Biomaterial strategies to combat implant infections: new perspectives to old challenges

ABSTRACT

Peri-implant infection is rapidly becoming an – if not the most – important clinical challenge for indwelling medical devices. To alleviate the global rise in antibiotic use for the treatment of such infections, a plethora of biomaterials/bioengineering-based antimicrobial strategies are emerging to restrict or ideally to eliminate microbial adhesion and biofilm formation on implant surfaces. Yet, the development of such approaches faces specific challenges, like biocompatibility concerns, reduced antimicrobial effectiveness, long-term stability issues and antibiotic resistance development, which limit translation to the clinic. This review provides insights into the antimicrobial activity of current state-of-the-art biomaterial-based approaches to address the aforementioned issues. Translational research strategies and regulatory framework are also emphasised as key elements facilitating clinical implementation of anti-infective biomaterials. This review closes with the vision that the integration of computational tools and experimental databases using artificial intelligence (AI) would provide new insights for the accelerated development of next-generation biomaterial-based antimicrobial strategies.

GRAPHICAL ABSTRACT

KEYWORDS:

• Implantable medical device
• Biofilms
• Smart multifunctional biomaterials
• Antimicrobial therapy
• Nanoparticles
• Surface modification

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The authors acknowledge funding from the Industrial Research Fund of KU Leuven [C32/18/059]. A.B. acknowledges the receipt of a starting grant from Internal Funds KU Leuven [STG/17/024]. N.H.N.K. acknowledges the Research University Grant [GUP-2022-020] received from Universiti Kebangsaan Malaysia. A.R.B and Z.H. acknowledge the DFG [Deutsche Forschungsgemeinschaft, Project BO 1191/25-1] for funding. E.I. acknowledges funding from the Australian Research Council (ARC) Industrial Transformation Research Hubs Scheme [ARC Research Hub for Australian Steel Manufacturing, Project Number IH130100017] and Australian Research Council (ARC), Industrial Transformation Training Centre (ITTC) in Surface Engineering for Advanced Materials (SEAM) [Grant number IC180100005]. B.B. acknowledges the Department of Biotechnology [DBT-BT/PR13466/COE/34/26/2015], Science and Engineering Research Board [SERB-IMPRINT-IMP/2018/000622], Ministry of Science and Technology, Government of India and Department of Science and Technology-Indian National Academy of Engineering funded Abdul Kalam National Innovation Fellowship. N.B. is grateful to the Department of Science and Technology [DST no. SR/WOS-A/LS-513/2017], Ministry of Science and Technology, Goverment of India. D.M. acknowledges the Discovery and the Collaborative Research and Development (CRD) grants received from the Natural Science and Engineering Research Council (NSERC) of Canada. I.R. and A.M. acknowledge funding obtained from the British Council within the scheme Innovative Collaborative Research Grants under the PAK UK Education Gateway.