Mechanical deformation of elastomer medical devices can enable microbial surface colonization

Elastomers such as silicone are common in medical devices (catheters, prosthetic implants, endoscopes), but they remain prone to microbial colonization and biofilm infections. For the first time, our work shows that rates of microbial surface attachment to polydimethylsiloxane (PDMS) silicone can be significantly affected by mechanical deformation. For a section of bent commercial catheter tubing, bacteria (P. aeruginosa) show a strong preference for the 'convex' side compared to the 'concave' side, by a factor of 4.2. Further testing of cast PDMS materials in bending only showed a significant difference for samples that were manually wiped (damaged) beforehand (1.75 × 10⁴ and 6.02 × 10³ cells/mm² on the convex and concave sides, respectively). We demonstrate that surface microcracks in elastomers are opened under tensile stress (convex bending) to become 'activated' as sites for microbial colonization. This work demonstrates that the high elastic limit of elastomers enables these microcracks to reversibly open and close, as 'dynamic defects'. Commercial catheters have relatively high surface roughness inherent to manufacturing, but we show that even manual wiping of newly-cast PDMS is sufficient to generate surface microcracks. We consider the implication for medical devices that feature sustained, surgical, or cyclic deformation, in which localized tensile conditions may expose these surface defects to opportunistic microbes. As a result, our work showcases serious potential problems in the widespread usage and development of elastomers in medical devices.

Surface Texturing and Combinatorial Approaches to Improve Biocompatibility of Implanted Biomaterials

Biomaterial associated microbial infection and blood thrombosis are two of the barriers that inhibit the successful use of implantable medical devices in modern healthcare. Modification of surface topography is a promising approach to combat microbial infection and thrombosis without altering bulk material properties necessary for device function and without contributing to bacterial antibiotic resistance. Similarly, the use of other antimicrobial techniques such as grafting poly(ethylene glycol) (PEG) and nitric oxide (NO) release also improve the biocompatibility of biomaterials. In this review, we discuss the development of surface texturing techniques utilizing ordered submicron-size pillars for controlling bacterial adhesion and biofilm formation, and we present combinatorial approaches utilizing surface texturing in combination with poly(ethylene glycol) (PEG) grafting and NO release to improve the biocompatibility of biomaterials. The manuscript also discusses efforts towards understanding the molecular mechanisms of bacterial adhesion responses to the surface texturing and NO releasing biomaterials, focusing on experimental aspects of the approach.

Surface Modification of Titanium by Femtosecond Laser in Reducing Bacterial Colonization

In the past few decades, titanium and its alloys have been widely used in the orthopaedic field. However, because titanium is bioinert and lacks antibacterial properties, infection may happen when bacteria attach to implant surfaces and form biofilms. It has been studied that some naturally existing micron-scale topographies can reduce bacterial attachment such as cicada wings and gecko skins. The aim of this in vitro study was to find an implant with good biocompatibility and antimicrobial properties by the modification of micron-scale topographies. In this paper, a femtosecond laser was used to provide microtopography coatings on Ti substrates. The surface morphology of Ti substrates was observed by scanning electron microscopy (SEM). XPS was used to fulfil the chemical compositional analysis. The surface wettability was measured by contact angle measurement system. The effect of microtopography coatings with different surface microstructures on bacterial activities and bone marrow mesenchymal stem cells (BMSC) functions was investigated. The results of in vitro study revealed that microtopography coatings restrain the adhesion of Staphylococcus aureus (S. aureus) and Staphylococcus epidermidis (S. epidermidis), which are common pathogens of orthopaedic implant infections. In addition, microtopography coatings stimulated BMSC adhesion and proliferation. Our studies suggest that a microtopography-coated sample modified by femtosecond laser showed promising antibacterial properties and favourable biocompatibility. The femtosecond laser technique provides an accurate and valid way to produce microtopography coatings with outstanding biocompatibility and antimicrobial properties, and could be widely used to modify the surface of orthopaedic metal implants with great potential.

How microbes read the map: Effects of implant topography on bacterial adhesion and biofilm formation

Microbes have remarkable capabilities to attach to the surface of implanted medical devices and form biofilms that adversely impact device function and increase the risk of multidrug-resistant infections. The physicochemical properties of biomaterials have long been known to play an important role in biofilm formation. More recently, a series of discoveries in the natural world have stimulated great interest in the use of 3D surface topography to engineer antifouling materials that resist bacterial colonization. There is also increasing evidence that some medical device surface topographies, such as those designed for tissue integration, may unintentionally promote microbial attachment. Despite a number of reviews on surface topography and biofilm control, there is a missing link between how bacteria sense and respond to 3D surface topographies and the rational design of antifouling materials. Motivated by this gap, we present a review of how bacteria interact with surface topographies, and what can be learned from current laboratory studies of microbial adhesion and biofilm formation on specific topographic features and medical devices. We also address specific biocompatibility considerations and discuss how to improve the assessment of the anti-biofilm performance of topographic surfaces. We conclude that 3D surface topography, whether intended or unintended, is an important consideration in the rational design of safe medical devices. Future research on next-generation smart antifouling materials could benefit from a greater focus on translation to real-world applications.

Exploring the potential of polyethylene terephthalate in the design of antibacterial surfaces

Polyethylene terephthalate (PET) is one of the most used polymeric materials in the health care sector mainly due to its advantages that include biocompatibility, high uniformity, mechanical strength and resistance against chemicals and/or abrasion. However, avoiding bacterial contamination on PET is still an unsolved challenge and two main strategies are being explored to overcome this drawback: the anti-adhesive and biocidal modification of PET surface. While bacterial adhesion depends on several surface properties namely surface charge and energy, hydrophilicity and surface roughness, a biocidal effect can be obtained by antimicrobial compounds attached to the surface to inhibit the growth of bacteria (bacteriostatic) or kill bacteria (bactericidal). Therefore, it is well known that granting antibacterial properties to PET surface would be beneficial in the prevention of infectious diseases. Different modification methods have been reported for such purpose. This review addresses some of the strategies that have been attempted to prevent or reduce the bacterial contamination on PET surfaces, including functionalisation, grafting, topographical surface modification and coating. Those strategies, particularly the grafting method seems to be very promising for healthcare applications to prevent infectious diseases and the emergence of bacteria resistance.

Reduced bacterial adhesion on zirconium-based bulk metallic glasses by femtosecond laser nanostructuring

As high-performing materials, bulk metallic glasses have attracted widespread attention for biomedical applications. Herein, the bacterial adhesion properties of femtosecond laser-nanostructured surfaces of four types of zirconium-based bulk metallic glasses are assessed. Laser-induced periodical surface structures and nanoparticle structures were fabricated by femtosecond laser irradiation under different energy intensities (0.23 and 2.3 J/mm2). Surface topography, roughness, wettability, and surface energy were investigated after femtosecond laser irradiation and the surface bacterial adhesion properties were explored using Escherichia coli and Staphylococcus aureus as respective representatives of Gram-negative and Gram-positive bacteria. 4',6-Diamidino-2-phenylindole fluorescence staining was used to characterize and assess the bacterial surface coverage rate. The in vitro cytotoxicity of polished and laser-nanostructured surfaces was investigated using MC3T3-E cells. The obtained results demonstrate that femtosecond laser surface nanostructuring retained the amorphous structure of zirconium-based bulk metallic glasses and led to an obvious decrease in bacterial adhesion compared with polished surfaces. The inhibition of bacterial adhesion on laser-induced periodical surface structures was greater than on nanostructured surfaces after 24 h of bacterial incubation. In addition, femtosecond laser nanostructuring did not have an apparent effect on the cytotoxicity of zirconium-based bulk metallic glasses.

Bacterial mechanosensing: the force will be with you, always

Whether bacteria are in the planktonic state, free-swimming or free-floating in liquid, or in the biofilm state, sessile on surfaces, they are always subject to mechanical forces. The long, successful evolutionary history of bacteria implies that they are capable of adapting to varied mechanical forces, and probably even actively respond to mechanical cues in their changing environments. However, the sensing of mechanical cues by bacteria, or bacterial mechanosensing, has been under-investigated. This leaves the mechanisms underlying how bacteria perceive and respond to mechanical cues largely unknown. In this Review, we first examine the surface-associated behavior of bacteria, outline the clear evidence for bacterial mechanosensing and summarize the role of flagella, type-IV pili, and envelope proteins as potential mechanosensors, before presenting indirect evidence for mechanosensing in bacteria. The general themes underlying bacterial mechanosensing that we highlight here may provide a framework for future research.

Microorganisms @ materials surfaces in aircraft: Potential risks for public health? - A systematic review

BACKGROUND

Civil air travel is increasingly recognized as an important potential source for the rapid spread of infectious diseases that were geographically confined in the past, creating international epidemics with great health and socio-economic impact.

OBJECTIVE

The objective of this systematic review is to elucidate the correlations of materials surfaces (composition, structure, properties) and microbial dependences on them in aircraft.

METHODS

The review was prepared according to PRISMA guidelines. Based on a systematic search for studies published before 30 June 2018 in English, we selected and reviewed the contamination, tenacity, and transmission of microorganisms related to specific surfaces within the aircraft cabin. We also reviewed the chemical composition and properties of these surface materials applied within aircraft.

RESULTS

From a total of 828 records 15 articles were included for further analysis in this systematic review, indicating that the aircraft interior surfaces in seat areas (tray tables, armrests, seat covers) and lavatories (door knob handles, toilet flush buttons) are generally colonized by various types of potentially hazardous microorganisms.

CONCLUSIONS

The interior surfaces in seat and lavatory areas could pose higher health risks by causing infections due to their relatively high microbial contamination compared with other interior surfaces. The classification, chemical composition, surface structures and physicochemical properties of materials surfaces have a varied effect on the adhesion, colonization, tenacity and potential transmission of microorganisms within the aircraft cabin. Strategies are proposed for the interruption of surface-related infection chains in the aircraft field.

Micro-textured films for reducing microbial colonization in a clinical setting

BACKGROUND

Transmission of microbes in the hospital environment occurs frequently through human interactions with high-touch surfaces such as patient beds and over-bed tables. Although stringent cleaning routines are implemented as a preventive measure to minimize transmission of microbes, it is desirable to have high-touch surfaces made of antimicrobial materials. Physical texturing of solid surfaces offers a non-bactericidal approach to control the colonization of such surfaces by microbes.

AIM

To investigate the efficacy of micro-textured polycarbonate films in reducing bacterial load on over-bed tables in a hospital ward.

METHODS

Two different micro-patterns were fabricated on polycarbonate film via a thermal imprinting method. Micro-textured films were then mounted on patient over-bed tables in a general hospital ward and the bacterial load monitored over 24 h. Total colony counts, which represented on-specific bacterial loading, and meticillin-resistant Staphylococcus aureus counts were monitored at each time-point.

FINDINGS

Over a period of 24 h, both micro-textured surfaces showed consistently lower bacterial load as compared to the unpatterned polycarbonate and the bare over-bed table laminate. This study supports the findings of earlier laboratory-scale studies that microscale physical texturing can reduce bacterial colonization on a solid surface.

CONCLUSION

Results of the current study suggest that micro-textured surfaces could provide a viable method for reducing microbial contamination of high-touch surfaces in hospitals.

Bacterial growth, detachment and cell size control on polyethylene terephthalate surfaces

In medicine and food industry, bacterial colonisation on surfaces is a common cause of infections and severe illnesses. However, the detailed quantitative information about the dynamics and the mechanisms involved in bacterial proliferation on solid substrates is still lacking. In this study we investigated the adhesion and detachment, the individual growth and colonisation, and the cell size control of Escherichia coli (E. coli) MG1655 on polyethylene terephthalate (PET) surfaces. The results show that the bacterial growth curve on PET exhibits the distinct lag and log phases, but the generation time is more than twice longer than in bulk medium. Single cells in the lag phase are more likely to detach than clustered ones in the log phase; clustered bacteria in micro-colonies have stronger adhesive bonds with surfaces and their neighbours with the progressing colonisation. We show that the cell size is under the density-dependent pathway control: when the adherent cells are at low density, the culture medium is responsible for coordinating cell division and cell size; when the clustered cells are at high population density, we demonstrate that the effect of quorum sensing causes the cell size decrease as the cell density on surfaces increases.