Photoactive TiO₂ antibacterial coating on surgical external fixation pins for clinical application

Adjusting the Dose of Ag-Ion Implantation on TiN-Ag-Modified SLA-Ti Creates Different Micronanostructures: Implications on Bacteriostasis, Biocompatibility, and Osteogenesis in Dental Implants

The prevention of aseptic loosening and peri-implantitis is crucial for the success of dental implant surgery. In this study, different doses of Ag-implanted TiN/Ag nanomultilayers were prepared on the sandblasting with large grit and acid etching (SLA)-Ti surface using a multiarc ion-plating system and an ion-implantation system, respectively. The physical and chemical properties of the samples were assessed using various techniques, including scanning electron microscopy, energy-dispersive spectroscopy, X-ray diffraction, X-ray photoelectron spectroscopy, atomic force microscopy, inductively coupled plasma atomic emission spectrometry, and water contact angle measurements. In addition, the applicability and biosafety of the SLA/1 × 1017-Ag and SLA/1 × 1018-Ag surfaces were determined via biocompatibility testing in vivo and in vitro. The results demonstrated that the physical and chemical properties of SLA/1 × 1017-Ag and SLA/1 × 1018-Ag surfaces were different to some extent. However, compared with SLA-Ti, silver-loaded TiN/Ag-modified SLA-Ti surfaces (SLA/1 × 1018-Ag) with enhanced bacteriostatis, osteogenesis, and biocompatibility have great potential for dental applications.

Self-assembled BiFeO3@MIL-101 nanocomposite for antimicrobial applications under natural sunlight

In this paper, we report on the synthesis of a new hybrid photocatalytic material activated by natural sunlight irradiation. The material consists of multiferroic nanoparticles of bismuth ferrite (BFO) modified through the growth of the Fe-based MIL-101 framework. Material characterization, conducted using various techniques (X-ray diffraction, transmission electron microscopy, FTIR, and X-ray photoelectron spectroscopies), confirmed the growth of the MIL-101 metal-organic framework on the BFO surface. The obtained system possesses the intrinsic photo-degradative properties of BFO nanoparticles significantly enhanced by the presence of MIL-101. The photocatalytic activity of this material was tested in antibacterial experiments conducted under natural sunlight exposure within the nanocomposite concentration range of 100-0.20 µg/ml. The MIL-modified BFO showed a significant decrease in both Minimum Inhibiting Concentration and Minimum Bactericide Concentration values compared to bare nanoparticles. This confirms the photo-activating effect of the MIL-101 modification. In particular, they show an increased antimicrobial activity against the tested Gram-positive species and the ability to begin to inhibit the growth of the four Escherichia coli strains, although at the maximum concentration tested. These results suggest that the new nanocomposite BiFeO3@MOF has been successfully developed and has proven to be an effective antibacterial agent against a wide range of microorganisms and a potential candidate in disinfection processes.

Preparation and Real World Applications of Titania Composite Materials for Photocatalytic Surface, Air, and Water Purification: State of the Art

The semiconducting transition metal oxide TiO2 is a rather cheap and non-toxic material with superior photocatalytic properties. TiO2 thin films and nanoparticles are known to have antibacterial, antiviral, antifungal, antialgal, self, water, and air-cleaning properties under UV or sun light irradiation. Based on these excellent qualities, titania holds great promises in various fields of applications. The vast majority of published field and pilot scale studies are dealing with the modification of building materials or generally focus on air purification. Based on the reviewed papers, for the coating of glass, walls, ceilings, streets, tunnels, and other large surfaces, titania is usually applied by spray-coating due to the scalibility and cost-efficiency of this method compared to alternative coating procedures. In contrast, commercialized applications of titania in medical fields or in water purification are rarely found. Moreover, in many realistic test scenarios it becomes evident that the photocatalytic activity is often significantly lower than in laboratory settings. In this review, we will give an overview on the most relevant real world applications and commonly applied preparation methods for these purposes. We will also look at the relevant bottlenecks such as visible light photocatalytic activity and long-term stability and will make suggestions to overcome these hurdles for a widespread usage of titania as photocalyst.

Surface coating of orthopedic implant to enhance the osseointegration and reduction of bacterial colonization: a review

The use of orthopedic implants in surgical technology has fostered restoration of physiological functions. Along with successful treatment, orthopedic implants suffer from various complications and fail to offer functions correspondent to native physiology. The major problems include aseptic and septic loosening due to bone nonunion and implant site infection due to bacterial colonization. Crucial advances in material selection in the design and development of coating matrixes an opportunity for the prevention of implant failure. However, many coating materials are limited in in-vitro testing and few of them thrive in clinical tests. The rate of implant failure has surged with the increasing rates of revision surgery creating physical and sensitive discomfort as well as economic burdens. To overcome critical pathogenic activities several systematic coating techniques have been developed offering excellent results that combat infection and enhance bone integration. This review article includes some more common implant coating matrixes with excellent in vitro and in vivo results focusing on infection rates, causes, complications, coating materials, host immune responses and significant research gaps. This study provides a comprehensive overview of potential coating technology, with functional combination coatings which are focused on ultimate clinical practice with substantial improvement on in-vivo tests. This includes the development of rapidly growing hydrogel coating techniques with the potential to generate several accurate and precise coating procedures.

Fungal-derived Selenium Nanoparticles and Their Potential Applications in Electroless Silver Coatings for Preventing Pin-tract Infections

Pin-tract infections (PTIs) are a common complication of external fixation of fractures and current strategies for preventing PTIs have proven to be ineffective. Recent advances show that the use of anti-infection coatings with local antibacterial activity may solve this problem. Selenium has been considered as a promising anti-infection agent owing to its antibacterial and antibiofilm activities. In this study, selenium nanoparticles (SeNPs) were synthesized via a cost-effective fungi-mediated biorecovery approach and demonstrated excellent stability and homogeneity. To investigate their anti-infection potential, the SeNPs were doped in silver coatings through an electroless plating process and the silver–selenium (Ag–Se) coatings were tested for antibacterial and antibiofilm properties against Staphylococcus aureus F1557 and Escherichia coli WT F1693 as well as corrosion resistance in simulated body fluid. It was found that the Ag–Se coating significantly inhibited S.aureus growth and biofilm formation on the surface, reducing 81.2% and 59.7% of viable bacterial adhesion when compared with Ag and Ag–PTFE-coated surfaces after 3 days. The Ag–Se coating also exhibited improved corrosion resistance compared with the Ag coating, leading to a controlled release of Ag⁺, which in turn reduced the risk of cytotoxicity against hFOBs. These results suggest that the fungal-derived SeNPs may have potential in use as implant coatings to prevent PTIs.

Current and novel diagnostics for orthopedic implant biofilm infections: a review

Biofilm infections involving orthopedic implants are a global problem. They contribute to severe complications and mortality, as well as increased use of antibiotic treatments and development of antibiotic-resistant microorganisms. More than 1 million hip and knee arthroplasties are performed each year in the United States. These hard-to-treat infections lead to patient distress, increased morbidity, and high financial costs to both patients and healthcare systems. There is a need to improve the diagnosis of such biofilm infections to allow for earlier detection and treatment. Current diagnostics rely on clinical signs for infections such as loss of function, fever, rubor, patient history of the predisposing condition, persisting infection, failure of antibiotic treatment, and documentation of antibiotic failure. Below, we present a framework which outlines the data gaps in the conventional laboratory techniques used in clinical diagnostics; we also discuss promising novel diagnostic methods which are currently used solely in research. It is critical to assess these novel infection diagnostic techniques and address the data gaps and clinical hesitance preventing application in a clinical setting. Additionally, the combination of conventional and novel diagnostic technologies would streamline the diagnostic process of biofilm infections associated with orthopedic implants.

Investigating and correlating photoelectrochemical, photocatalytic, and antimicrobial properties of [Formula: see text] nanolayers

Semiconducting transition metal oxides such as [Formula: see text] are promising photo(electro)catalysts for solar water splitting and photoreduction of [Formula: see text] as well as for antibacterial, self-, water and air-cleaning coatings and admixtures in paints, building materials, on window glass or medical devices. In photoelectrocatalytic applications [Formula: see text] is usually used as photoanode only catalyzing the oxidation reaction. In coatings and admixtures [Formula: see text] works as heterogeneous catalyst and has to catalyze a complete redox cycle. While photoelectrochemical charge transport parameters are usually quite well accessible by electrochemical measurements, the quantitative description of photocatalytic properties is more challenging. Here, we present a systematic structural, photoelectrocatalytic, photocatalytic and antimicrobial study to understand if and how photoelectrochemical parameters can be used to predict the photocatalytic activity of [Formula: see text]. For this purpose [Formula: see text] thin films on flourine-doped tin oxide substrates were prepared and annealed at temperatures between 200 and 600 [Formula: see text]. The film morphologies and thicknesses were studied by GIXRD, FESEM, and EDX. Photoelectrochemical properties were measured by linear sweep voltammetry, photoelectrochemical impedance spectroscopy, chopped light chronoamperometry, and intensity modulated photocurrent/ photovoltage spectroscopy. For comparison, photocatalytic rate constants were determined by methylene blue degradation and Escherichea coli inactivation and correlated with the deduced photoelectrocatalytic parameters. We found that the respective photoactivities of amorphous and crystalline [Formula: see text] nanolayers can be best correlated, if the extracted photoelectrochemical parameters such as charge transfer and recombination rates, charge transfer efficiencies and resistances are measured close to the open circuit potential (OCP). Hence, the interfacial charge transport parameters at the OCP can be indeed used as descriptors for predicting and understanding the photocatalytic activity of [Formula: see text] coatings.

The prospects of antimicrobial coated medical implants

The implants are increasingly being a part of modern medicine in various surgical procedures for functional or cosmetic purposes. The progressive use of implants is associated with increased infectious complications and prevention of such infections always remains precedence in the clinical settings. The preventive approaches include the systemic administration of antimicrobial agents before and after the surgical procedures as well as the local application of antibiotics. The relevant literature and existing clinical practices have highlighted the role of antimicrobial coating approaches in the prevention of implants associated infections, although the applications of these strategies are not yet standardized, and the clinical efficacy is not much clear. The adequate data from the randomized control trials is challenging because of the unavailability of a large sample size although it is compulsory in this context to assess the clinical efficacy of preemptive practices. This review compares the efficacy of preventive approaches and the prospects of antimicrobial-coated implants in preventing implant-related infections.

Ultrasound Triggered Drug Release from Affinity-Based β-Cyclodextrin Polymers for Infection Control

This work demonstrates a slow, sustained drug delivery system that provides on-demand delivery bursts through the application of pulsed therapeutic ultrasound (TUS). Insoluble β-cyclodextrin-polymer (pCD) disks were loaded with a saturated antibiotic solution of rifampicin (RIF) and used for drug delivery studies. To obtain on-demand release from the implants, TUS was applied at an intensity of 1.8 W/cm². The therapeutic efficacy of the combination treatment was assessed in bacterial culture via an in vitro Staphylococcus aureus bioluminescence assay. The results demonstrated that the application of pulsed TUS at 3 MHz and 1.8 W/cm² to pCD implants leads to a significantly higher short-term burst in the drug release rate compared to samples not treated with TUS. The addition of TUS increased the drug release by 100% within 4 days. The pCD disk + RIF stimulated with TUS showed a comparatively higher bacterial eradication with CFU/mL of 4.277E+09, and 8.00E+08 at 1 and 24 h compared with control treated bacteria at 1.48E+10. Overall, these results suggest that the addition of pulsed TUS could be an effective technology to noninvasively expedite antibiotic release on demand at desired intervals.

An integrated approach to highlight biological responses of Pisum sativum root to nano-TiO2 exposure in a biosolid-amended agricultural soil

This study focused on crop plant response to a simultaneous exposure to biosolid and TiO₂ at micro- and nano-scale, being biosolid one of the major sink of TiO₂ nanoparticles released into the soil environment. We settled an experimental design as much as possible realistic, at microcosm scale, using the crop Pisum sativum. This experimental design supported the hypotheses that the presence of biosolid in the farming soil might influence plant growth and metabolism and that, after TiO₂ spiking, the different dimension and crystal forms of TiO₂ might be otherwise bioavailable and differently interacting with the plant system. To test these hypotheses, we have considered different aspects of the response elicited by TiO₂ and biosolid at cellular and organism level, focusing on the root system, with an integrative approach. In our experimental conditions, the presence of biosolid disturbed plant growth of P. sativum, causing cellular damages at root level, probably through mechanisms not only oxidative stress-dependent but also involving altered signalling processes. These disturbances could depend on non-humified compounds and/or on the presence of toxic elements and of nanoparticles in the biosolid-amended soil. The addition of TiO₂ particles in the sludge-amended soil, further altered plant growth and induced oxidative and ultrastructural damages. Although non typical dose-effect response was detected, the most responsiveness treatments were found for the anatase crystal form, alone or mixed with rutile. Based on ultrastructural observations, we could hypothesise that the toxicity level of TiO₂ nanoparticles may depend on the cell ability to isolate nanoparticles in subcellular compartments, avoiding their interaction with organelles and/or metabolic processes. The results of the present work suggest reflections on the promising practice of soil amendments and on the use of nanomaterials and their safety for food plants and living organisms.

Antifouling and antimicrobial biomaterials: an overview

The use of implantable medical devices is a common and indispensable part of medical care for both diagnostic and therapeutic purposes. However, as side effect, the implant of medical devices quite often leads to the occurrence of difficult-to-treat infections, as a consequence of the colonization of their abiotic surfaces by biofilm-growing microorganisms increasingly resistant to antimicrobial therapies. A promising strategy to combat device-related infections is based on anti-infective biomaterials that either repel microbes, so they cannot attach to the device surfaces, or kill them in the surrounding areas. In general, such biomaterials are characterized by antifouling coatings, exhibiting low adhesion or even repellent properties towards microorganisms, or antimicrobial coatings, able to kill microbes approaching the surface. In this light, the present overview will address the development in the last two decades of antifouling and antimicrobial biomaterials designed to potentially limit the initial stages of microbial adhesion, as well as the microbial growth and biofilm formation on medical device surfaces.

Recent coating developments for combination devices in orthopedic and dental applications: A literature review

Orthopedic and dental implants have been used successfully for decades to replace or repair missing or damaged bones, joints, and teeth, thereby restoring patient function subsequent to disease or injury. However, although device success rates are generally high, patient outcomes are sometimes compromised due to device-related problems such as insufficient integration, local tissue inflammation, and infection. Many different types of surface coatings have been developed to address these shortcomings, including those that incorporate therapeutic agents to provide localized delivery to the surgical site. While these coatings hold enormous potential for improving device function, the list of requirements that an ideal combination coating must fulfill is extensive, and no single coating system today simultaneously addresses all of the criteria. Some of the primary challenges related to current coatings are non-optimal release kinetics, which most often are too rapid, the potential for inducing antibiotic resistance in target organisms, high susceptibility to mechanical abrasion and delamination, toxicity, difficult and expensive regulatory approval pathways, and high manufacturing costs. This review provides a survey of the most recent developments in the field, i.e., those published in the last 2-3years, with a particular focus on technologies that have potential for overcoming the most significant challenges facing therapeutically-loaded coatings. It is concluded that the ideal coating remains an unrealized target, but that advances in the field and emerging technologies are bringing it closer to reality. The significant amount of research currently being conducted in the field provides a level of optimism that many functional combination coatings will ultimately transition into clinical practice, significantly improving patient outcomes.

Interaction of New-Developed TiO₂-Based Photocatalytic Nanoparticles with Pathogenic Microorganisms and Human Dermal and Pulmonary Fibroblasts

TiO₂-based photocatalysts were obtained during previous years in order to limit pollution and to ease human daily living conditions due to their special properties. However, obtaining biocompatible photocatalysts is still a key problem, and the mechanism of their toxicity recently received increased attention. Two types of TiO₂ nanoparticles co-doped with 1% of iron and nitrogen (TiO₂-1% Fe–N) atoms were synthesized in hydrothermal conditions at pH of 8.5 (HT1) and 5.5 (HT2), and their antimicrobial activity and cytotoxic effects exerted on human pulmonary and dermal fibroblasts were assessed. These particles exhibited significant microbicidal and anti-biofilm activity, suggesting their potential application for microbial decontamination of different environments. In addition, our results demonstrated the biocompatibility of TiO₂-1% Fe–N nanoparticles at low doses on lung and dermal cells, which may initiate oxidative stress through dose accumulation. Although no significant changes were observed between the two tested photocatalysts, the biological response was cell type specific and time- and dose-dependent; the lung cells proved to be more sensitive to nanoparticle exposure. Taken together, these experimental data provide useful information for future photocatalytic applications in the industrial, food, pharmaceutical, and medical fields.

From prevention of pin-tract infection to treatment of osteomyelitis during paediatric external fixation

Pin-tract infection (PTI) is the most commonly expected problem, or even an almost inevitable complication, when using external fixation. Left unteated, PTI will progress unavoidably, lead to mechanical pin loosening, and ultimately cause instability of the external fixator pin-bone construct. Thus, PTI remains a clinical challenge, specifically in cases of limb lengthening or deformity correction. Standardised pin site protocols which encompass an understanding of external fixator biomechanics and meticulous surgical technique during pin and wire insertion, postoperative pin site care and pin removal could limit the incidence of major infections and treatment failures. Here we discuss concepts regarding the epidemiology, physiopathology and microbiology of PTI in paediatric populations, as well as the clinical presentations, diagnosis, classification and treatment of these infections.

Antimicrobial technology in orthopedic and spinal implants

Infections can hinder orthopedic implant function and retention. Current implant-based antimicrobial strategies largely utilize coating-based approaches in order to reduce biofilm formation and bacterial adhesion. Several emerging antimicrobial technologies that integrate a multidisciplinary combination of drug delivery systems, material science, immunology, and polymer chemistry are in development and early clinical use. This review outlines orthopedic implant antimicrobial technology, its current applications and supporting evidence, and clinically promising future directions.

Anti-biofilm Activity as a Health Issue

The formation and persistence of surface-attached microbial communities, known as biofilms, are responsible for 75% of human microbial infections (National Institutes of Health). Biofilm lifestyle confers several advantages to the pathogens, notably during the colonization process of medical devices and/or patients’ organs. In addition, sessile bacteria have a high tolerance to exogenous stress including anti-infectious agents. Biofilms are highly competitive communities and some microorganisms exhibit anti-biofilm capacities such as bacterial growth inhibition, exclusion or competition, which enable them to acquire advantages and become dominant. The deciphering and control of anti-biofilm properties represent future challenges in human infection control. The aim of this review is to compare and discuss the mechanisms of natural bacterial anti-biofilm strategies/mechanisms recently identified in pathogenic, commensal and probiotic bacteria and the main synthetic strategies used in clinical practice, particularly for catheter-related infections.