Novel infection-resistant surface coatings: A bioengineering approach

Despite modern advancements in sterilization and aseptic procedures, bacterial infections remain a major and significant impediment to the long-term success of medical implants and devices, including catheters, artificial prosthetics, and subcutaneous sensors. It has been estimated that upward of 60% of nosocomial, or hospital-acquired, infections are associated with implants, with an estimated one million cases per year in the United States alone. Current treatment regimens primarily rely on the systemic administration of antibiotics or local administration through irrigation of the surgical site. However, after decades of prophylactic antibiotic use, high infection rates continue to persist, particularly with the emergence of drug-resistant strains such as methicillin-resistant Staphylococcus aureus (MRSA). Consequently, recent research efforts have focused on the use of non-antibiotic-based coatings to inhibit bacteria colonization and subsequent biofilm formation on implant surfaces. In particular, advancements in surface treatment strategies and ongoing development of new antimicrobial agents have led to encouraging progress in the design of better coatings. Here, we present and discuss representative examples of novel surface engineering approaches to address device-associated infections, focusing in particular on coatings that can be easily administered onto implant material surfaces.