopropylacrylamide) (PNIPAAm) is deposited on diverse substrates. This surface is shown to have bacteria-killing and bacteria-releasing properties based on, respectively, near-infrared photothermal activation and subsequent cooling. The TA/Fe complex has three roles in this system: (i) as a universal adhesive "anchor" for surface modification, (ii) as a high-efficiency photothermal agent for ablation of attached bacteria (including multidrug resistant bacteria), and (iii) as a robust linker for immobilization of NH₂-terminated PNIPAAm via either Michael addition or Schiff base formation. Moreover, because of the thermoresponsive properties of the immobilized PNIPAAm, almost all of the killed bacteria and other debris can be removed from the surface simply by lowering the temperature. It is shown that this hybrid film can maintain good antibacterial performance after being used for multiple "kill-and-release" cycles and can be applied to various substrates regardless of surface chemistry or topography, thus providing a broadly applicable, simple, and reliable solution to the problems associated with surface-attached bacteria in various healthcare applications.

Photo-responsive chitosan/Ag/MoS2 for rapid bacteria-killing

Bacterial infection is a serious problem threatening human health. The chitosan (CS)-modified MoS₂ coating loaded with silver nanoparticles (Ag NPs) was designed on the surface of titanium (Ti) to kill bacteria rapidly and efficiently under 660 nm visible light. Ag/MoS₂ exhibited high photocatalytic activity due to the rapid transfer of photo-inspired electrons from MoS₂ to Ag NPs, resulting in higher yields of radical oxygen species (ROS) to kill bacteria. The covering of CS made the composite coating positively charged to further enhance the antibacterial property of the coating. In addition, CS/Ag/MoS₂-Ti also showed a certain photothermal effect. in vitro results showed that the antibacterial efficiency of the coating on Staphylococcus aureus and Escherichia coli was 98.66% and 99.77% respectively, when the coating was irradiated by 660 nm visible light for 20 min. Cell culture tests showed that CS/Ag/MoS₂-Ti had no adverse effects on cell growth. Hence, this surface system will be a very promising strategy for eliminating bacterial infection on biomedical device and implants safely and effectively within a short time.

Zn2+-assisted photothermal therapy for rapid bacteria-killing using biodegradable humic acid encapsulated MOFs

Bacterial infection is seriously threatening human health all over the world, especially with the emergence of increasing drug-fast bacteria. It is urgent to develop a drug-free strategy to kill bacteria rapidly and efficiently. In this work, humic acid (HuA) encapsulated zeolitic imidazole framework-8 (ZIF-8) (HuA@ZIF-8) nanocomposites are synthesized by the in-situ growth of ZIF-8 on the surface of polyvinylpyrrolidone (PVP)-modified HuA. The synthesized nanocomposites possesses good photothermal effects, i.e., the temperature increased to 59.4 °C under the particle concentration of 1000 μg/mL with 10 min NIR irradiation. In addition, NIR irradiation can also control the release of Zn²⁺ from the composites. The good photothermal effects originate from HuA that can effectively absorb NIR light. The controlled release of Zn²⁺ is ascribed to the induced-dissociation of ZIF-8 under NIR light irradiation. The synergistic action of photothermal therapy and release of zinc ions contributes to the excellent antibacterial efficiency of HuA@ZIF-8 within a short time, i.e. 99.59 % and 99.37 % against Staphylococcus aureus and Escherichia coli with 20 min NIR irradiation, respectively. This work provides a promising strategy to develop a light-responsive platform with good biodegradability and low cost for rapid and effective sterilization.

Additive Manufactured Graphene Coating with Synergistic Photothermal and Superhydrophobic Effects for Bactericidal Applications

Drug-resistant bacterial infection is a global threat to public health due to the high mobility of the population. Novel therapy methods have been intensively studied for the eradication of antibiotic-resistant bacteria, including photothermal treatment, which has established outstanding bacterial killing efficiencies under laser radiation, and superhydrophobic surfaces have exhibited excellent antifouling properties. However, an effective, scalable, and affordable bactericidal coating for eliminating drug-resistant bacteria is lacking. Herein, a novel graphene coating using one-step laser-induced graphene and simultaneous laser-induced forward transfer is introduced. The graphene coating shows high photothermal conversion and superhydrophobic performance, and these synergistic effects can make the bacteria number decrease with over 99.99% proportions under one sun illumination. The superhydrophobic properties can also reduce 99.87% of bacteria compared to the control sample when the solar energy is not available. This additive and scalable method can quickly coat functional graphene onto various substrates, with bacterial applications in many areas, such as water pipeline robots.

Structural design and antimicrobial properties of polypeptides and saccharide–polypeptide conjugates

The development and progress of antimicrobial polypeptides and saccharide–polypeptide conjugates in regards to their structural design, biological functions and antimicrobial mechanism.

Dual functional β-peptide polymer-modified resin beads for bacterial killing and endotoxin adsorption

Background

Bacterial infections and endotoxin contaminations are serious problems in the production/manufacture of food, water, drinks, and injections. The development of effective materials to kill bacteria and adsorb endotoxins, particularly those caused by gram-negative bacteria, represents a major step toward improved safety. As synthetic mimic of host defense peptides, β-peptide polymers are not susceptible to bacterial resistance and exhibit potent bacteria-killing abilities upon antibiotic-resistant bacteria. This study investigated the potential of synthetic β-peptide polymer-modified polyacrylate (PA) beads to kill bacteria and remove endotoxin, i.e. lipopolysaccharide (LPS), produced by these bacteria.

Results

Synthetic β-peptide polymer-modified PA beads displayed strong antimicrobial activity against Escherichia coli and methicillin-resistant Staphylococcus aureus, as well as excellent biocompatibility. In addition, these β-peptide polymer-modified beads removed around 90% of the endotoxins, even at 200 EU/mL of LPS, a very high concentration of LPS.

Conclusions

β-peptide polymer-modified PA beads are efficient in bacterial killing and endotoxin adsorption. Hence, these modified beads demonstrate the potential application in the production/manufacture of food, water, drinks, and injections.

Host defense peptide mimicking poly-β-peptides with fast, potent and broad spectrum antibacterial activities

Microbial infections have always been serious challenges to human health considering that antibiotics almost inevitably induce microbial resistance. Therefore, it is urgent to develop a new antibacterial agent that is active against drug-resistant bacteria and is less susceptible to microbial resistance. In this work, a series of host defense peptide (HDP) mimicking antibacterial poly-β-peptides were synthesized, characterized and evaluated for their biological activities. The best poly-β-peptide within this study (20 : 80 Bu : DM) displays potent and broad spectrum antibacterial activity against antibiotic-resistant super bugs and low toxicity toward mammalian cells. Moreover, these poly-β-peptides are bactericidal and kill bacteria very fast within 5 min. An antimicrobial resistance test demonstrated that bacteria develop no resistance toward the selected poly-β-peptides even over 1000 generations. Our studies demonstrate that random copolymers of heterochiral poly-β-peptides, without the need for defined secondary structures, can mimic the antimicrobial HDP. These results imply the potential application of these poly-β-peptides as new antimicrobial agents to tackle drug resistant antimicrobial infections.

Fluorescent Imidazolium-Type Poly(ionic liquid)s for Bacterial Imaging and Biofilm Inhibition

Fluorescent imidazolium-type poly(ionic liquid)s (PIL)s were synthesized by anion exchange of bromide (Br^-) in poly(3-butyl-1-vinylimidazolium bromide) (PIL-Br) with a fluorescent anion, namely, 3-(4-(1,2,2-triphenylvinyl)phenoxy)propane-1-sulfonate (TPESO₃^-). Such an anion exchange provided antibacterial PILs with aggregation-induced emission (AIE) properties that simultaneously kill and image bacteria. These fluorescence and antibacterial properties could be regulated by controlling the Br^-/TPESO₃^- ratio. The fluorescence intensity increases as this ratio increases, while the antibacterial property exhibits an opposite trend. Moreover, the AIE-type PILs are useful for fluorescently imaging dead bacteria (macroscopically and microscopically) and could effectively inhibit biofilm growth. This study provided a convenient method to obtain fluorescent PILs with adjustable antibacterial and imaging properties.

Engineering Antifouling Conducting Polymers for Modern Biomedical Applications

Conducting polymers are considered to be favorable electrode materials for implanted biosensors and bioelectronics, because their mechanical properties are similar to those of biological tissues such as nerve and brain tissues. However, one of the primary challenges for implanted devices is to prevent the unwanted protein adhesion or cell binding within biological fluids. The nonspecific adsorption generally causes the malfunction of implanted devices, which is problematic for long-term applications. When responding to the requirements of solving the problems caused by nonspecific adsorption, an increasing number of studies on antifouling conducting polymers has been recently published. In this review, synthetic strategies for preparing antifouling conducting polymers, including direct synthesis of functional monomers and post-functionalization, are introduced. The applications of antifouling conducting polymers in modern biomedical applications are particularly highlighted. This paper presents focuses on the features of antifouling conducting polymers and the challenges of modern biomedical applications.

Efficient capture and photothermal ablation of planktonic bacteria and biofilms using reduced graphene oxide-polyethyleneimine flexible nanoheaters

Bacterial infections are one of the leading causes of disease worldwide. Conventional antibiotics are becoming less efficient, due to antibiotic-resistant bacterial strains. Therefore, the development of novel antibacterial materials and advanced treatment strategies are becoming increasingly important. In the present work, we developed a simple and efficient strategy for effective bacterial capture and their subsequent eradication through photothermal killing. The developed device consists of a flexible nanoheater, comprising a Kapton/Au nanoholes substrate, coated with reduced graphene oxide-polyethyleneimine (K/Au NH/rGO-PEI) thin films. The Au NH plasmonic structure was tailored to feature strong absorption in the near-infrared (NIR) region, where most biological matter has limited absorption, while PEI was investigated for its strong binding with bacteria through electrostatic interactions. The K/Au NH/rGO-PEI device was demonstrated to capture and eliminate effectively both planktonic Gram-positive Staphilococcus aureus (S. aureus) and Gram-negative Escherichia coli (E. coli) bacteria after 10 min of NIR (980 nm) irradiation and, to destroy and eradicate Staphilococcus epidermidis (S. epidermidis) biofilms after 30 min irradiation. The technique developed herein is simple and universal with potential applications for eradication of different micro-organisms.

Responsive and Synergistic Antibacterial Coatings: Fighting against Bacteria in a Smart and Effective Way

Antibacterial coatings that eliminate initial bacterial attachment and prevent subsequent biofilm formation are essential in a number of applications, especially implanted medical devices. Although various approaches, including bacteria-repelling and bacteria-killing mechanisms, have been developed, none of them have been entirely successful due to their inherent drawbacks. In recent years, antibacterial coatings that are responsive to the bacterial microenvironment, that possess two or more killing mechanisms, or that have triggered-cleaning capability have emerged as promising solutions for bacterial infection and contamination problems. This review focuses on recent progress on three types of such responsive and synergistic antibacterial coatings, including i) self-defensive antibacterial coatings, which can "turn on" biocidal activity in response to a bacteria-containing microenvironment; ii) synergistic antibacterial coatings, which possess two or more killing mechanisms that interact synergistically to reinforce each other; and iii) smart "kill-and-release" antibacterial coatings, which can switch functionality between bacteria killing and bacteria releasing under a proper stimulus. The design principles and potential applications of these coatings are discussed and a brief perspective on remaining challenges and future research directions is presented.

Developing Biopolymer Mesocrystals by Crystallization of Secondary Structures

Particle-based mesocrystals have been known for over 10 years; however, examples of biopolymer mesocrystals are rather scarce. The synthesis of particle precursors of biopolymers, the identification of particle-mediated crystallization processes, and thus the synthesis of mesocrystals of biopolymers are challenging. Here, we summarize the existing examples of biopolymer crystallization based on self-assembly of the secondary structures, which could induce the formation of biopolymer mesocrystals. As basic building units, simple secondary structures such as β-sheets or α-helixes could provide a useful tool for the design of biopolymer mesocrystals.

“Imitative” click chemistry to form a sticking xerogel for the portable therapy of bacteria-infected wounds

Xerogels usually possess a stable structure and have a low swelling rate due to their inferior dynamics.

Fabrication of Supramolecular Bioactive Surfaces via β-Cyclodextrin-Based Host-Guest Interactions

Supramolecular host-guest interactions provide a facile and versatile basis for the construction of sophisticated structures and functional assemblies through specific molecular recognition of host and guest molecules to form inclusion complexes. In recent years, these interactions have been exploited as a means of attaching bioactive molecules and polymers to solid substrates for the fabrication of bioactive surfaces. Using a common host molecule, β-cyclodextrin (β-CD), and various guest molecules as molecular building blocks, we fabricated several types of bioactive surfaces with multifunctionality and/or function switchability via host-guest interactions. Other groups have also taken this approach, and several intelligent designs have been developed. The results of these investigations indicate that, compared to the more common covalent bonding-based methods for attachment of bioactive ligands, host-guest based methods are simple, more broadly ("universally") applicable, and allow convenient renewal of bioactivity. In this Spotlight on Applications, we review and summarize recent developments in the fabrication of supramolecular bioactive surfaces via β-CD-based host-guest interactions. The main focus is on the work from our laboratory, but highlights on work from other groups are included. Applications of the materials are also emphasized. These surfaces can be categorized into three types based on: (i) self-assembled monolayers, (ii) polymer brushes, and (iii) multilayered films. The host-guest strategy can be extended from material surfaces to living cell surfaces, and work along these lines is also reviewed. Finally, a brief perspective on the developments of supramolecular bioactive surfaces in the future is presented.

Self-assembled proteinaceous wound dressings attenuate secondary trauma and improve wound healing in vivo

Stimuli-responsive gauze coated with a phase-transitioned lysozyme nanofilm (PTLF@gauze) has been developed, which exhibits great potential for clinical applications by reducing secondary trauma and relieving the pain of patients.