Surface modifications for antimicrobial effects in the healthcare setting: a critical overview

Abstract

The spread of infections in healthcare environments is a persistent and growing problem in most countries, aggravated by the development of microbial resistance to antibiotics and disinfectants. In addition to indwelling medical devices (e.g. implants, catheters), such infections may also result from adhesion of microbes either to external solid-water interfaces such as shower caps, taps, drains, etc., or to external solid-gas interfaces such as door handles, clothes, curtains, computer keyboards, etc. The latter are the main focus of the present work, where an overview of antimicrobial coatings for such applications is presented. This review addresses well-established and novel methodologies, including chemical and physical functional modification of surfaces to reduce microbial contamination, as well as the potential risks associated with the implementation of such anticontamination measures. Different chemistry-based approaches are discussed, for instance anti-adhesive surfaces (e.g. superhydrophobic, zwitterions), contact-killing surfaces (e.g. polymer brushes, phages), and biocide-releasing surfaces (e.g. triggered release, quorum sensing-based systems). The review also assesses the impact of topographical modifications at distinct dimensions (micrometre and nanometre orders of magnitude) and the importance of applying safe-by-design criteria (e.g. toxicity, contribution for unwanted acquisition of antimicrobial resistance, long-term stability) when developing and implementing antimicrobial surfaces.

Synthesis and fabrication of high‐potent antimicrobial polymeric ultrathin coatings

“…One of the global strategy recommendations dictated by the World Health Organization is to make the control of antimicrobial resistance a priority for National Governments and health Systems. 5 The widespread and fast-growing area in current research is the development of antimicrobial coatings (AMCs) to avoid the problems associated with antimicrobial contaminated surfaces and also a successful attempt to control biofouling. 3 Biofouling and biocontamination of surfaces are of important threat due to undesirable growth of microorganism on solid surfaces in diverse surface settings 4 like in solid-water interfaces like taps, shower caps, drains, and so on, and also in solid-gas interfaces like door handles, curtains, computer keyboards, clothes, and so on, especially in hospital environment.…”

“…5 The global market of antimicrobial coatings (AMCs) will reach $4.5 billion and nearly 590 kt of production volume by 2020, forecasted by International Antimicrobial Council, 2015. 1,5,[7][8][9] The attention is paid on the synthesis of antimicrobial reactive polymers/coatings due to their low toxicity, long-term activity, increased antimicrobial activity, high effectiveness and selectivity, stability, and also due to eco-friendly performance. ], or antibiotics); (2) contact active immobilized molecules (e.g., quaternary ammonium/chitosan polymers or peptides); or (3) light-activated molecules (e.g., TiO 2 or photosensitizers).…”

“…3 Biofouling and biocontamination of surfaces are of important threat due to undesirable growth of microorganism on solid surfaces in diverse surface settings 4 like in solid-water interfaces like taps, shower caps, drains, and so on, and also in solid-gas interfaces like door handles, curtains, computer keyboards, clothes, and so on, especially in hospital environment. 5 The widespread and fast-growing area in current research is the development of antimicrobial coatings (AMCs) to avoid the problems associated with antimicrobial contaminated surfaces and also a successful attempt to control biofouling. 4 The development of antimicrobial (polymeric) coatings is a potential and promising weapon against the growth and spread of microorganisms.…”

“…4 The development of antimicrobial (polymeric) coatings is a potential and promising weapon against the growth and spread of microorganisms. 5 The global market of antimicrobial coatings (AMCs) will reach $4.5 billion and nearly 590 kt of production volume by 2020, forecasted by International Antimicrobial Council, 2015. 4 Various chemical strategies and technologies for AMCs are described in the literature: (1) AMCs containing active eluting agents (e.g., ions, nanoparticles [silver, copper, zinc, etc.…”

“…4,6 The demand is increased for the biocidal polymeric coating materials due to their capability of killing microbes upon contact. 1,5,[7][8][9] The attention is paid on the synthesis of antimicrobial reactive polymers/coatings due to their low toxicity, long-term activity, increased antimicrobial activity, high effectiveness and selectivity, stability, and also due to eco-friendly performance. 10,11 Most of AMCs describes the use of nanoparticles, natural polymers, synthetic polymers, peptides, and so on, because of exhibiting superior antimicrobial efficacy.…”