New trends in antimicrobial polymers: A state-of-the-art review

Nanoparticles as Novel Emerging Therapeutic Antibacterial Agents in the Antibiotics Resistant Era

Microorganisms are highly resistant to the antibiotics that are commonly used and thus are becoming serious public health problem. There is an urgent need for new approaches to monitor microbial behavior, and hence, nanomaterial can be a very promising solution. Nanotechnology has led to generation of novel antimicrobial agents such as gold, silver, zinc, copper, poly-£-lysine, iron, and chitosan which have shown remarkable potential, demonstrating their applicability as proficient antibiotic agents against various pathogenic bacterial species. The antimicrobial nanoproduct physically kills the organism's cell membranes that prevent the production of drug-resistant microorganisms. These nanosized particles can also be used as diagnostic agents, targeted drug delivery vehicle, noninvasive imaging technologies, and in vivo visual monitoring of tumors angiogenesis. These nanomaterials provide a promising platform for diagnostics, prognostic, drug delivery, and treatment of diseases by means of nanoengineered products/devices. This owes to their small size, prolonged antimicrobial efficacy with insignificant toxicity creating less environmental hazard or toxicity. Scientists address several problems such as health, bioethical problems, toxicity risks, physiological, and pharmaceutical concerns related with the usage of NPs as antimicrobial agents as current research lack adequate data and information on the safe use of certain tools and materials.

Antimicrobial polymer modifications to reduce microbial bioburden on endotracheal tubes and ventilator associated pneumonia

Hospital associated infections (HAIs), infections acquired by patients during care in a hospital, remain a prevalent issue in the healthcare field. These infections often occur with the use of indwelling medical devices, such as endotracheal tubes (ETTs), that can result in ventilator-associated pneumonia (VAP). When examining the various routes of infection, VAP is associated with the highest incidence, rate of morbidity, and economic burden. Although ETTs are essential for the survival of patients requiring mechanical ventilation, their use comes with complications. The presence of an ETT in the airway impairs physiological host defense mechanisms for clearance of pathogens and provides a platform for oropharynx microorganism transport to the sterile tracheobronchial network. Antibiotics are administered to treat lower respiratory infections; however, they are not always effective and consequently can result in increased antibiotic resistance. Prophylactic approaches by altering the surface of ETTs to prevent the establishment and growth of bacteria have exhibited promising results. In addition, passive surface modifications that prevent bacterial establishment and growth, or active coatings that possess a bactericidal effect have also proven effective. In this review we aim to highlight the importance of preventing biofilm establishment on indwelling medical devices, focusing on ETTs. We will investigate successful antimicrobial modifications to ETTs and the future avenues that will ultimately decrease HAIs and improve patient care. STATEMENT OF SIGNIFICANCE: Infections that occur with indwelling medicals devices remain a constant concern in the medical field and can result in hospital-acquired infections. Specifically, ventilator associated pneumonia (VAP) occurs with the use of an endotracheal tube (ETT). Infections often require use of antibiotics and can result in patient mortality. Our review includes a summary of the recent collective work of antimicrobial ETT modifications and potential avenues for further investigations in an effort to reduce VAP associated with ETTs. Polymer modifications with antibacterial nature have been developed and tested; however, a focus on ETTs is lacking and clinical availability of new antimicrobial ETT devices is limited. Our collective work shows the successful and prospective applications to the surfaces of ETTs that can support researchers and physicians to create safer medical devices.

Perspectives on polymeric nanostructures for the therapeutic application of antimicrobial peptides

Antimicrobial peptides (AMPs) are a class of promising anti-infective molecules but their therapeutic application is opposed by their poor bioavailability, susceptibility to protease degradation and potential toxicity. The advancement of nanoformulation technologies offers encouraging perspectives for the development of novel therapeutic strategies based on AMPs to treat antibiotic resistant microbial infections. Additionally, the use of polymers endowed per-se with antibacterial properties, stands out as an innovative approach for the development of a new generation of drug delivery systems in which an enhanced antimicrobial action could be obtained by the synergic combination of bioactive polymer matrices and drugs. Herein, the latest AMPs drug delivery research is discussed.