Abstract
SummaryDespite the advancements in material science and surgical techniques, the incidence of implant-associated infections (IAIs) has increased significantly. IAIs are mainly caused by microbial adhesion and biofilm formation on implant surfaces. In this study, we aimed to evaluate and critically discuss the antimicrobial efficacy of chitosan-based coatings to prevent the occurrence of IAIs. For this purpose, a PRISMA-oriented systematic review was conducted based on predefined criteria and forty studies were selected for qualitative analysis. Results indicated that chitosan (CS) association with enzymes and antimicrobial peptides improves its antimicrobial activity and extends its use in a broad range of physiological conditions. Likewise, CS association with polymers resulted in enhanced antimicrobial and anti-adhesive coatings with desirable properties, such as biocompatibility and durability, for implantable medical devices (IMDs). These findings can assist researchers in the design of new CS coatings for application in IMDs.
Highlights
Of the 2 million healthcare-associated infections (HAIs) reported annually in the United States, about 60%– 70% are attributed to some type of implanted medical device (Bryers, 2008; Vanepps and Younger, 2016)
Results demonstrated that S. aureus biofilm formation was suppressed on CS-coated silicone films
Results suggested that the antibacterial activity of CS-coated PU films was higher for P. aeruginosa than S. aureus, which may be explained by bacterial surface polarity
Summary
Of the 2 million healthcare-associated infections (HAIs) reported annually in the United States, about 60%– 70% are attributed to some type of implanted medical device (Bryers, 2008; Vanepps and Younger, 2016). Together with Staphylococcus aureus, they account for 50%–60% of the causative bacteria (Tande and Patel, 2014) Owing to their ability to rapidly form biofilm on the inert surface, they manage to grow and impair the defensive mechanisms of the host and the bactericidal activity of antibiotics (Donlan and Costerton, 2002). The development of new strategies to prevent device colonization and biofilm formation is essential
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