Abstract
Implantable medical devices (IMDs) are susceptible to microbial adhesion and biofilm formation, which lead to several clinical complications, including the occurrence of implant-associated infections. Polylactic acid (PLA) and its composites are currently used for the construction of IMDs. In addition, chitosan (CS) is a natural polymer that has been widely used in the medical field due to its antimicrobial and antibiofilm properties, which can be dependent on molecular weight (Mw). The present study aims to evaluate the performance of CS-based surfaces of different Mw to inhibit bacterial biofilm formation. For this purpose, CS-based surfaces were produced by dip-coating and the presence of CS and its derivatives onto PLA films, as well surface homogeneity were confirmed by contact angle measurements, Fourier transform infrared spectroscopy (FTIR) and scanning electron microscopy (SEM). The antimicrobial activity of the functionalized surfaces was evaluated against single- and dual-species biofilms of Staphylococcus aureus and Pseudomonas aeruginosa. Chitosan-based surfaces were able to inhibit the development of single- and dual-species biofilms by reducing the number of total, viable, culturable, and viable but nonculturable cells up to 79%, 90%, 81%, and 96%, respectively, being their activity dependent on chitosan Mw. The effect of CS-based surfaces on the inhibition of biofilm formation was corroborated by biofilm structure analysis using confocal laser scanning microscopy (CLSM), which revealed a decrease in the biovolume and thickness of the biofilm formed on CS-based surfaces compared to PLA. Overall, these results support the potential of low Mw CS for coating polymeric devices such as IMDs where the two bacteria tested are common colonizers and reduce their biofilm formation.
Highlights
Implantable medical devices (IMDs), such as prosthetic joints and catheters, have been widely used in the medical field for both diagnosis and therapeutic purposes [1,2]
Despite Implant-associated infections (IAIs) being often caused by Staphylococcus spp. [10], many other pathogens may be responsible for these infections, including Enterococcus spp. [11], Escherichia coli [12], Pseudomonas aeruginosa [13], and Candida spp
CS-based surfaces with different molecular weight (Mw) were produced, and their efficacy to inhibit the development of single- and dual-species biofilms of S. aureus and P. aeruginosa was evaluated through the analysis of biofilm cell composition and structure
Summary
Implantable medical devices (IMDs), such as prosthetic joints and catheters, have been widely used in the medical field for both diagnosis and therapeutic purposes [1,2]. The number of implanted medical devices has increased significantly with the aging population and the growing occurrence of comorbidities [3,4]. Implant-associated infections (IAIs) have an incidence between 2% and 40%, depending on the type of medical device [6], and are responsible for prolonged hospital stays, increased costs, and high morbidity and mortality rates [7]. Most IMDs are susceptible to microbial adhesion and, biofilm formation, which is the leading cause of IAIs. A variety of pathogens can cause devicerelated infections, depending on the type of implantable device and the anatomical site of implantation [4,9]. [10], many other pathogens may be responsible for these infections, including Enterococcus spp. Biofilms often harbor viable but nonculturable (VBNC) cells, which are living cells that have lost the ability to divide in media on which they normally grow
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