The major strategies for designing surfaces that prevent fouling due to proteins, bacteria, and marine organisms are reviewed. Biofouling is of great concern in numerous applications ranging from biosensors to biomedical implants and devices, and from food packaging to industrial and marine equipment. The two major approaches to combat surface fouling are based on either preventing biofoulants from attaching or degrading them. One of the key strategies for imparting adhesion resistance involves the functionalization of surfaces with poly(ethylene glycol) (PEG) or oligo(ethylene glycol). Several alternatives to PEG-based coatings have also been designed over the past decade. While protein-resistant coatings may also resist bacterial attachment and subsequent biofilm formation, in order to overcome the fouling-mediated risk of bacterial infection it is highly desirable to design coatings that are bactericidal. Traditional techniques involve the design of coatings that release biocidal agents, including antibiotics, quaternary ammonium salts (QAS), and silver, into the surrounding aqueous environment. However, the emergence of antibiotic- and silver-resistant pathogenic strains has necessitated the development of alternative strategies. Therefore, other techniques based on the use of polycations, enzymes, nanomaterials, and photoactive agents are being investigated. With regard to marine antifouling coatings, restrictions on the use of biocide-releasing coatings have made the generation of nontoxic antifouling surfaces more important. While considerable progress has been made in the design of antifouling coatings, ongoing research in this area should result in the development of even better antifouling materials in the future.

https://onlinelibrary.wiley.com/doi/pdf/10.1002/adma.201001215

Antifouling coatings: recent developments in the design of surfaces that prevent fouling by proteins, bacteria, and marine organisms.

A review of the biomaterials technologies for infection-resistant surfaces.

This article reviews the mechanisms of bacterial adhesion to biomaterial surfaces, the factors affecting the adhesion, the techniques used in estimating bacteria-material interactions and the models that have been developed in order to predict adhesion. The process of bacterial adhesion includes an initial physicochemical interaction phase and a late molecular and cellular one. It is a complicated process influenced by many factors, including the bacterial properties, the material surface characteristics, the environmental factors, such as the presence of serum proteins and the associated flow conditions. Two categories of techniques used in estimating bacteria-material interactions are described: those that utilize fluid flowing against the adhered bacteria and counting the percentage of bacteria that detach, and those that manipulate single bacteria in various configurations which lend themselves to more specific force application and provide the basis for theoretical analysis of the receptor-ligand interactions. The theories that are reviewed are the Derjaguin-Landau-Verwey-Overbeek (DLVO) theory, the thermodynamic approach and the extended DLVO theory. Over the years, significant work has been done to investigate the process of bacterial adhesion to biomaterial surfaces, however a lot of questions still remain unanswered.

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Concise review of mechanisms of bacterial adhesion to biomaterials and of techniques used in estimating bacteria-material interactions.

Despite sterilization and aseptic procedures, bacterial infection remains a major impediment to the utility of medical implants including catheters, artificial prosthetics, and subcutaneous sensors. Indwelling devices are responsible for over half of all nosocomial infections, with an estimate of 1 million cases per year (2004) in the United States alone. Device-associated infections are the result of bacterial adhesion and subsequent biofilm formation at the implantation site. Although useful for relieving associated systemic infections, conventional antibiotic therapies remain ineffective against biofilms. Unfortunately, the lack of a suitable treatment often leaves extraction of the contaminated device as the only viable option for eliminating the biofilm. Much research has focused on developing polymers that resist bacterial adhesion for use as medical device coatings. This tutorial review focuses on coatings that release antimicrobial agents (i.e., active release strategies) for reducing the incidence of implant-associated infection. Following a brief introduction to bacteria, biofilms, and infection, the development and study of coatings that slowly release antimicrobial agents such as antibiotics, silver ions, antibodies, and nitric oxide are covered. The success and limitations of these strategies are highlighted.

Reducing implant-related infections: active release strategies.

Polymeric materials with antimicrobial activity

The infection of biomaterials is determined by an interplay of adhesion and surface growth of the infecting organisms. In this study, the antimicrobial effects on adhering bacteria of a positively charged poly(methacrylate) surface (xi potential +12 mV) were compared with those of negatively charged poly(methyl methacrylate) (-12 mV) and a highly negatively charged poly(methacrylate) (-18 mV) surface. Initial adhesion of Staphylococcus aureus ATCC 12600, Staphylococcus epidermidis HBH(2) 102, Escherichia coli O2K2 and Pseudomonas aeruginosa AK1 to these surfaces was measured in a parallel plate flow chamber in phosphate-buffered saline. Adhering bacteria were allowed to multiply by perfusing the flow chamber with growth medium. All bacteria adhered most rapidly to the positively charged surface, but there was no subsequent surface growth of the Gram-negative strains. On the negatively charged surfaces, despite a slower initial adhesion, surface growth of the adhering bacteria was exponential for both Gram-positive and Gram-negative strains. These results suggest that positively charged biomaterial surfaces exert an antimicrobial effect on adhering Gram-negative bacteria, but not on Gram-positive ones.

Antimicrobial effects of positively charged surfaces on adhering Gram-positive and Gram-negative bacteria

https://www.rug.nl/research/biomaterials/publications/presentations/hm2/gottenbos-2002%281%29.pdf

In vitro and in vivo antimicrobial activity of covalently coupled quaternary ammonium silane coatings on silicone rubber.

The infection risk of biomaterials implants varies between different materials and is determined by an interplay of adhesion and surface growth of the infecting organisms. In this study, we compared initial adhesion and surface growth of Staphylococcus epidermidis HBH(2) 102 and Pseudomonas aeruginosa AK1 on poly(dimethylsiloxane), Teflon, polyethylene, polypropylene, polyurethane, poly(ethylene terephthalate), poly(methyl methacrylate), and glass. Initial adhesion was measured in situ in a parallel plate flow chamber with microorganisms suspended in phosphate-buffered saline, while subsequent surface growth was followed in full and in 20 times diluted growth medium. Initial adhesion of both bacterial strains was similar to all biomaterials. In full growth medium, generation times of surface growing S. epidermidis ranged from 17 to 38 min with no relation to wettability, while in diluted growth medium generation times increased from 44 to 98 min with increasing surface wettability. For P. aeruginosa no influence of surface wettability on generation times was observed, but generation times increased with decreasing desorption rates, maximal generation times being 47 min and minimal values down to 30 min. Generally, generation times of adhering bacteria were shorter than of planktonic bacteria. In conclusion, surface growth of initially adhering bacteria is influenced by biomaterials surface properties to a greater extent than initial adhesion.

Initial adhesion and surface growth of Staphylococcus epidermidis and Pseudomonas aeruginosa on biomedical polymers

One of the major drawbacks in the use of biomedical materials is the occurrence of biomaterials centered infections. After implantation, the host interacts with a biomaterial by forming a conditioning film on its surface and an immune reaction towards the foreign material. When microorganisms can reach the biomaterials surface they can adhere to it. Adhesion of microorganisms to an implant is mediated by their physico-chemical surface properties and the properties of the biomaterials surface itself. Subsequent surface growth of the microorganisms will lead to a mature biofilm and infection, which is difficult to eradicate by antibiotics. The purpose of this review is to give an overview of the mechanisms involved in biomaterials centered infection and the possible methods to prevent these infections.

Pathogenesis and prevention of biomaterial centered infections

Publisher Summary To control beneficial biofilms, conditions have to be adapted to obtain the optimal equilibrium of growth and detachment of biofilm organisms. The growth rate can be controlled by nutrient conditions, reactor design, oxygen, removal of metabolic end products, and temperature. Detachment can be influenced by substratum surface properties, fluid flow rate, mechanical stress, and surface active substances. The total removal of biofilms is only possible when biofilms are directly accessible, such as on exterior parts of the human body. The strength of biofilm adhesion to a substratum surface—that is, the ease with which it can be removed, is greatly dependent on the strength with which the initially adhering organisms bind the substratum surface and cohesiveness of the conditioning film that makes initial microbial adhesion and surface growth an important issue of research. This chapter summarizes the use of a parallel plate flow chamber model to study the initial microbial adhesion to surfaces and extends the use of flow chamber devices and data analysis to include surface growth of the initially adhering organisms.

B Gottenbos

Papers

Antimicrobial effects of positively charged surfaces on adhering Gram-positive and Gram-negative bacteria

In vitro and in vivo antimicrobial activity of covalently coupled quaternary ammonium silane coatings on silicone rubber.

Initial adhesion and surface growth of Staphylococcus epidermidis and Pseudomonas aeruginosa on biomedical polymers

Pathogenesis and prevention of biomaterial centered infections

Models for studying initial adhesion and surface growth in biofilm formation on surfaces.