Acyclic N-halamine-immobilized polyurethane: Preparation and antimicrobial and biofilm-controlling functions

A review on the promising antibacterial agents in bone cement-From past to current insights

Antibacterial bone cements (ABCs), such as antibiotic-loaded bone cements (ALBCs), have been widely utilized in clinical treatments. Currently, bone cements loaded with vancomycin, gentamicin, tobramycin, or clindamycin are approved by the US Food and Drug Administration. However, traditional ALBCs exhibit drawbacks like burst release and bacterial resistance. Therefore, there is a demand for the development of antibacterial bone cements containing novel agents to address these defects. In this review, we provide an overview and prospect of the new antibacterial agents that can be used or have the potential to be applied in bone cement, including metallic antibacterial agents, pH-switchable antibacterial agents, cationic polymers, N-halamines, non-leaching acrylic monomers, antimicrobial peptides and enzymes. Additionally, we have conducted a preliminary assessment of the feasibility of bone cement containing N-halamine, which has demonstrated good antibacterial activities. The conclusion of this review is that the research and utilization of bone cement containing novel antibacterial agents contribute to addressing the limitations of ALBCs. Therefore, it is necessary to continue expanding the research and use of bone cement incorporating novel antibacterial agents. This review offers a novel perspectives for designing ABCs and treating bone infections.

High-efficacy antimicrobial acyclic N-halamine-grafted polyvinyl alcohol film

With N,N'-methylenebisacrylamide (MBA) and polyvinyl alcohol (PVA) as raw materials, a polymer (PVA-MBA) containing N-halamine precursor functional groups was obtained via grafting reaction between the active hydroxyl groups on PVA and α, β-unsaturated functional groups of MBA under the catalysis of sodium carbonate in an aqueous solution. An acyclic N-halamine precursor-grafted PVA (MBA-PVA) film was formed by simply spreading PVA-MBA aqueous solution in a glass dish and drying it. An antimicrobial acyclic N-halamine-grafted PVA (PVA-MBA-Cl) film was achieved by spraying the diluted sodium hypochlorite solution onto the surface of PVA-MBA film. The performance test of PVA-MBA-Cl film under the optimal preparation conditions showed that the tensile performance and the hydrophobicity were improved, compared to the PVA film. The storage stability test indicated that the oxidative chlorine content Cl+ (atoms/cm2) of the as-prepared PVA-MBA-Cl film only reduced by 14.3% after storage for 9 weeks, showing that the antibacterial N-halamine functional groups in PVA-MBA-Cl film has excellent storage stability under room temperature. Antibacterial test showed that the PVA-MBA-Cl film had very strong antibacterial efficacies and could completely kill 1.28 × 106 CFU/mL S. aureus and 1.89 × 106 CFU/mL E. coli within 1 min. Therefore, PVA-MBA-Cl film will have more potential applications in food package.

Virucidal properties of new multifunctional fibrous N-halamine-immobilized styrene-divinylbenzene copolymers

Virucidal properties of N-chlorosulfonamides immobilized on fibrous styrene-divinylbenzene copolymers have been studied. Corresponding materials with different functional group structures and chlorine content have been synthesized on FIBAN polymer carriers in the form of staple fibers and non-woven fabrics. The study has been conducted in general accordance with EN 14476 standard on poliovirus type-1 and adenovirus type-5. It has been found that all tested samples exhibit pronounced virucidal activity: regardless of the carrier polymer form, sodium N-chlorosulfonamides inactivated both viruses in less than 30 s, and N,N-dichlorosulfonamides—in 30–60 s. The main mechanism of action of these materials, obviously, consists in the emission of active chlorine from the functional group into the treated medium under the action of the amino groups of virus fragments and cell culture. Considering the previously described antimicrobial and reparative properties of such materials, as well as their satisfactory physical and mechanical properties, the synthesized polymers are promising for the creation of medical devices with increased resistance to microbial contamination, such as protective masks, filter elements, long-acting wound dressings, and others.

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.

A Novel N-Halamine Biocidal Nanofibrous Membrane for Chlorine Rechargeable Rapid Water Disinfection Applications

Disinfecting pathogenic contaminated water rapidly and effectively on sites is one of the critical challenges at point-of-use (POU) situations. Currently available technologies are still suffering from irreversible depletion of disinfectants, generation of toxic by-products, and potential biofouling problems. Herein, we developed a chlorine rechargeable biocidal nanofibrous membrane, poly(acrylonitrile-co-5-methyl-5-(4'-vinylphenyl)imidazolidine-2,4-dione) (P(AN-VAPH)), via a combination of a free radical copolymerization reaction and electrospun technology. The copolymer exhibits good electrospinnability and desirable mechanical properties. Also, the 5-methyl-5-(4'-vinylphenyl)imidazolidine-2,4-dione (VAPH) moieties containing unique hydantoin structures are able to be chlorinated and converted to halamine structures, enabling the P(AN-VAPH) nanofibrous membrane with rapid and durable biocidal activity. The chlorinated P(AN-VAPH) nanofibrous membranes showed intriguing features of unique 3D morphological structures with large specific surface area, good mechanical performance, rechargeable chlorination capacity (>5000 ppm), long-term durability, and desirable biocidal activity against both bacteria and viruses (>99.9999% within 2 min of contact). With these attributes, the chlorinated P(AN-VAPH) membranes demonstrated promising disinfecting efficiency against concentrated bacteria-contaminated water during direct filtration applications with superior killing capacity and high flowing flux (5000 L m^-2 h^-1).

Dynamically crosslinked polydimethylsiloxane-based polyurethanes with contact-killing antimicrobial properties as implantable alloplasts for urological reconstruction

A large population of patients is reported to suffer from urinary bladder-associated irreversible physiological disorders, rationalizing a continuous surge for structural and functional substitutes of urinary tissues, including ureters, bladder-wall, and urethra. The current gold standard for bladder reconstruction, an autologous gastrointestinal graft, is proven not to be an ideal substitute in the clinic. While addressing this unmet clinical need, a unique platform of antimicrobial polydimethyl siloxane-modified polyurethanes (TPU/PDMS) is designed and developed for its potential application as a urological implant. To the best of our knowledge, this study reports for the first time the successful integration of varying contents of PDMS within the molten polyurethane matrix using in situ crosslinking methodology. Thus, compatibilized binary blends possess clinically relevant viscoelastic properties to sustain high pressure, large distensions, and surgical manipulation. Furthermore, different chemical strategies are explored to covalently incorporate quaternized moieties, including 4-vinyl pyridine (4-VP), branched-polyethyleneimine (bPEI) as well as bPEI-grafted-(acrylic acid-co-vinylbenzyltriphenyl phosphonium chloride) (PAP), and counter urinary tract infections. The modified compositions, endowed with contact killing surfaces, reveal nearly three log reduction in bacterial growth in pathogenically infected artificial urine. Importantly, the antimicrobial TPU/PDMS blends support the uninhibited growth of mitochondrially viable murine fibroblasts, in a manner comparable to the medical-grade polyurethane. Collectively, the obtained results affirmed the newly developed polymers as promising biomaterials in reconstructive urology. STATEMENT OF SIGNIFICANCE: The clinical procedure for end-stage bladder disease remains replacement or augmentation of the bladder wall with a section of the patient's gastrointestinal tract. However, the absorptive and mucus-producing epithelium of intestinal segment is liable to short- and long-term complications. The dynamically crosslinked polydimethyl siloxane-based polyurethanes proposed herein, and the associated synthesis strategies to induce polycation grafted non-exhaustive contact-killing surfaces against uropathogents, have a significant clinical prospect in reconstructive urology. As an 'off-the-shelf' available alloplastic substitute, these blends offer the potential to circumvent the challenges associated with non-urinary autografts or scaffold based regenerative engineering and, thereby, shorten as well as simplify the surgical treatment. The targeted application has been conceived for a bladder patch to assist in various urinary diseases including, bladder carcinoma, refractory overactive bladder, interstitial cystitis, etc. However, given the ease of fabrication, moldability and the wide spectrum of mechanical properties that could be encompassed, these blends also present the possibility to be manifested into artificial ureteral or urethral conduits.

Sodium triphosphate–capped silver nanoparticles on a decellularized scaffold-based polyurethane vascular patch for bacterial infection inhibition and rapid endothelialization

With increasing incidence rate of cardiovascular diseases and implant-related infections, there is growing demand for vascular patches that can promote endothelialization and resist bacterial infection. In this work, we immobilized sodium triphosphate–capped silver nanoparticles onto a polyurethane film to obtain a composite film and evaluated its in vitro biocompatibility. Subsequently, we anchored sodium triphosphate–capped silver nanoparticles onto a polyurethane-coated decellularized scaffold to prepare a vascular patch and investigated its in vivo performance in a mouse model. The prepared vascular patch demonstrated excellent biocompatibility and potent antibacterial activity against Escherichia coli and Staphylococcus aureus. It still maintained the surgical artery patency at 30 days after implantation. At the same time, the endothelialization at the surgical site was achieved, showing its ability to facilitate endothelialization. Therefore, it may be a promising candidate for combating bacterial infection and treating diseased blood vessels.

N-Halamine modified thermoplastic polyurethane with rechargeable antimicrobial function for food contact surface

A TPU elastomer was modified with N-halamine polymers as a novel food contact surface material with rechargeable antimicrobial activity.

Evaluation of antimicrobial efficacy of quaternized poly[bis(2-chloroethyl)ether-alt-1,3-bis[3-(dimethylamino)propyl]urea] against targeted pathogenic and multi-drug-resistant bacteria

Here, we have investigated in vitro antimicrobial efficacy of a quaternized cationic polymer, poly[bis(2-chloroethyl)ether- alt-1,3-bis[3-(dimethylamino)propyl]urea] (polyquaternium-2), against gram-positive as well as gram-negative bacteria along with several multi-drug-resistant bacterial strains. The antimicrobial efficacy of this polymer was first tested against some clinical pathogens followed by microorganisms isolated from acne lesions. Interestingly, polyquaternium-2 exhibited significant antimicrobial activity against methicillin-resistant Staphylococcus aureus, for which very limited drugs are available. Most importantly, the polymer displayed low haemolytic activity and non-toxic behaviour against mammalian cells. The results showed the promising potential of the projected polymer to be utilized as an antibacterial agent for various biomedical applications.

Improved proliferation and osteogenic differentiation of human mesenchymal stem cells on a titanium biomaterial grafted with poly(sodium styrene sulphonate) and coated with a platelet-rich plasma proteins biofilm

In order to replace damaged or lost bone in the human body, it is necessary to produce ‘spare body parts’ which are dependent on the use of biomaterial and stem cells and are referred to as ‘tissue engineering’. Surface modification and stem cell interaction of orthopaedic implants offer a promising approach and are investigated here specifically to improve osseointegration of the biomaterial. Osseointegration of titanium implants used in orthopaedic surgery requires that osseo-progenitor cells attach and adhere to the surface, proliferate, then differentiate into osteoblasts and, finally, produce a mineralised matrix. The surface modification of titanium with anionic polymer combined with coating of platelet-rich plasma is provided to create a favourable environment to promote early and strong fixation of implants. The ability of progenitor cells to attach to the surface during early stages is important in the development of new tissue structures; therefore, we developed in our laboratory a strategy involving the grafting of titanium implants with a polymer of sodium styrene sulphonate (poly(sodium styrene sulphonate)) and a biofilm coating of platelet-rich plasma which enables human mesenchymal stem cell interactions. The resulting biomaterial, titanium-poly(sodium styrene sulphonate) and coating of platelet-rich plasma, Ti-poly(sodium styrene sulphonate)–platelet-rich plasma was developed in order to further improve the biomaterial. In this work, we studied and characterised the ‘in vitro’ response of human mesenchymal stem cells to titanium biomaterial grafted with poly(sodium styrene sulphonate) bioactive polymer and coated with platelet-rich plasma proteins (Ti-poly(sodium styrene sulphonate)–platelet-rich plasma). This study shows an increased cell proliferation with Ti-poly(sodium styrene sulphonate)–platelet-rich plasma compared to foetal calf serum and an enhancement of the Ti-poly(sodium styrene sulphonate)–platelet-rich plasma effects on osteoblast differentiation. The results suggest that Ti-poly(sodium styrene sulphonate)–platelet-rich plasma would be a suitable scaffold for bone tissue engineering.

Evaluation of the Antimicrobial Functions of N-halamine Dental Unit Waterline Tubing for One Year

OBJECTIVES

The objective of this study was to test the biofilm-controlling properties of N-halamine antimicrobial dental unit waterline (DUWL) tubing (T) tubing, without recharging over one year, compared to a control line (C).

METHODS

A simulated clinical model was used to pump ultrapure water through T and C lines at a rate of 1.4 mL/min, five minutes on, 15 minutes off, eight hours/day, five days a week. Samples of source water, effluent from T and C, and from the stagnant water in the carboy (liquid container) after bench work was completed (S2), were collected aseptically, serially diluted, and cultured on R2A agar for seven days every six weeks. SEM images of the inside surfaces of detached tubing sections were also taken. The carboy was rinsed with a 1:10 dilution of sodium hypochlorite after six months. Means of log transformed CFU values obtained in triplicate were paired by T and C lines across months for comparison by paired Student's t-tests.

RESULTS

An increase in effluent and carboy bacterial counts were noted after six months, but decreased after bleach rinse of the carboy. No significant difference (p > 0.25) between T and C lines were observed; similarly, T and carboy were not significantly different (p > 0.30). SEM images showed biofilm attachment on the inside surface of C after two months, but not on T. Organisms identified in the effluent reflected those in the source carboy.

CONCLUSIONS

No biofilm attachment was detected on the N-halamine test line after 12 months, indicating its antimicrobial properties were retained. Further evaluation is recommended to determine the optimal recharge interval for N-halamine DUWL tubing when ultrapure source water is used.

Infection-resistant styrenic thermoplastic elastomers that can switch from bactericidal capability to anti-adhesion

Infection-resistant styrenic thermoplastic elastomers that can switch from bactericidal capability to anti-adhesion are facilely chloromethylated, followed by quaternization with methyl 3-(dimethylamino) propionate.

Facile Fabrication of Lubricant-Infused Wrinkling Surface for Preventing Thrombus Formation and Infection

Despite the advanced modern biotechniques, thrombosis and bacterial infection of biomedical devices remain common complications that are associated with morbidity and mortality. Most antifouling surfaces are in solid form and cannot simultaneously fulfill the requirements for antithrombosis and antibacterial efficacy. In this work, we present a facile strategy to fabricate a slippery surface. This surface is created by combining photografting polymerization with osmotically driven wrinkling that can generate a coarse morphology, and followed by infusing with fluorocarbon liquid. The lubricant-infused wrinkling slippery surface can greatly prevent protein attachment, reduce platelet adhesion, and suppress thrombus formation in vitro. Furthermore, E. coli and S. aureus attachment on the slippery surfaces is reduced by ∼98.8% and ∼96.9% after 24 h incubation, relative to poly(styrene-b-isobutylene-b-styrene) (SIBS) references. This slippery surface is biocompatible and has no toxicity to L929 cells. This surface-coating strategy that effectively reduces thrombosis and the incidence of infection will greatly decrease healthcare costs.

Immobilization of heparin on chitosan-grafted polyurethane films to enhance anti-adhesive and antibacterial properties

Infections caused by bacteria adhering to implant surfaces are one of the main reasons for the failure of the implants. In this study, polyurethane (PU), which is the most commonly used polymer in the production of medical devices, was synthesized and surfaces of polyurethane films were modified by chitosan (CH) grafting and heparin (Hep) immobilization in order to enhance anti-adhesiveness and antibacterial properties. Functional groups present on the surface, topographical shapes, and free energies of the polyurethane films were determined. Pristine polyurethane, chitosan-grafted polyurethane (PU–CH), and heparin immobilized polyurethane (PU–CH–Hep) films demonstrated high anti-adhesive efficacy against bacteria in the given order, where PU–CH–Hep was the most effective one. When PU–CH–Hep samples were incubated with different bacteria, complete death was observed for Pseudomonas aeruginosa (Gram negative), Staphylococcus aureus (Gram positive), and Staphylococcus epidermidis (Gram positive). Some living Escherichia coli (Gram negative) were observed after 24 h of incubation. Pristine and modified polyurethane samples demonstrated no adverse effect on proliferation of L929 fibroblast cells and were found to be biocompatible according to MTT cytotoxicity tests.