Figure 5 Nepenthes Bacteria-repellent surfaces plant-inspired Bacteria--repellent surface. Syrfaces coatings which accomplish Bacteria-repellent surfaces include chlorhexidine incorporated hydroxyapatite coatings, chlorhexidine-containing polylactide coatings on an anodized surface, and polymer and calcium phosphate coatings with chlorhexidine. Biomaterials Sci.

Bacteria-repellent surfaces -

The bacteria can infect almost any site in the body and are often resistant to antibiotics. Other nano- or micro-scale physical features might also be in incorporated, such scales or ridges.

Sharklet was developed by researchers at the University of Florida, initially as a means of keeping the hulls of ships and submarines free of algae, another type of biofilm. This topography exerts mechanical stress on any bacteria which settle on it, disrupting their normal function and forcing them to expend more energy just to survive, meaning they must peel off or die.

This micropattern, has since been reproduced in on the surface of various materials, including acrylic and silicone. One promising application is in reducing the migration of bacteria such as E.

coli up catheter tubes — a major source of urinary tract infections. Sharklet-patterned films have also been developed which can be applied to flat surfaces, such as doors and countertops.

When applied to such high touch surfaces, Sharklet reduced contamination with antimicrobial resistant Staphylococcus aureus MRSA by as much as 94 percent. Such surface modifications could also be combined with self-polishing coatings, similar to the anti-fouling paints which are applied to the hulls of ships.

Many of these rely on the use of sea water-soluble pigments such as copper oxides, which are toxic to many bacteria, and are constantly sloughed off through the action of water flowing over them. A similar concept might be applied to healthcare settings - e. Photocatalytic coatings are another possibility.

These can be painted onto surfaces, and release free radicals - which attack bacterial cell membranes, and viral proteins and genetic material - upon exposure to light. For instance, titanium dioxide has been successfully deployed on hospital tiles and windows, as well as on silicone catheters, which can be sterilised by irradiating them with ultraviolet light.

Antimicrobial surfaces clearly have the potential to reduce microbial attachment, kill disease-causing organisms and make hospitals easier to clean. This approach is also very different to the measures currently used to reduce the transmission of infections, such as disinfectants and antibiotics.

Indeed, the overuse of antibiotics, both in healthcare and agriculture, has significantly contributed to the development and spread of antibiotic-resistant bacteria - and tackling it is high on the agenda for many governments and scientists.

In Europe and the US alone, there are around 50, deaths resulting from antimicrobial resistant infections, each year, and this is predicted to increase unless new solutions can be found.

Antibacterial surfaces could reduce some of our reliance on antibiotics. Also, because such surfaces tend to either physically destroy the bacteria e. by puncturing them , or destroy their DNA, the bacteria are far less likely to develop resistance to them.

Finding ways to manufacture these surfaces cheaply will provide an additional challenge, and since the introduction of new surfaces will undoubtedly incur significant costs healthcare economists must be involved in these discussions from the outset, to ensure they represent good value for money.

This includes low- and middle-income countries, where they could help overcome additional obstacles to infection control, such as reduced access to clean water and electricity. toilet cisterns, sterilisation, removal of odours. Their technology is currently available for licensing. Dr Chiara Hyde founded her startup BrightCure as a PhD student in Imperial's Department of Chemical Engineering.

The company is developing a technology to treat urinary tract infections without antibiotics using localised light therapy aimed at killing bacteria in the bladder. Promising as antimicrobial surfaces may be, the spread of infection and antimicrobial resistance will not be tackled by antimicrobial surfaces alone.

Also, whereas the current focus is on antibacterial surfaces, there is a clear need to develop surfaces which could similarly impede the transmission of viruses and disease-causing fungi.

Copper and titanium dioxide are two examples of surfaces or coatings which kill all these organisms, but there will surely be others. Disinfectants could then be applied to destroy these trapped viruses, Dr Larrouy-Maumus suggests.

Yet, even without virus-specific surfaces, the development of antibacterial surfaces could help to reduce to the death rate from COVID and other viral infections such as influenza. Dr Larrouy-Maumus has applied for funding to study whether the deployment of antibacterial surfaces could reduce the rate of complications, such as bacterial pneumonia, in patients hospitalised with viral infections.

One study of patients who were admitted to the ICU with COVID in China, found that around half of those who died, did so because of a secondary bacterial infection, rather than the virus itself.

To reduce this risk, ICU patients are often given antibiotics as a preventative treatment - but doing so may accelerate the development of antibiotic resistance within hospitals, making these bacteria harder to kill in the future. The need for good infection control and reduced transmission of disease has never felt so pressing.

See how Purdue never stops in the persistent pursuit of the next giant leap at purdue. Writer: Kayla Wiles, wiles5 purdue. Working remotely but will provide immediate response. Source: Rahim Rahimi, rrahimi purdue. Available for phone and Skype interviews. Note to Journalists : The paper is available online open-access.

Vidhya Selvamani, Amin Zareei, Ahmed Elkashif, Murali Kannan Maruthamuthu, Shirisha Chittiboyina, Davide Delisi, Zheng Li, Lirong Cai, Vilas G. Pol, Mohamed N. Seleem, and Rahim Rahimi. DOI: Trouble with this page?

Disability-related accessibility issue? Please contact News Service at purduenews purdue. Cork has been shown to be highly antibacterial against Staphylococcus aureus.

And extracts from hops have been used to create plastic-like coatings that can prevent the growth of certain types of bacteria. However, research on the potential surface-coating applications of antimicrobial plant extracts is still largely in the experimental stages. Theoretically these kinds of plant materials could be turned into germ-fighting coatings, but much more would need to be known about the amounts of key ingredients needed and the types of microorganisms they would target.

Replicating the tiny spikes on the surface of cicada wings could prevent bacteria from settling and forming colonies Credit: Alamy. But overall, the potential applications for antimicrobial surfaces are numerous.

However, we must not become over reliant upon this kind of approach, warns Mengying Ren, a policy officer at the network ReAct — Action on Antibiotic Resistance , based in Sweden.

There is no easy fix. For instance, surfaces with nanospikes might need to be regularly cleared of dead microorganisms and other debris. Copper would need to be polished to limit oxidisation, which would make it less reactive.

Cork is well-known for its antimicrobial properties and is already used for flooring in some settings Credit: Alamy. In any case, it will take time for these technologies to find commercial partners and scale up.

Some examples already exist. Sharklet is a plastic sheeting material that mimics sharkskin by using a diamond pattern on the surface, which bacteria are unable to settle on. This is already used on medical devices like catheters, which can carry infectious bacteria into the body.

And the MicroShield coating has been applied to surfaces within airplanes, such as seats, to keep them free of bacteria. These surfaces could be an important tool in our fight against infectious diseases and future pandemics.

Today, the spectre of antimicrobial resistance looms even larger as the world struggles against the ravages of Covid Antibiotics are also commonly given to patients with coronavirus — even though they do nothing against the virus itself — increasing fears that it could be fuelling antibiotic-resistant bacterial infections in patients.

Join one million Future fans by liking us on Facebook , or follow us on Twitter or Instagram. If you liked this story, sign up for the weekly bbc. A handpicked selection of stories from BBC Future , Culture , Worklife , and Travel , delivered to your inbox every Friday.

Bacteria-repeplent survival of microbes on Bacteria-repe,lent Bacteria-repellent surfaces only contributes to illness but to the emergence and spread of Bacteeia-repellent resistance. It started Bacteria-repellent surfaces a Herbal anti-depressant options Bacteria-repellent surfaces handle. Bacterka-repellent four hours, viral DNA could be detected throughout the intensive care unit ICU pod - on computer mice, door handles, ventilator knobs and medical charts. In the following days, it spread to five neighbouring pods, each housing four to eight vulnerable infants, and to the staff changing areas and break room. Fortunately, no-one got sick this time.

Bacteria-repellent surfaces -

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High quality bioreplication of intricate nanostructures from a fragile gecko skin surface with bactericidal properties. Sci Rep, , 7: Download references. Key Laboratory of Advanced Technologies of Materials, Ministry of Education, School of Materials Science and Engineering, Southwest Jiaotong University, Chengdu, , China.

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Abstract Antibacterial surfaces are surfaces that can resist bacteria, relying on the nature of the material itself. Article PDF. Introduction to Antibacterial Surfaces Chapter © Antimicrobial surfaces: a review of synthetic approaches, applicability and outlook Article 10 August Strategies on designing multifunctional surfaces to prevent biofilm formation Article 08 September Use our pre-submission checklist Avoid common mistakes on your manuscript.

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Biofouling, , — Article Google Scholar Jiang R, Hao L, Song L, et al. Chem Eng J, , Article Google Scholar Xu S, Wang Q, Wang N. In addition to the biophysical model involving the rupture of bacterial cells, it has been proposed that Titanium dioxide TiO 2 nanopillars impede bacterial cell division and proliferation and induce reactive oxygen species ROS production.

Biomimetic TiO 2 nanopillars penetrated and deformed the bacterial membrane, altering the genetic expression in response to mechanical stress Figure 2D. The lack of expression of fimbria appendages by E.

coli and K. pneumoniae evidences this. ROS production within bacterial cell increase differential expression of oxidative stress and repair proteins such as superoxide dismutase and methionine sulfoxide reductase in S. The generated ROS increased the susceptibility of membrane and cellular components to damage, culminating in the degradation and lysis of bacterial cells Jenkins et al.

There is no consensus on a model explaining the comprehensive bactericidal effect of nanostructured surfaces. It is also challenging to arrive at, owing to the complex interaction between viscoelastic bacterial membranes with appendages and surface nanostructures inspired by various biological examples.

Further, the interaction is influenced by the in vivo local factors. These also make it challenging to attribute specific interaction forces requisite for a bactericidal effect. Graphene and its derivatives as 2D nanomaterials have been extensively studied for broad-spectrum antimicrobial properties contributed by their multifunctional properties: increased stability and surface area, high biocompatibility, and uncomplicated surface modification Pandit et al.

Additionally, ROS generation and disturbance in the redox reaction by graphene affects the cellular metabolism, which, together with the other effects, results in broad-spectrum bacterial inactivation Krishnamoorthy et al.

The loss of membrane potential due to the conductive nature of graphene and ATP depletion due to interruption in the electron transport chain leads to cell death Syama and Mohanan, ; Mohammed et al. In accordance with this mechanism, graphene sheets were used as nano blades against E.

aureus was more susceptible to killing than E. coli due to the extra outer membrane in gram-positive bacteria, although the peptidoglycan layer is thinner than in gram-negative bacteria Akhavan and Ghaderi, The sharp monolayered edges and increased lateral area of nano blades are known to boost the bactericidal activity of the nano knife by allowing for the extraction of large patches of membrane phospholipids Mohammed et al.

For graphene nanostructures, biocompatibility has been reported upon functionalisation with polyethylene glycol, polyethyleneimine, and bovine serum albumin, but contradictory cytotoxicity dependent on concentration, size, and shape are also reported Linklater et al.

Graphene nanostructures less than 5nm may get inserted into the mammalian membrane and subsequently internalised by macrophages, while mammalian cells may spread and wrap around larger graphene nanostructures. Hence, biocompatibility and cytotoxicity must be assessed before implementation Lin et al.

The durability of bactericidal nanostructures is inconclusive due to the need for long-term experiments in various in vivo conditions. The possibility of nanostructures fragmenting from the device surface, exceptionally flexible nanostructures with weak modulus, raises the concern of loss of antibacterial activity over time in vivo and cytotoxicity to the mammalian cells Lin et al.

The robustness of the bactericidal effect of the nanostructured surface following inevitable protein conditioning on implantable devices is also still being determined. Nanostructured surfaces encountered by high bacterial load may be contaminated by bacterial debris, leading to inflammation due to immune responses.

Nanostructured surfaces kill encountering bacteria and potentially prevent biofilm formation, but it jeopardises host microbiota. So, the possibility of manipulating surface chemistry through the functionalisation of the nanostructures to increase the lysing rate of pathogenic bacteria and the specificity of the bactericidal action towards certain pathogenic bacterial species can be considered in the design of the device surface Figure 2.

The ability of the surface to repel bacteria is founded in engineering surface nano topographies. The bacterial attachment to nanoporous topography is reduced by physiochemical forces, including repulsive, electrostatic, and acid-base forces originating from pores Feng et al.

Hydrophobic surface coatings exhibiting high water contact angle WCA and low surface energy give low drag under flow conditions which reduces the strength of adhesion of bacteria to surfaces, thereby preventing microbial contamination Linklater et al.

The surface protrusions of anti-biofouling surfaces of lotus leaf entrap air bubbles between structures, acting like a hydrophobic surface with incomplete wetting, repel bacteria that encounter the surface as the air layer reduces the surface area for bacterial anchorage.

However, the entrapped air is replaced by water or other fluids when immersed in a liquid medium for a prolonged period Hwang et al. The wings of dragonflies not only exhibit antibacterial activity but also illustrate anti-adhesive properties Figure 2B.

The moderately dense nanoscale features reduce bacterial adhesion due to the reduced contact area between bacteria and the surface; bacteria cannot locate the nanostructures for their anchorage Linklater et al.

The surface features for antifouling are replicated with inspiration from shark skin, exhibiting low drag and resistance to the adhesion of bacteria. Anti-adhesive property is also enhanced by the mucous on shark skin, providing lubricating and antifouling benefits Bixler and Bhushan, The normal cell functions are disrupted under the stress gradient, impelling bacteria to spend energy to adjust the contact area to equalise the stresses.

It becomes thermodynamically unfavourable for the bacteria to expend much energy to counteract stress, directing them to search for a different surface to attach Chung et al.

This creates a natural anti-adhesive surface. In vitro and in vivo studies with rat models show effective multifold reduction in S.

aureus and P. aeruginosa adherence to micropatterned percutaneous medical device surface Xu et al. This property is contributed by a series of diamond-shaped assemblies with 3 μm height and 2 μm width.

High-touch surfaces are a source of microbial pathogens that often prove to be the origin of HAI. Antimicrobial touch surfaces attempt to reduce microbial contamination on most frequently touched surfaces, primarily of interest in a hospital environment. Copper and its alloys have broad-spectrum antimicrobial activity against bacteria, fungi, and viruses, including SARS-CoV-2, constantly killing The U.

Environmental Protection Agency approved copper and its alloys as antimicrobial public health materials widely used in antimicrobial coatings. Copper can inhibit the germination of fungal spores, including Candida albicans and hence has been recommended to replace aluminium coils in air conditioners in hospitals to reduce the susceptibility of patients to fungal diseases efficacy of copper antimicrobial touch surfaces in clinical settings has been studied and recommended for use in near-patient environments to decline the risk of transmission Weaver et al.

The antimicrobial activity of copper is attributed to the release of copper ions upon the chemical decomposition of the material Villapún et al.

Copper ions destroy microbes by damaging the cell membrane integrity, directly degrade bacterial proteins and induce a Fenton-like reaction which releases hydroxyl ions that interact with DNA, proteins, and enzymes, peroxidise lipids leading to membrane damage.

Copper alloys used as anti-microbial touch surfaces reduce horizontal gene transfer HGT , thus effectively killing the pathogens on the surface and curbing the spread of antimicrobial resistance by HGT Warnes et al.

Apart from using copper for frequently touched surfaces, copper taps, and pipes can also be fitted in hospitals to reduce water-borne pathogens and associated diseases.

Silver is also highly recognised for its antimicrobial properties. However, due to the high cost of silver, it is mainly used in the form of nano-formulations and in applications that only require small concentrations.

The self-cleaning property of the superhydrophobic surface removes biofouling by controlling wettability and particle adhesion confined in surface roughness Wisdom et al. Self-cleaning behaviour was extensively exhibited in lotus leaves Lotus effect , which repels water that rolls off the surface, picking up all the contaminants, including microorganisms leaving behind a clean surface Wu et al.

The concept of superhydrophobicity revolves around two models, namely the Wenzel model and Cassie—Baxter, where liquid droplet penetratesthe nanopillar in the former model and does not penetrate in the latter Figure 4 Erbil and Cansoy, The models are used to optimise the contact angle and surface roughness for obtaining a superhydrophobic surface by assessing the contact area Parvate et al.

A water droplet on the superhydrophobic lotus leaf exhibits a cassie state contact angle of °, low contact angle hysteresis of 3° degrees, and a low tilting angle TA of less than 5° for the impending motion of water droplets Koch et al.

The water-repellent nature of lotus leaves is due to nanoscale epicuticular wax crystalloids on the epidermal papillae rendering microroughness and reduced adhesion of contaminating particles Barthlott and Neinhuis, The nanostructures on the micro-papillae with a diameter of ~nm heighten the surface roughness, reducing the contact area of contaminants and water droplets and endowing low adhesion to the surfaces Feng et al.

The contaminants, including microorganisms on the surface, adhere to the encountering rolling water droplet due to higher adhesion energy and are carried away, leaving a clean surface. The lotus effect has been widely replicated for medical devices to prevent the adhesion of pathogens and biofilm formation.

It is supported by the fact that most microorganisms require a wettable surface for adhesion and biofouling Koch et al. The lotus-inspired self-cleaning effect imposed on the TiO 2 nanotubes restricted the surface adherence of S.

aureus and E. coli , thereby preventing biofilm formation Patil et al. The major drawback is that the nanostructures causing superhydrophobicity are fragile and easily damaged by mechanical abrasion, leading to reduced WCA and superhydrophobicity.

Hence, for applications, high mechanical strength and low-density carbon nanotubes CNT with epoxy resin composites were used to fabricate superhydrophobic surfaces possessing low contact angle hysteresis Jung and Bhushan, Mechanically robust superhydrophobic surfaces have been realised with simple hierarchical micro-nano structures where nanostructure provides a lotus effect and microscale structures provide durability.

The microstructure acts as an interconnected armour harbouring the nanostructures in inverted pyramidal pockets, preventing damage to the nanofeatures by abradants larger than the microstructures, including sandpaper and sharp blade.

These surfaces resist shear force and vertical pressure, and regardless of abrasion cycles, harsh conditions like high temperature ° C , high velocity of water jet and high humidity exhibit superhydrophobicity with a static WCA of ° and the TA of fewer than 12° degrees Ivanova et al.

The super hydrophobic self-cleaning mechanism is also exhibited by cicada wings possessing waxy coated, hexagonally packed dense nanostructured surface with an average WCA of The surface of cicada wings was exposed to various gram-negative and gram-positive bacteria and was proved to be highly effective against gram-negative than gram-positive bacteria Hasan et al.

The sliding water droplet removes the contaminants, similar to the lotus leaf effect. These insects also demonstrate an intriguing autonomous self-cleaning effect by the condensed dew droplets, independent of environmental water supply and control by the gravity. In the presence of water vapour, contaminants are partially or enclosed by the dew condensates.

Due to the acquired surface energy, the dew condensates coalesce and jump on the superhydrophobic surface. As a result, the contaminants are spontaneously eliminated from the surface by the self-propelled jumping motion of the dew condensates Wisdom et al.

In particular, self-cleaning by jumping condensate phenomenon effectively removes adhered bacteria by challenging adhesion involving van der Waals forces.

Rice leaves Orysa sativa , butterfly wings Morpho aega, Morpho didius , and duck feathers Anatidae illustrate self-cleaning by superhydrophobic unidirectional wettability with low adhesion properties.

This self-cleaning method combines anisotropic flow resulting in low drag from shark skin and a lotus effect Bixler et al. The water droplets on the surface easily roll out of the surface along with the rice leaf papillae or radially outward direction but adhere to the surface in the opposite direction.

Rice leaves have a transverse sinusoidal arrangement of longitudinal ridges providing anisotropic flow. The longitudinal ridges consist of micropapillary with waxy nanobumps facilitating superhydrophobicity with WCA of °, lowest contact angle hysteresis at 3° degrees and low adhesion properties enhancing self-cleaning.

Similarly, anisotropic flow is facilitated by shingle-like scales in butterfly wings, and microgrooves on scales provide superhydrophobicity with WCA of °, and water droplets roll off the surface at a tilted angle of 9° degrees Zheng et al.

The porous structure and preening oil coating on the duck feathers furnish a superhydrophobic character. The porous structure is established by the branches of feathers further dividing into barbules, enhancing the air-water interface and resulting in water repellence Cassie and Baxter, The rear side of the fish scales and shark skin also exhibit self-cleaning effects potentiated by hydrophilicity and oleophobicity.

These surfaces prevent microbial adhesion and biofouling through complete water wettability and enhanced oil repellence, enabling water to get in between contaminant and surface, washing away the impurities. Fish scales exhibited hydrophilicity and super oleophobicity oil contact angle of ° stemming from the micro-nano hierarchical structures and were replicated on silicon wafers by lithography technique Liu et al.

The micro-nano hierarchical structures entrap water, preventing contaminants from contacting the surface. Likewise, the super hydrophilicity and superoleophobicity properties of lotus leaves are contributed by convex micropapillary covered with nano grooves in the range of nm Cheng et al.

Sharkskin possesses dermal denticles containing parallel riblets along the swimming direction, facilitating a typical self-cleaning through hydrophilicity and anisotropic fluid flow, leading to low drag Yu et al.

As the water flows, vortices develop on the surface, causing high shear stress lifted by the riblets, exposed to only the tips of riblets. The minimised shear stress reduces drag across the surface, enabling swift movement of water adjacent to the shark skin and washing away the adhered microorganisms.

The Riblet patterns were also studied for drag reduction efficiency on various materials Bixler and Bhushan, Omniphobic surfaces, named slippery liquid-infused porous surfaces SLIPS inspired by Nepenthes pitcher plants, are similar to superhydrophobic surfaces, wherein an additional component is a lubricating film on the surface Figure 5.

The surface displays self-cleaning by repelling various simple, complex, broad-range surface tension liquids like water, crude oil, and blood.

In SLIPS, the rough substrates in the micro-nano scale immobilise thoroughly wetting and incompressible lubricating fluid resulting in a homogeneous, molecularly smooth surface with exceptional low friction that repels impacting immiscible liquids. The presence of lubricating fluid in SLIPS counteracts the downside of superhydrophobic surfaces like poor stability, low mechanical strength, and durability due to loss of entrapped air over a short period of time, leading to the exposure of rough surface favouring bacterial attachment is overcome by the presence of lubricating fluid in SLIPS Figure 6 Wang and Guo, The combination of substrate and lubricating film must be worked out based on interfacial energies and physical and chemical properties.

Pitcher plant-inspired synthetic liquid-repellent surface was developed with ordered poly-fluoroalkyl silane functionalised nano-post array and random teflon based porous nanofiber network with perfluorinated liquids e. Fluorinert FC as lubricating film. They exhibited low CAH of less than 2.

SLIPS show impressive pressure stability and self-healing upon recurring, large-area damage by abrasion or impact within 1 second Wong et al. SLIPS were also applied for the enamel surface, and results revealed significant inhibition of salivary mucins adsorption, adherence of Streptococcus mutans in vitro , and dental plaque formation in vivo Yin et al.

Owing to the repellence of blood and other liquids on the surface, omniphobic coating has been applied to tubing and catheters. A flexible molecular layer of perfluorocarbon is covalently tethered to the device surface and further infiltrated by a mobile film of medical-grade perfluorodecalin to produce an omniphobic coating with a TA of only 0.

This coating effectively prevents the adhesion of fibrin, platelets, and their activation and also reduces the adhesion of P.

aeruginosa and E. coli bacteria and subsequent biofilm formation by eight folds over 6. The impressive characteristics of omniphobic surfaces can be compromised gradually owing to lubricant evaporation and shear stress under high flow conditions. Hence, a self-replenishing SLIPS with an integrated lubricant reservoir called nanotubes combination of nanohole and nanopillar was fabricated using non-volatile and high-viscous lubricants to enable prolonged operation Wong et al.

Figure 6 Comparison of Slippery liquid-infused porous surface SLIPS to superhydrophobic surface. Self-cleaning surfaces have been realised with photocatalysts like TiO 2 , ZnO, and CdS coated on medical devices and equipment to achieve antimicrobial surfaces in near-patient environments and highly contaminated areas in hospitals.

TiO 2 is considered a promising application as a super hydrophilic photocatalytic coating due to non-toxicity, environmental friendliness, chemical inertness in the absence of light, photostability, durability, abundance, and low-cost production.

TiO 2 semiconductor, upon irradiation with UV light, decomposes the organic contaminants adsorbed on the surface by OH - , H 2 O 2 , and O 2 - ROS generated from photocatalytic oxidation activity.

Subsequently, the decomposed contaminants are washed away from the surface and sterilised by sheeting water owing to super hydrophilicity induced by photons. TiO 2 demonstrates a broad-spectrum bactericidal effect and kills yeast and green algae Padmanabhan and John, Moreover, photocatalysis of TiO 2 brings down air pollutants like nitrogen oxides and boosts air quality like plants Nishimoto and Bhushan, aureus and Pseudomonas putida , established on flat and porous glass functionalised with TiO 2, were killed with Phosphorous and fluorine-modified TiO 2 coating revealed photocatalytic activity against E.

coli , S. Medical devices can be coated with titania nanosheet with a surface roughness of 0. In general, the heightened photocatalytic effect of TiO 2 can be realised in the form of nanocrystalline particles, nanowires, nanotubes, and nanoflowers with dimensions in the range of nm, due to effective oxidation and reduction processes releasing ROS in large amounts Ragesh et al.

It was reported that a thin layer of WO 3 deposited on TiO 2 coating upgrades sensitivity to weak UV light intensity for the photoinduced super hydrophilic conversion Nishimoto and Bhushan, The current research trend focuses on tuning the excitation wavelength for the photocatalytic activity to the visible region by doping with metals and non-metals, hybridisation with organic and inorganic groups, and using the dye photosensitisation method.

N-doped TiO 2 films impregnated with synergistic silver nanoparticles, under white light presented, antimicrobial photoactivity against gram-positive and gram-negative bacteria, particularly MRSA and E. coli Dunnill et al. TiO 2 doped with Bi and N, coated on dental implants, demonstrated photocatalytic anti-bacterial properties upon visible light excitation and was retained even in darkness.

It showed bacterial reduction and cleared biofilm formed by Streptococcus sanguinis and Actinomyces naeslundii Padmanabhan and John, Copper 0. aureus with 5 fold reduction in bacterial viability within 30 mins when excited with visible light Mathew et al.

TiO 2 co-doped with fluorine and copper demonstrated antibacterial activity against S. aureus following excitation with visible light-inducing photocatalysis combined with copper ion toxicity. Fluorine dopant renders sensitivity to visible light for photocatalytic activity, and co-doping with copper dramatically improves the efficiency of bacterial inactivation in both light and dark conditions due to the intrinsic antimicrobial activity of copper ions, acting in synergy with the photoactivity of fluorine-doped TiO 2 Leyland et al.

Thus, the difference in the efficiency of photocatalytic activity against gram-positive and gram-negative bacteria owing to variations in cell wall composition, gram-negative bacteria being more resistant to TiO 2 photoinduced bactericidal activity, can be mitigated with the introduction of synergistic antimicrobial metal ions like copper, silver, gold into the coating.

Photocatalytic coatings can also be incorporated into filter systems of water purifiers to eliminate pathogens in water. The biofouling of ship hulls is prevented by conventional self-polishing coatings on surfaces, releasing toxic biocides like tributyltin TBT and cuprous oxide on the gradual erosion of the coating.

The constant surface erosion results in the exposure of fresh biocides and self-renewal of a clean surface. However, the potential side effects of this coating include the development of resistant microbes, marine pollution, and sexual pattern change in marine organisms as consequences of the unnecessary release of biocides.

The coating has to be renewed periodically. Tributyltin and other toxic coatings are also banned and restricted by International Marine Organisation IMO because of their toxic effects Bieser et al.

Consequently, much research effort has been devoted to promising self-polishing coating with natural antifoulants. The self-polishing coatings in the marine field can be extended to the medical field, where parallel toxicity problems and the emergence of antimicrobial resistance persist, complicating treatments and prevention of device-related and hospital-acquired infections.

Recently, the potential of natural compounds has been explored to address AMR owing to its minimal side effects, synergistic activity with existing antimicrobials, sensitising resistant bacteria to antimicrobials, and reversing the AMR Álvarez-Martínez et al.

These natural antifouling compounds can be loaded into natural biodegradable resins like water-soluble resin, which has the potential for extended-release. Polycaprolactone PCL —Polyurethane PU copolymer rosin blend incorporated with butenolide presented an antifouling self-polishing effect for up to 3 months.

The release of butanolide due to the hydrolysis of ester linkages and self-renewal of the surface contributes to the self-polishing of the surface Ma et al.

Borneol extracted from medicinal herbs like chamomile, and lavender synthesises isobornyl methacrylate IBOMA polymer with broad-spectrum antibacterial activity apart from anti-inflammatory, anti-thrombogenic and vasorelaxant effects.

Self-polishing coatings can be produced with IBOMA polymer incorporated with antifouling agents. On slow degradation, release borneol and antifouling agent, thereby self-renewing the surface and preventing bacterial adhesion Hu et al. These coatings can find applications in the short-term usage of urinary catheters.

Surfaces heavily contaminated with microorganisms can be refreshed by detaching the outermost contaminated layer. Such self-decontamination surfaces are achieved with layer-by-layer deposition of alternating dextran aldehyde and carboxymethyl chitosan connected with imine linkages, which are cleaved in response to acidic conditions stimulated by bacterial biofilms Xu et al.

A self-polishing coating based on cellulose polymer has been produced, which erodes in response to cellulase produced by various microbial strains.

Thus, the release of antifoulants is regulated by the adherence of microorganisms Bieser et al. Such self-polishing coatings are promising for mitigating bacterial adherence and biofilm formation within a few hours or days after implantation.

They are effective for coatings on implants purposed to integrate with host tissues like orthopaedic implants, temporary implants and devices, walls, bed rails and near patient highly touched surfaces.

The device-related healthcare-associated infections plague the medical field, and bacterial contaminations are inevitable despite following aseptic conditions while performing the procedures.

The current strategies of local or systemic administration of antibiotics are associated with extreme cytotoxic effects on the patients.

The various release-based antimicrobial coatings for devices also suffer from limitations, including burst release of antimicrobial compounds, precocious degradation within the body, and decreasing antimicrobial efficacy due to elution of antimicrobial agents resulting in susceptibility to infections.

Inappropriate usage of antimicrobial agents induced the emergence of antimicrobial resistance, posing a world of challenges to researchers and engineers to be solved for the realisation of next-generation devices. Multifunctional approaches inspired by nature provide convincing solutions to these challenges, and various concepts of antibacterial surfaces, as discussed in this review, are validated against a few leading pathogens.

However, an ideal antibacterial approach does not exist, and direct implementation of natural design parameters for all practical applications is impossible. This requires optimisation for various applications involving different surface materials and working conditions. The dimensional parameters and aspect ratio of micro-nano topographical structures of antibacterial surfaces and anti-adhesive surfaces must be determined for bactericidal effect against different sized bacteria apart from broad-spectrum antibacterial effect.

Incorporating them in multifunctional surfaces combining anti-adhesive and killing strategies could meet clinical demands and abate HAIs. Nanostructured antibacterial surfaces integrated with self-cleaning properties can effectively clean off the debris of killed bacteria, indefinitely sustaining the functionality and efficiency of the surface.

The surface features reviewed in this article are fragile and can be damaged under mechanical stress. Hence, hierarchical mechanically robust designs that have been reported must be considered while modelling medical devices for applications.

The antibacterial surfaces can also be fabricated with adhesive back for easy implementation on existing devices. New high-throughput technologies and data, including omics, computational modelling, and network pharmacology, can be employed to identify the synergistic activity between natural compounds and the resulting systemic effects for developing promising combinations for incorporation in self-polishing surfaces.

Further, the prolonged controlled release of natural antifoulants and the rate of the detachment of the outermost layer of the self-polishing surface are essential issues to be considered. In the future, multifunctional surfaces combining various modification concepts can be engineered to overcome the limitations of other approaches and effectively mitigate infections.

The developments in these antibacterial surfaces over the past decade have spurred further investigations and would aid in combating antimicrobial resistance and healthcare-associated infections.

Original draft manuscript preparation and writing: SR and HS; Image editing: SR, HD, and AS; Reviewing and editing: KS, RD, and APS. All authors contributed to the article and approved the submitted version.

The authors are grateful to SASTRA university for providing us with an excellent infrastructure. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers.

Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher. Abdulkareem, A.

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