Regulating molecular brush structure on cotton textiles for efficient antibacterial properties

The molecular brush structures have been developed on cotton textiles for long-term and efficient broad-spectrum antimicrobial performances through the cooperation of alkyl-chain and quaternary ammonium sites. Results show that efficient antibacterial performances can be achieved by the regulation of the alkyl chain length and quaternary ammonium sites. The antibacterial efficiency of the optimized molecular brush structure of [3-(N,N-Dimethylamino)propyl]trimethoxysilane with cetyl modification on cotton textiles (CT-DM-16) can reach more than 99 % against both E. coli and S. aureus. Alkyl-chain grafting displayed significantly improvement in the antibacterial activity against S. aureus with (N,N-Diethyl-3-aminopropyl)trimethoxysilane modification on cotton textiles (CT-DE) based materials. The positive N sites and alkyl chains played important roles in the antibacterial process. Proteomic analysis reveals that the contributions of cytoskeleton and membrane-enclosed lumen in differentially expressed proteins have been increased for the S. aureus antibacterial process, confirming the promoted puncture capacity with alkyl-chain grafting. Theoretical calculations indicate that the positive charge of N sites can be enhanced through alkyl-chain grafting, and the possible distortion of the brush structure in application can further increase the positive charge of N sites. Uncovering the regulation mechanism is considered to be important guidance to develop novel and practical antibacterial materials.

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

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

Functional Zwitterionic Polyurethanes: State-of-the-Art Review

Recent advancements in bioengineering and medical devices have been greatly influenced and dominated by synthetic polymers, particularly polyurethanes (PUs). PUs offer customizable mechanical properties and long-term stability, but their inherent hydrophobic nature poses challenges in practically biological application processes, such as interface high friction, strong protein adsorption, and thrombosis. To address these issues, surface modifications of PUs for generating functionally hydrophilic layers have received widespread attention, but the durability of generated surface functionality is poor due to irreversible mechanical wear or biodegradation. As a result, numerous researchers have investigated bulk modification techniques to incorporate zwitterionic polymers or groups onto the main or side chains of PUs, thereby improving their hydrophilicity and biocompatibility. This comprehensive review presents an extensive overview of notable zwitterionic PUs (ZPUs), including those based on phosphorylcholine, sulfobetaine, and carboxybetaine. The review explores their wide range of biomedical applications, from blood-contacting devices to antibacterial coatings, fouling-resistant marine coatings, separation membranes, lubricated surfaces, and shape memory and self-healing materials. Lastly, the review summarizes the challenges and future prospects of ZPUs in biological applications.

A Facile Surface Modification Scheme for Medical-Grade Titanium and Polypropylene Using a Novel Mussel-Inspired Biomimetic Polymer with Cationic Quaternary Ammonium Functionalities for Antibacterial Application

Medical device-associated infection remains a critical problem in the healthcare setting. Different clinical- or device-related methods have been attempted to reduce the infection rate. Among these approaches, creating a surface with bactericidal cationic functionality has been proposed. To do so, a sophisticated multi-step chemical procedure would be needed. Instead, a simple immersion approach was utilized in this investigation to render the titanium and polypropylene surface with the quaternary ammonium functionality by using a mussel-inspired novel lab-synthesized biomimetic catechol-terminated polymer, PQA-C8. The chemical oxidants, CuSO4/H2O2, as well as dopamine, were added into the novel PQA-C8 polymer immersion solution for one-step surface modification. Additionally, a two-step immersion scheme, in which the polypropylene substrate was first immersed in the dopamine solution and then in the PQA-C8 solution, was also attempted. Surface analysis results indicated the surface characteristics of the modified substrates were affected by the immersion solution formulation as well as the procedure utilized. The antibacterial assay has shown the titanium substrates modified by the one-step dopamine + PQA-C8 mixtures with the oxidants added and the polypropylene modified by the two-step scheme exhibited bacterial reduction percentages greater than 90% against both Gram-positive S. aureus and Gram-negative E. coli and these antibacterial substrates were non-cytotoxic.

Shifting from Ammonium to Phosphonium Salts: A Promising Strategy to Develop Next-Generation Weapons against Biofilms

Since they are difficult and sometimes impossible to treat, infections sustained by multidrug-resistant (MDR) pathogens, emerging especially in nosocomial environments, are an increasing global public health concern, translating into high mortality and healthcare costs. In addition to having acquired intrinsic abilities to resist available antibiotic treatments, MDR bacteria can transmit genetic material encoding for resistance to non-mutated bacteria, thus strongly decreasing the number of available effective antibiotics. Moreover, several pathogens develop resistance by forming biofilms (BFs), a safe and antibiotic-resistant home for microorganisms. BFs are made of well-organized bacterial communities, encased and protected in a self-produced extracellular polymeric matrix, which impedes antibiotics' ability to reach bacteria, thus causing them to lose efficacy. By adhering to living or abiotic surfaces in healthcare settings, especially in intensive care units where immunocompromised older patients with several comorbidities are hospitalized BFs cause the onset of difficult-to-eradicate infections. In this context, recent studies have demonstrated that quaternary ammonium compounds (QACs), acting as membrane disruptors and initially with a low tendency to develop resistance, have demonstrated anti-BF potentialities. However, a paucity of innovation in this space has driven the emergence of QAC resistance. More recently, quaternary phosphonium salts (QPSs), including tri-phenyl alkyl phosphonium derivatives, achievable by easy one-step reactions and well known as intermediates of the Wittig reaction, have shown promising anti-BF effects in vitro. Here, after an overview of pathogen resistance, BFs, and QACs, we have reviewed the QPSs developed and assayed to this end, so far. Finally, the synthetic strategies used to prepare QPSs have also been provided and discussed to spur the synthesis of novel compounds of this class. We think that the extension of the knowledge about these materials by this review could be a successful approach to finding effective weapons for treating chronic infections and device-associated diseases sustained by BF-producing MDR bacteria.

Recent advances in surface-mounted metal-organic framework thin film coatings for biomaterials and medical applications: a review

Coatings of metal-organic frameworks (MOFs) have potential applications in surface modification for medical implants, tissue engineering, and drug delivery systems. Therefore, developing an applicable method for surface-mounted MOF engineering to fabricate protective coating for implant tissue engineering is a crucial issue. Besides, the coating process was desgined for drug infusion and effect opposing chemical and mechanical resistance. In the present review, we discuss the techniques of MOF coatings for medical application in both in vitro and in vivo in various systems such as in situ growth of MOFs, dip coating of MOFs, spin coating of MOFs, Layer-by-layer methods, spray coating of MOFs, gas phase deposition of MOFs, electrochemical deposition of MOFs. The current study investigates the modification in the implant surface to change the properties of the alloy surface by MOF to improve properties such as reduction of the biofilm adhesion, prevention of infection, improvement of drugs and ions rate release, and corrosion resistance. MOF coatings on the surface of alloys can be considered as an opportunity or a restriction. The presence of MOF coatings in the outer layer of alloys would significantly demonstrate the biological, chemical and mechanical effects. Additionally, the impact of MOF properties and specific interactions with the surface of alloys on the anti-microbial resistance, anti-corrosion, and self-healing of MOF coatings are reported. Thus, the importance of multifunctional methods to improve the adhesion of alloy surfaces, microbial and corrosion resistance and prospects are summarized.

Janus functional electrospun polyurethane fibrous membranes for periodontal tissue regeneration

The guided tissue regeneration (GTR) technique with GTR membranes is an efficient method for repairing periodontal defects. Conventional periodontal membranes act as physical barriers that resist the growth of fibroblasts, epithelial cells, and connective tissue. However, they cannot facilitate the regeneration of periodontal tissue. To address this issue, the exploitation of novel GTR membranes with bioactive functions based on therapeutic requirements is critical. Herein, we exploited a biodegradable bilayer polyurethane fibrous membrane by uniaxial electrostatic spinning to construct two sides with Janus properties by integrating the bioactive molecule dopamine (DA) and antimicrobial Gemini quaternary ammonium salt (QAS). The DA-containing side, located inside the injury, can effectively promote cell adhesion and mesenchymal stem cell growth as well as support mineralization and antioxidant properties, which are beneficial for bone regeneration. The QAS-containing side, located on the outer surface of the injury, endows antibacterial properties and limits fibroblast adhesion and growth on its surface owing to its strong hydrophilicity. An in vivo study demonstrates that the Janus polyurethane fibrous membrane can significantly promote the regeneration of periodontal defects in rats. Owing to its superior mechanical properties and biocompatibility, this polyurethane fibrous membrane has potential applications in the field of periodontal regeneration.

Recent nanotechnology-based strategies for interfering with the life cycle of bacterial biofilms

Biofilm formation plays an important role in the resistance development in bacteria to conventional antibiotics. Different properties of the bacterial strains within biofilms compared with their planktonic states and the protective effect of extracellular polymeric substances contribute to the insusceptibility of bacterial cells to conventional antimicrobials. Although great effort has been devoted to developing novel antibiotics or synthetic antibacterial compounds, their efficiency is overshadowed by the growth of drug resistance. Developments in nanotechnology have brought various feasible strategies to combat biofilms by interfering with the biofilm life cycle. In this review, recent nanotechnology-based strategies for interfering with the biofilm life cycle according to the requirements of different stages are summarized. Additionally, the importance of strategies that modulate the bacterial biofilm microenvironment is also illustrated with specific examples. Lastly, we discussed the remaining challenges and future perspectives on nanotechnology-based strategies for the treatment of bacterial infection.

Photoinduced micropatterning on biodegradable aliphatic polyester surfaces for anchoring dual brushes and its application in bacteria and cell patterning

In view of intrinsic challenges encountered in surface patterning on actual biomaterials such as the ones based on biodegradable polymers, we have demonstrated an innovative strategy to create micro-patterns on the surface of tartaric acid based aliphatic polyester P (poly(hexamethylene 2,3-O-isoprpylidentartarate)) without significant loss of its molecular weight. Around 10 wt% PAG (photoacid generator, 2-(4-methoxystyryl)-4,6-bis(trichloromethyl)-1,3,5-triazine) was purposefully encapsulated in a polyester matrix comprising of P and PLA (polylactide) at a ratio of 5 : 95. With the help of a photomask, selective areas of the matrix were exposed to UV radiation at 395 nm for 25 min to trigger the acid release from PAG entrapped unmasked areas for generating hydroxyl functionality that was later converted to an ATRP (atom transfer radical polymerization) initiating moiety on the irradiated domain of P. In subsequent steps, spatio-selective surface modification by surface initiated ATRP was carried out to generate an alternate pattern of polyPEGMA (poly(ethylene glycol)methyl ether methacrylate) and polyDMAPS (poly(3-dimethyl-(methacryloyloxyethyl)ammonium propane sulfonate)) brushes on the matrix. The patterned surface modified with dual brushes was found to be antifouling in nature (rejection of >97% of proteins). Strikingly, an alternate pattern of live bacterial cells (E. coli and S. aureus) was evident and a relatively high population of bacteria was found on the polyPEGMA brush modified domain. However, a complete reverse pattern was visible in the case of L929 mouse fibroblast cells, i.e., cells were found to predominantly adhere to and proliferate on the zwitterionic brush modified surface. An attempt was made to discuss a plausible mechanism of selective cell adhesion on the zwitterionic brush domain. This novel strategy employed on the biodegradable polymer surface provides an easy and straightforward way to micro-pattern various cells, bacteria, etc. on biodegradable substrates which hold great potential to function as biochips, diagnostics, bacteria/cell microarrays, etc.

Zwitterionic Biomaterials

The term "zwitterionic polymers" refers to polymers that bear a pair of oppositely charged groups in their repeating units. When these oppositely charged groups are equally distributed at the molecular level, the molecules exhibit an overall neutral charge with a strong hydration effect via ionic solvation. The strong hydration effect constitutes the foundation of a series of exceptional properties of zwitterionic materials, including resistance to protein adsorption, lubrication at interfaces, promotion of protein stabilities, antifreezing in solutions, etc. As a result, zwitterionic materials have drawn great attention in biomedical and engineering applications in recent years. In this review, we give a comprehensive and panoramic overview of zwitterionic materials, covering the fundamentals of hydration and nonfouling behaviors, different types of zwitterionic surfaces and polymers, and their biomedical applications.

Surface Coassembly of Binary Mixed Polymer Brushes and Linear Block Copolymer Chains

Binary mixed polymer brushes (BMPBs) are two different homopolymer chains that are covalently anchored to the solid surfaces at high grafting densities. One feature of the BMPBs is the unique ability to make surface phase separation under external stimuli. In this research, we demonstrate that different surface nanostructures can be fabricated by surface coassembly of BMPBs and free block copolymer (BCP) chains. Polystyrene/poly(2-(dimethylamino)ethyl methacrylate) (PS/PDMAEMA) BMPBs on silica particles (PS-PDMAEMA-SiO₂) are synthesized by a two-step "grafting to" approach. PDMAEMA-b-PS block copolymer (BCP) chains and PS-PDMAEMA-SiO₂ make surface self-assembly and a variety of surface nanostructures are formed in methanol. The grafting densities of PS and PDMAEMA brushes, solvent, and the BCP structures all exert significant influences on the surface morphology. With an increase in PDMAEMA grafting density, the surface structures change from perforated layers, to rods, and to spherical surface micelles (s-micelles). The PS grafting density also exerts an effect on the formation of the surface nanostructures. At low PS grafting density, sparsely distributed s-micelles are produced, and at high density, densely distributed s-micelles are observed. Based on transmission electron microscopy and scanning electron microscopy results, a surface phase diagram is constructed, which provides a guide to the surface morphology control.

Mussel-inspired polyurethane coating for bio-surface functionalization to enhance substrate adhesion and cell biocompatibility

Considerable implant materials are prone to cause a severe inflammatory reaction due to poor histocompatibility, which leads to various complications and implant failure. Surface coating modification of these implant materials is one of the most important techniques to settle this problem. However, fabricating a coating with both adequate adhesiveness and excellent biocompatibility remains a challenge. Inspired by the adhesion mechanism of mussels, a series of mussel-inspired polyurethanes (PU-LDAs) were synthysized through a step growth polymerization based on hexamethylene diisocyanate as a hard segment, polytetra-methylene-ether-glycol as a soft segment, lysine-dopamine (LDA) and butanediol as chain extenders with different mole ratios.The coatings of PU-LDAs were applied to various substrates, such as stainless steel, glass and PP using a facile one-step coating process. The introduction of 3,4-dihydroxyphenylalanine (DOPA) groups can greatly improve the adhesion ability of the coatings to the substrates demonstrated by a 180° peel test. The peel strength of the PU-LDA100 coating containing high LDA content was 76.3, 48.5 and 67.5 N/m, which was 106.2%, 246.4% and 192.2% higher than that of the PU-LDA00 coating without LDA on the surface of stainless steel, glass and PP, respectively. Meanwhile, this PU coating has a lower immune inflammatory response which provides a universal method for surface modification of implant materials. Moreover, the DOPA groups in PU-LDAs could combine with the amino and thiol groups on cell membrane surface, leading to the improvement of cell adhesion and growth. Therefore, it has great potential application in the field of biomedical implant materials for the clinic.

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.

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

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

Surgical Applications of Materials Engineered with Antimicrobial Properties

The infection of surgically placed implants is a problem that is both large in magnitude and that broadly affects nearly all surgical specialties. Implant-associated infections deleteriously affect patient quality-of-life and can lead to greater morbidity, mortality, and cost to the health care system. The impact of this problem has prompted extensive pre-clinical and clinical investigation into decreasing implant infection rates. More recently, antimicrobial approaches that modify or treat the implant directly have been of great interest. These approaches include antibacterial implant coatings (antifouling materials, antibiotics, metal ions, and antimicrobial peptides), antibacterial nanostructured implant surfaces, and antibiotic-releasing implants. This review provides a compendium of these approaches and the clinical applications and outcomes. In general, implant-specific modalities for reducing infections have been effective; however, most applications remain in the preclinical or early clinical stages.

A bioinspired Janus polyurethane membrane for potential periodontal tissue regeneration

Guided tissue regeneration (GTR) is the main therapeutic method for periodontal tissue regeneration. The key to the GTR strategy is the membrane which can assist the reconstruction of bone tissue in the periodontal defect and prevent the migration of epithelium and fibroblasts to the defect. However, the existing periodontal membrane cannot effectively promote periodontal tissue regeneration due to the limited bioactivity and physicochemical function. Here, we developed a bioinspired degradable polyurethane membrane with Janus surface morphology by integrating bioactive dopamine (DA) and an antibacterial Gemini quaternary ammonium salt (QAS). The Janus surface of the membrane is fabricated through spontaneous microphase separation, resulting from the different migration of functional segments between the air-contact upper surface with enriched antibacterial QAS and the substrate-contact bottom with enriched bioactive DA. The smooth surface of the upper membrane used to face the soft tissues can reduce cell adhesion to suppress the migration of fibroblasts, while the rough surface with a topological micro-pit structure of the bottom side facing the bone has excellent function of autonomic mineralization and cell adhesion to promote bone tissue reconstruction. In addition, the membrane containing the antibacterial QAS shows excellent antibacterial effect on common oral pathogens, such as S. aureus and S. mutans. Moreover, the specific dopamine group also endows the membrane with excellent antioxidant efficiency. In vivo research shows that this Janus polyurethane membrane can effectively promote periodontal tissue regeneration in a rat periodontal defect model. Combined with its excellent mechanical properties and biocompatibility, the polyurethane membrane is a promising material for potential periodontal tissue regeneration.

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...

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

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

Recent advances of zwitterionic based topological polymers for biomedical applications

Zwitterionic polymers, comprising hydrophilic anionic and cationic groups with the same total number of positive and negative charges on the same monomer residue, have received increasing attention due to their...

One-step zwitterionization and quaternization of thick PDMAEMA layer grafted through subsurface-initiated ATRP for robust antibiofouling and antibacterial coating on PDMS

In this work, we demonstrate the grafting of thick poly((2-dimethylamino) ethyl methacrylate) (PDMAEMA) layer on PDMS via subsurface-initiated atom transfer radical polymerization (SSI-ATRP). The self-migration of DMAEMA monomers into the subsurface of PDMS is proven to be the dominant factor for the success of SSI-ATRP. The as-prepared thick microscale graft layer on PDMS shows much better abrasion resistance than nanoscale graft layer obtained by conventional surface-initiated atom transfer radical polymerization (SI-ATRP) under identical condition. Taking advantage of the tertiary amines of PDMAEMA, the simultaneous zwitterionization and quaternization of the PDMAEMA thick layer is realized through a facile one-step process. The effect of zwitterionization and quaternization degree on the antibiofouling and antibacterial properties is investigated. The results show that a relatively high zwitterionization degree (75 mol%) and a low quaternization degree (25 mol%) exhibit a good well-balanced effect on both fouling repellence and bactericidal activity. This work may lead to the development of robust bifunctional antibiofouling and antibacterial surfaces via SSI-ATRP strategy.

Strategies toward development of antimicrobial biomaterials for dental healthcare applications

Several approaches for elimination of oral pathogens are being explored at the present time since oral diseases remain prevalent affecting approximately 3.5 billion people worldwide. Need for antimicrobial biomaterials in dental healthcare include but is not restricted to designing resin composites and adhesives for prevention of dental caries. Constant efforts are also being made to develop antimicrobial strategies for clearance of endodontic space prior root canal treatment and for treatment of periimplantitis and periodontitis. This article discusses various conventional and nanotechnology-based strategies to achieve antimicrobial efficacy in dental biomaterials. Recent developments in the design and synthesis of antimicrobial peptides and antifouling zwitterionic polymers to effectively lessen the risks of antimicrobial drug resistance are also outlined in this review. Further, the role of contemporary strategies such as use of smart biomaterials, ionic solvent-based biomaterials and quorum quenchers incorporated biomaterials in the elimination of dental pathogens are described in detail. Lastly, we mentioned the approach of using polymers to print custom-made three-dimensional antibacterial dental products via additive manufacturing technologies. This review provides a critical perspective on the chemical, biomimetic, and engineering strategies intended for developing antimicrobial biomaterials that have the potential to substantially improve the dental health.

Antibiofilm Activity of Gallium(III) Complexed Anionic Polymers in Combination with Antibiotics

Pseudomonas aeruginosa (P. aeruginosa) is a life-threatening pathogen associated with multiantibiotic resistance, which is largely caused by its strong ability to form biofilms. Recent research has revealed that gallium (III) shows an activity against the biofilm of P. aeruginosa by interfering with Fe metabolism. The antibacterial activity of the combination of Ga³⁺ ion and antibiotic rifampicin (RMP) against P. aeruginosa PAO1 is investigated. An anionic polymer poly{{2-[(2-methylprop-2-enoyl)oxy]ethyl}phosphonic acid} (PDMPOH) is exploited to form complexes (GaPD) with Ga³⁺ . The GaPD complexes act as a carrier of Ga³⁺ and release Ga³⁺ via enzymatic degradation by bacterial lipases. GaPD is found to damage the outer membrane, leading to enhanced cellular uptake of RMP and Ga³⁺ due to increased outer membrane permeability, which inhibits the RNA polymerase and interferes with Fe metabolism. The antibiofilm activity and biocompatibility of the GaPD system offer a promising treatment option for P. aeruginosa biofilm-related infections.

Rapid Assembly of Infection-Resistant Coatings: Screening and Identification of Antimicrobial Peptides Works in Cooperation with an Antifouling Background

Bacterial adhesion and the succeeding biofilm formation onto surfaces are responsible for implant- and device-associated infections. Bifunctional coatings integrating both nonfouling components and antimicrobial peptides (AMPs) are a promising approach to develop potent antibiofilm coatings. However, the current approaches and chemistry for such coatings are time-consuming and dependent on substrates and involve a multistep process. Also, the information is limited on the influence of the coating structure or its components on the antibiofilm activity of such AMP-based coatings. Here, we report a new strategy to rapidly assemble a stable, potent, and substrate-independent AMP-based antibiofilm coating in a nonfouling background. The coating structure allowed for the screening of AMPs in a relevant nonfouling background to identify optimal peptide combinations that work in cooperation to generate potent antibiofilm activity. The structure of the coating was changed by altering the organization of the hydrophilic polymer chains within the coatings. The coatings were thoroughly characterized using various surface analytical techniques and correlated with the efficiency to prevent biofilm formation against diverse bacteria. The coating method that allowed the conjugation of AMPs without altering the steric protection ability of hydrophilic polymer structure results in a bifunctional surface coating with excellent antibiofilm activity. In contrast, the conjugation of AMPs directly to the hydrophilic polymer chains resulted in a surface with poor antibiofilm activity and increased adhesion of bacteria. Using this coating approach, we further established a new screening method and identified a set of potent surface-tethered AMPs with high activity. The success of this new peptide screening and coating method is demonstrated using a clinically relevant mouse infection model to prevent catheter-associated urinary tract infection (CAUTI).

Antifouling hydrogel film based on a sandwich array for salivary glucose monitoring

A glucose biosensor prepared using interpenetrating polymer network (IPN) hydrogel as a sensing material is the subject of growing interest due to its fast response and high sensitivity. However, the IPN hydrogel circumvents the traditional antifouling strategy, which often requires thick antifouling coating that can result in poor glucose sensitivity owing to its energetic physical barrier (greater than 43 nm); thus a complex, time-consuming and high-cost salivary preprocessing is needed to remove protein contaminants before salivary glucose detection using the IPN hydrogel. This limits its practical application in trace salivary glucose-level monitoring. Herein, a new hydrogel film based on a sandwich array (HFSA) with a weak physical barrier, which exhibits superior antifouling and sensitivity in salivary glucose detection is reported. HFSA relies on the formation of the sandwich structure containing substrate-grafted, surface-grafted zwitterionic polymer brushes (pSBMA) and phenylboronic acid (PBA)-functionalized hydrogel. The synergistic effect originating from pSBMA brushes on the surface of HFSA and inside the HFSA matrix provides a suitable physical barrier (∼28 nm) and a robust hydration layer for HFSA, which can enhance its sensitivity and antifouling. The results show that HFSA reduce the adsorption of nonspecific protein in 10% saliva by nearly 90% and enhanced the glucose sensitivity by 130%, compared to the IPN hydrogel film. These results demonstrate that HFSA exhibits significant potential as an antifouling and sensitive glucose probe for QCM sensors in non-invasive salivary glucose monitoring.

Mussel Adhesive Mimetic Silk Sericin Prepared by Enzymatic Oxidation for the Construction of Antibacterial Coatings

With the rapid development and advancement in orthodontic and orthopedic technologies, the demand for biomedical-grade titanium (Ti) alloys is growing. The Ti-based implants are susceptible to bacterial infections, leading to poor healing and osteointegration, resulting in implant failure or repeated surgical intervention. Silk sericin (SS) is hydrophilic, biocompatible, and biodegradable and could induce a low immunological response in vivo. As a result, it would be intriguing to investigate the use of hydrophilic SS in surface modification. In this work, the tyrosine moiety in SS was oxidized by tyrosinase (or polyphenol oxidase) to the 3,4-dihydroxyphenylalanine (DOPA) form, generating the catechol moiety-containing SS (SSC). Inspired by the adhesion of mussel foot proteins, the SSC coatings could be directly deposited onto multiple surfaces in SS and tyrosinase mixed stock solutions to create active surfaces with catechol groups. Further, the SSC-coated Ti surfaces were hybridized with silver nanoparticles (Ag NPs) via in situ silver ion (Ag⁺) reduction. The antibacterial properties of the Ag NPs/SS-coated Ti surfaces are demonstrated, and they can prevent bacterial cell adhesion as well as early-stage biofilm formation. In addition, the developed Ag NPs/SSC-coated Ti surfaces exhibited a negligible level of cytotoxicity in L929 mouse fibroblast cells.

Effective and biocompatible antibacterial surfaces via facile synthesis and surface modification of peptide polymers

It is an urgent need to tackle drug-resistance microbial infections that are associated with implantable biomedical devices. Host defense peptide-mimicking polymers have been actively explored in recent years to fight against drug-resistant microbes. Our recent report on lithium hexamethyldisilazide-initiated superfast polymerization on amino acid N-carboxyanhydrides enables the quick synthesis of host defense peptide-mimicking peptide polymers. Here we reported a facile and cost-effective thermoplastic polyurethane (TPU) surface modification of peptide polymer (DLL: BLG = 90 : 10) using plasma surface activation and substitution reaction between thiol and bromide groups. The peptide polymer-modified TPU surfaces exhibited board-spectrum antibacterial property as well as effective contact-killing ability in vitro. Furthermore, the peptide polymer-modified TPU surfaces showed excellent biocompatibility, displaying no hemolysis and cytotoxicity. In vivo study using methicillin-resistant Staphylococcus aureus (MRSA) for subcutaneous implantation infectious model showed that peptide polymer-modified TPU surfaces revealed obvious suppression of infection and great histocompatibility, compared to bare TPU surfaces. We further explored the antimicrobial mechanism of the peptide polymer-modified TPU surfaces, which revealed a surface contact-killing mechanism by disrupting the bacterial membrane. These results demonstrated great potential of the peptide-modified TPU surfaces for practical application to combat bacterial infections that are associated with implantable materials and devices.

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A convenient surface modification of peptide polymer 90 : 10 DLL : BLG to enable material surfaces antibacterial properties.

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The modified thermoplastic polyurethane (TPU) surfaces show board-spectrum antibacterial performance and excellent biocompatibility both in vitro and in vivo.

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The contact-killing surfaces demonstrate great potential for practical application to combat bacterial infections associated with implantable materials and devices.

The recent advances in surface antibacterial strategies for biomedical catheters

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

Bacterial Antifouling Characteristics of Helicene-Graphene Films

Herein, we describe interfacially-assembled [7]helicene films that were deposited on graphene monolayer using the Langmuir-Schaefer deposition by utilizing the interactions of nonplanar (helicene) and planar (graphene) π–π interactions as functional antifouling coatings. Bacterial adhesion of Staphylococcus aureus on helicene—graphene films was noticeably lower than that on bare graphene, up to 96.8% reductions in bacterial adhesion. The promising bacterial antifouling characteristics of helicene films was attributed to the unique molecular geometry of helicene, i.e., nano-helix, which can hinder the nanoscale bacterial docking processes on a surface. We envision that helicene—graphene films may eventually be used as protective coatings against bacterial antifouling on the electronic components of clinical and biomedical devices.

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.

Theoretical and Experimental Optimization of the Graft Density of Functionalized Anti-Biofouling Surfaces by Cationic Brushes

Diseases and complications related to catheter materials are severe problems in biomedical material applications, increasing the infection risk and medical expenses. Therefore, there is an enormous demand for catheter materials with antibacterial and antifouling properties. Considering this, in this work, we developed an approach of constructing antibacterial surfaces on polyurethane (PU) via surface-initiated atom transfer radical polymerization (SI-ATRP). A variety of cationic polymers were grafted on PU. The biocompatibility and antifouling properties of all resulting materials were evaluated and compared. We also used a theoretical algorithm to investigate the anticoagulant mechanism of our PU-based grafts. The hemocompatibility and anti-biofouling performance improved at a 86–112 μg/cm² grafting density. The theoretical simulation demonstrated that the in vivo anti-fouling performance and optimal biocompatibility of our PU-based materials could be achieved at a 20% grafting degree. We also discuss the mechanism responsible for the hemocompatibility of the cationic brushes fabricated in this work. The results reported in this paper provide insights and novel ideas on material design for applications related to medical catheters.

Antifouling and antibacterial behavior of membranes containing quaternary ammonium and zwitterionic polymers

To overcome the organic-/bio- fouling of the membrane, a dual-functional ultrafiltration membrane containing quaternary ammonium and zwitterionic polymers via quaternization and surface radical polymerization was designed, and its antifouling and antibacterial behavior was studied. In this work, poly(vinylidene fluoride)/poly(methyl methacrylate-co-dimethylamino-2-ethyl methacrylate) (PVDF/P(MMA-co-DMAEMA)) blend membrane was quaternized by p-chloromethyl styrene (p-CMS), and the double bonds were introduced onto the membrane surface, which further participated in the polymerization of zwitterionic monomers on the membrane surface. The results indicated that the resultant membrane exhibited obviously improved hydrophilicity and weak positive charge (isoelectric point, 7.49). The membrane presented higher flux recovery ratio and lower protein adhesion compared with the pure PVDF membrane. Meanwhile, the membrane showed high-efficiency broad-spectrum antibacterial performance, that is, the bacteria killing efficiency of S. aureus and E. coli reached 98.2% and 97.0%, respectively. Moreover, the membrane effectively inhibited bacterial adhesion, which is important for the long-term antibacterial properties of membrane. This antifouling and antibacterial PVDF membrane may have potential in the long-term filtration process, especially when dealing with microbiologically contaminated water.

Contact/Release Coordinated Antibacterial Cotton Fabrics Coated with N-Halamine and Cationic Antibacterial Agent for Durable Bacteria-Killing Application

Coating a cationic antibacterial layer on the surface of cotton fabric is an effective strategy to provide it with excellent antibacterial properties and to protect humans from bacterial cross-infection. However, washing with anionic detergent will inactivate the cationic antibacterial coating. Although this problem can be solved by increasing the amount of cationic antibacterial coating, excessive cationic antibacterial coating reduces the drapability of cotton fabric and affects the comfort of wearing it. In this study, a coordinated antibacterial coating strategy based on quaternary ammonium salt and a halogenated amine compound was designed. The results show that the antibacterial effect of the modified cotton fabric was significantly improved. In addition, after mechanically washing the fabric 50 times in the presence of anionic detergent, the antibacterial effect against Staphylococcus aureus and Escherichia coli was still more than 95%. Furthermore, the softness of the obtained cotton fabric showed little change compared with the untreated cotton fabric. This easy-to-implement and cost-effective approach, combined with the cationic contact and the release effect of antibacterial agents, can endow cotton textiles with durable antibacterial properties and excellent wearability.

Surface modification approaches for prevention of implant associated infections

In this highlight, we summarize the surface modification approaches for development of infection-resistant coatings for biomedical devices and implants. We discuss the relevant key and highly cited research that have been published over the last five years which report the generation of infection-resistant coatings. An important strategy utilized to prevent bacterial adhesion and biofilm formation on device/implant surface is anti-adhesive protein repellant polymeric coatings based on polymer brushes or highly hydrated hydrogel networks. Further, the attachment of antimicrobial agents that can efficiently kill bacteria on the surface while also prevent bacterial adhesion on the surface is also investigated. Other approaches include the incorporation of antimicrobial agents to the surface coating resulting in a depot of bactericides which can be released on-demand or with time to prevent bacterial colonization on the surface that kill the adhered bacteria on the surface to make surface infection resistant.

Modified silica nanoparticle coatings: Dual antifouling effects of self-assembled quaternary ammonium and zwitterionic silanes

This work examines the antifouling effect of quaternary ammonium silane (QAS) grafted from coatings of silica nanoparticles (SiNPs), independently and in combination with a zwitterionic sulfobetaine (SB) silane. The binding of QAS to the SiNP coatings was monitored using quartz crystal microgravimetry with dissipation monitoring (QCM-D) under varied pH and solution concentrations. Adsorption of bovine serum albumin protein was reduced on QAS modified SiNP coatings prepared under alkaline conditions due to the proposed generation of a pseudozwitterionic interface, where the underlying SiNP surface presents an anionic charge at high pH. Significant reductions in protein binding were achieved at low functionalization concentrations and short modification times. Additionally, SiNP coatings modified with a combination of QAS and SB chemistries were investigated. Surface modifications were performed sequentially, varying silane concentration and order of addition, and monitored using QCM-D. Dual-functionalized surfaces presented enhanced resistance to protein adsorption compared to QAS or SB modified surfaces alone, even at low functionalization concentrations. The antiadhesive and antibacterial properties of functionalized surfaces were investigated by challenging the surfaces against the bacterium Escherichia coli. All dual-functionalized coatings showed equal or reduced bacterial adhesion compared to QAS and SB functionalizations alone, while coatings functionalized with high concentrations of combined chemistries reduced the adhesion of bacteria by up to 95% compared to control SiNP surfaces.

Myristyltrimethylammonium Bromide (MYTAB) as a Cationic Surface Agent to Inhibit Streptococcus mutans Grown over Dental Resins: An In Vitro Study

This in vitro study evaluated the effect of myristyltrimethylammonium bromide (MYTAB) on the physical, chemical, and biological properties of an experimental dental resin. The resin was formulated with dental dimetacrylate monomers and a photoinitiator/co-initiator system. MYTAB was added at 0.5 (G_0.5%), 1 (G_1%), and 2 (G_2%) wt %, and one group remained without MYTAB and was used as the control (G_Ctrl). The resins were analyzed for the polymerization kinetics, degree of conversion, ultimate tensile strength (UTS), antibacterial activity against Streptococcus mutans, and cytotoxicity against human keratinocytes. Changes in the polymerization kinetics profiling were observed, and the degree of conversion ranged from 57.36% (±2.50%) for G_2% to 61.88% (±1.91%) for G_0.5%, without a statistically significant difference among groups (p > 0.05). The UTS values ranged from 32.85 (±6.08) MPa for G_0.5% to 35.12 (±5.74) MPa for G_Ctrl (p > 0.05). MYTAB groups showed antibacterial activity against biofilm formation from 0.5 wt % (p < 0.05) and against planktonic bacteria from 1 wt % (p < 0.05). The higher the MYTAB concentration, the higher the cytotoxic effect, without differences between G_Ctrl e G_0.5% (p > 0.05). In conclusion, the addition of 0.5 wt % of MYTAB did not alter the physical and chemical properties of the dental resin and provided antibacterial activity without cytotoxic effect.

The synergistic effect of hierarchical structure and alkyl chain length on the antifouling and bactericidal properties of cationic/zwitterionic block polymer brushes

A well-organized hierarchical structure and appropriate alkyl chain length facilitate the synergistic anti-biofilm effect.