Biomaterials associated
infection (BAI) has been identified as
one of the leading causes of failure of bioimplants. A failed implant
requires revision surgery, which is about 20 times costlier and more
painful than primary surgery. Infection starts from initial attachment
of bacteria onto the surface of biomaterials followed by colonization
and biofilm formation. Once a biofilm is developed the bacteria become
resistant toward antibiotics. On account of microbial cell development,
their metabolic activity and viability are strongly affected by the
adhesion. Hence a thorough investigation warrants an in-depth understanding
of the interfacial adhesion. Several methods such as plate-and-wash
assay, spinning–disc assay, centrifugation assay, step-pressure
technique, optical tweezers, atomic force microscopy (AFM) and nanoindentation
are used for the measurement of the bacterial adhesion. Most of the
aforementioned techniques are nonquantitative and provide only approximate
values of adhesion forces. Techniques such as AFM and nanoindentation
can quantify a wide range of force 10 pN to 1 μN and 1 nN to
10 μN respectively, and hence they are particularly useful for
exact quantification of the adhesion force as well as adhesion strength
of bacterial cells on various surfaces of biomaterials. In this review,
we present a comparative study of the techniques available to measure
the bacterial adhesion force and strength, discuss the use of AFM
in adhesion force quantification in detail and conclude by hypothesizing
that the AFM technique has an edge over other techniques for quantification
of bacterial adhesion force.