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A special issue of Materials (ISSN 1996-1944). This special issue belongs to the section "Biomaterials".

Deadline for manuscript submissions: closed (10 November 2021) | Viewed by 36748

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Prof. Dr. Carla Renata Arciola

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Research Unit on Implant Infections, Rizzoli Orthopaedic Institute, Via di Barbiano 1/10, 40136 Bologna, Italy
Interests: antimicrobial peptides
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Lucio Montanaro

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Laboratorio di Patologia delle Infezioni Associate all’Impianto, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136 Bologna, Italy
Interests: bacteria responsible of implant-infections; bacterial toxins; biocompatibility of implant materials; biofilm; emerging opportunistic pathogens; immunity in implant infections; molecular basis of bacterial adhesion; molecular epidemiology

Dr. Davide Campoccia

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Research Unit on Implant Infections, Rizzoli Orthopaedic Institute, 40136 Bologna, Italy
Interests: bacterial interactions with material surfaces; implant-related infections; bioactive biomaterials; bacteria-repelling surfaces; anti-infective biomaterials; antibacterial coatings; intrinsically antimicrobial materials; material-based antibacterial strategies; nanostructured materials with enhanced bactericidal activity; antibacterial materials with immunomodulatory activity

Special Issue Information

Dear Colleagues,

Nosocomial infections can compromise the health and recovery of patients in a multiplicity of medical scenarios. Bacterial contamination of medical device surfaces is a primary cause of nosocomial infections. Infection is recognized as the most severe and irreducible complication associated with the use of biomaterials, particularly in prosthetic surgery. Nonetheless, bacterial colonization represents a serious problem even for non-surgically invasive medical devices such urinary catheters, which cause a large proportion of all hospital-acquired infections and up to 13,000 deaths a year in the USA alone. Attracting increasing interest over the years, anti-infective biomaterials appear as the only winning strategy to prevent implant infections and significantly reduce their rates of occurrence. Various strategies have been devised to convert the surfaces of biomedical devices into antimicrobial surfaces. Anti-fouling and bacteria-repelling surfaces, antibacterial self-sterilizing coatings, bulk materials endowed with intrinsic antibacterial properties, nanostructured surfaces, local delivery systems of bactericidal, and anti-biofilm or immune-modulatory molecules are just some of the anti-infective solutions that are being proposed. The doping of biomaterials with antimicrobial substances for prophylaxis of infections through local delivery was initially carried out in dentistry and then extended, with the use of antibiotic-loaded cements, to orthopaedic surgery, where it has become a common practice. An interesting opportunity is currently offered by delivery systems based on antibacterial substances that are different from conventional antibiotics, for instance, new antimicrobial peptides, biofunctional molecules, and phytocompounds, and may eventually act synergistically to perioperative antibiotic treatments.

Given the broad diversity of medical devices, there is clearly not only one solution that suits all circumstances, and there is a need to fine tune the anti-infective properties of biomaterials based on the requirements of the specific type of application. An adequate, robust antibacterial activity has to be achieved without compromising the biocompatibility of the system.

The scope of this Special Issue, entitled “Anti-infective materials”, is to provide state-of-the-art research on the production, characterization, and application of biomaterials designed for their anti-infective properties and, at the same time, their biocompatibility. This Special Issue aims to thoroughly survey the innovative antibacterial biomaterials and the anti-infective technologies for infection-resistant and anti-infective biomaterials.

Prof. Dr. Carla Renata Arciola
Prof. Dr. Lucio Montanaro
Dr. Davide Campoccia
Guest Editors

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Keywords

implant infections
anti-infective biomaterials
Intrinsically bactericidal materials
antifouling coatings
anti-adhesive surfaces
bactericidal surfaces
self-sterilizing surfaces
antibiofilm compounds
nanostructured materials
local drug delivery of bactericidal substances

Published Papers (11 papers)

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Research

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16 pages, 2265 KiB

Open AccessArticle

Tissue Conditioner Incorporating a Nano-Sized Surface Pre-Reacted Glass-Ionomer (S-PRG) Filler

by Watcharapong Tonprasong, Masanao Inokoshi, Muneaki Tamura, Motohiro Uo, Takahiro Wada, Rena Takahashi, Keita Hatano, Makoto Shimizubata and Shunsuke Minakuchi

Materials 2021, 14(21), 6648; https://doi.org/10.3390/ma14216648 - 04 Nov 2021

Cited by 7 | Viewed by 2125

Abstract

We aimed to evaluate the properties of a novel tissue conditioner containing a surface pre-reacted glass-ionomer (S-PRG) nanofiller. Tissue conditioners containing 0 (control), 2.5, 5, 10, 20, or 30 wt% S-PRG nanofiller or 10 or 20 wt% S-PRG microfiller were prepared. The S-PRG nanofillers and microfillers were observed using scanning electron microscopy. The ion release, acid buffering capacity, detail reproduction, consistency, Shore A0 hardness, surface roughness, and Candida albicans adhesion of the tissue conditioners were examined. The results indicated that the nanofiller particles were smaller and more homogeneous in size than the microfiller particles. In addition, Al, B, F, and Sr ions eluted from S-PRG were generally found to decrease after 1 day. Acid neutralization was confirmed in a concentration-dependent manner. The mechanical properties of tissue conditioners containing S-PRG nanofiller were clinically acceptable according to ISO standard 10139-1:2018, although the surface roughness increased with increasing filler content. Conditioners with 5–30 wt% nanofiller had a sublethal effect on C. albicans and reduced fungal adhesion in vitro. In summary, tissue conditioner containing at least 5 wt% S-PRG nanofiller can reduce C. albicans adhesion and has potential as an alternative soft lining material. Full article

(This article belongs to the Special Issue Anti-Infective Materials)

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21 pages, 10349 KiB

Open AccessArticle

Polyurethane-Based Coatings with Promising Antibacterial Properties

by Maurizio Villani, Federico Bertoglio, Elisa Restivo, Giovanna Bruni, Stefano Iervese, Carla Renata Arciola, Francesco Carulli, Salvatore Iannace, Fabio Bertini and Livia Visai

Materials 2020, 13(19), 4296; https://doi.org/10.3390/ma13194296 - 25 Sep 2020

Cited by 19 | Viewed by 3196

Abstract

In coatings technology, the possibility of introducing specific characteristics at the surface level allows for the manufacture of medical devices with efficient and prolonged antibacterial properties. This efficiency is often achieved by the use of a small amount of antibacterial molecules, which can fulfil their duty while limiting eventual releasing problems. The object of this work was the preparation and characterization of silver, titanium dioxide and chitosan polyurethane-based coatings. Coatings with the three antibacterials were prepared using different deposition techniques, using a brush or a bar coater automatic film applicator, and compared to solvent casted films prepared with the same components. For silver containing materials, an innovative strategy contemplating the use and preparation of silver nanoparticles in a single step-method was employed. This preparation was obtained starting from a silver precursor and using a single compound as the reducing agent and stabilizer. Ultraviolet-visible spectroscopy, scanning electron microscopy, energy dispersive X-ray spectroscopy, contact angle measurements and adhesion test experiments were used to characterize the prepared coatings. Promising antibacterial properties, measured via direct and indirect methods, were registered for all the silver-based materials. Full article

(This article belongs to the Special Issue Anti-Infective Materials)

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14 pages, 8446 KiB

Open AccessFeature PaperArticle

A New Antibiotic-Loaded Sol-Gel can Prevent Bacterial Intravenous Catheter-Related Infections

by John Jairo Aguilera-Correa, Rosa Vidal-Laso, Rafael Alfredo Carias-Cálix, Beatriz Toirac, Amaya García-Casas, Diego Velasco-Rodríguez, Pilar Llamas-Sillero, Antonia Jiménez-Morales and Jaime Esteban

Materials 2020, 13(13), 2946; https://doi.org/10.3390/ma13132946 - 01 Jul 2020

Cited by 5 | Viewed by 2958

Abstract

The aim of this study was to evaluate the effectiveness of a moxifloxacin-loaded organic–inorganic sol-gel (A50) by locally preventing the catheter-related bloodstream infection (CRBSI) provoked by Staphylococcus epidermidis (S. epidermidis) and the effect resulting from its hydrolytic degradation on coagulation by using a rabbit in-vivo model. A50 coating can completely inhibit growth and would locally prevent CRBSI provoked by S. epidermidis. None of the coagulation blood parameters showed a significant difference constant over time between the control catheter group and the A50-coated catheter group, despite the visible silica release resulting from physiological A50 sol-gel degradation detected in serum at least during the first week. At pathological level, foreign body reaction was present in both of types of catheter, and it was characterized by the presence of macrophages and foreign body giant cell. However, this reaction was different in each group: the A50-coated catheter group showed a higher inflammation with histiocytes, which were forming granuloma-like aggregates with an amorphous crystalline material inside, accompanied by other inflammatory cells such as plasma cells, lymphocytes and mast cells. In conclusion, A50 coating a venous catheter showed excellent bactericidal anti-biofilm response since it completely inhibited S. epidermidis biofilm development and, far from showing procoagulant effects, showed slightly anticoagulant effects. Full article

(This article belongs to the Special Issue Anti-Infective Materials)

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7 pages, 217 KiB

Open AccessArticle

Ozonized Gel Against Four Candida Species: A Pilot Study and Clinical Perspectives

by Vincenzina Monzillo, Fabiola Lallitto, Alba Russo, Claudio Poggio, Andrea Scribante, Carla Renata Arciola, Francesco Rocco Bertuccio and Marco Colombo

Materials 2020, 13(7), 1731; https://doi.org/10.3390/ma13071731 - 08 Apr 2020

Cited by 28 | Viewed by 3575

Abstract

Ozone therapy can display a wide range of clinical beneficial effects, including antimicrobial, immune-stimulant, analgesic, anti-hypoxic actions. However, there is still a paucity of data regarding the ozone fungicide activity. Oral Candida is the most common fungal infection in the mouth among denture wearers and people with weakened immune systems. In the case of generalized candidiasis or immunocompromised patients, systemic therapy is needed, while localized infections are treated with topic medications. However, many Candida strains are resistant to antifungal drugs. The aim of this preliminary analysis is to evaluate the antimycotic efficacy of a new ozonided oil (GeliO₃), as a possible terapeutic alternative in local treatments of these infections, compared to chlorhexidine digluconate (Plak gel®). Chlorhexidine is a chemical synthesis disinfectant with a broad-spectrum antiseptic action, active against bacteria and fungi. Antimycotic activity was tested against the following four Candida species: C. albicans, C. parapsilosis, C. glabrata, C. tropicalis, through an agar diffusion method. No significant differences were found between the growth inhibition zone diameters of the ozonized gel and chlorhexidine. The results indicated that the ozonized gel may help to combat Candida infections. Moreover, useful applications could be used to counteract Candida colonization of endosseous implants. Full article

(This article belongs to the Special Issue Anti-Infective Materials)

13 pages, 724 KiB

Open AccessArticle

New Resin-Based Bulk-Fill Composites: in vitro Evaluation of Micro-Hardness and Depth of Cure as Infection Risk Indexes

by Marco Colombo, Simone Gallo, Claudio Poggio, Vittorio Ricaldone, Carla Renata Arciola and Andrea Scribante

Materials 2020, 13(6), 1308; https://doi.org/10.3390/ma13061308 - 13 Mar 2020

Cited by 43 | Viewed by 3639

Abstract

The current in vitro study evaluated the Vickers hardness number (VHN) and hardness ratio of four bulk-fill composites (VisCalor bulk; Admira Fusion x-tra; x-tra fil; and GrandioSO x-tra-Voco, Cuxhaven, Germany) to assess the risk of bacterial colonization in comparison with standard composite materials. Thirty samples were prepared for each group. The VHN of both the external (top) and internal surface (bottom) was determined with a micro-hardness tester (200 g load for 15 s), and the hardness ratio was also calculated for each sample. Subsequently, storage in an acidic soft drink (Coca-Cola, Coca-Cola Company, Milano, Italy) was performed; for each group, 10 samples were stored for 1 day, while another 10 were stored for 7 days and the remaining 10 were kept in water as controls. A significant reduction in VHN was shown for all the groups when comparing the external versus internal side (P < 0.05), although the hardness ratio was greater than 0.80, resulting in an adequate polymerization. Regarding the acid storage, all the groups showed a significant decrease of VHN when compared with the controls, both after 1 day (P < 0.05) and after 7 days (P < 0.001). All the products showed adequate depth of cure without further risk of bacterial colonization. However, acid exposure negatively affected micro-hardness values, which might promote subsequent colonization. Full article

(This article belongs to the Special Issue Anti-Infective Materials)

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9 pages, 423 KiB

Open AccessArticle

In Vitro Re-Hardening of Bleached Enamel Using Mineralizing Pastes: Toward Preventing Bacterial Colonization

by Andrea Scribante, Claudio Poggio, Simone Gallo, Paolo Riva, Antonella Cuocci, Manuel Carbone, Carla Renata Arciola and Marco Colombo

Materials 2020, 13(4), 818; https://doi.org/10.3390/ma13040818 - 11 Feb 2020

Cited by 22 | Viewed by 2485

Abstract

The search for materials able to remineralize human hard tissues is a modern medical challenge. In this study, the protective effect on the enamel microhardness by a paste based on hydroxyapatite and sodium fluoride (Remin Pro) was evaluated after two different enamel bleaching procedures. Forty sound human incisors were randomly assigned to different treatments: bleaching with an in-office agent (Perfect Bleach Office+); bleaching with an at-home agent (Perfect Bleach); bleaching with the in-office agent followed by the prophylaxis paste; bleaching with the at-home agent followed by the prophylaxis paste; no treatment (control). Bleaching was performed at 0, 8, 24 and 32 h, followed by a 3-min re-mineralizing treatment in the subgroups designed to receive it. Specimens underwent a micro-hardness tester and a mean Vickers Hardness number was considered for each specimen. ANOVA exhibited significant differences among groups. Post-hoc Tukey testing showed significant micro-hardness decrease after the application of both the two bleaching agents. The treatment with prophylaxis paste significantly increased the micro-hardness values of bleached enamel. Full article

(This article belongs to the Special Issue Anti-Infective Materials)

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16 pages, 1428 KiB

Open AccessArticle

Multi Dynamic Extraction: An Innovative Method to Obtain a Standardized Chemically and Biologically Reproducible Polyphenol Extract from Poplar-Type Propolis to Be Used for Its Anti-Infective Properties

by Vincenzo Zaccaria, Emanuele Ugo Garzarella, Carmen Di Giovanni, Fabio Galeotti, Lucia Gisone, Davide Campoccia, Nicola Volpi, Carla Renata Arciola and Maria Daglia

Materials 2019, 12(22), 3746; https://doi.org/10.3390/ma12223746 - 13 Nov 2019

Cited by 16 | Viewed by 3171

Abstract

Antimicrobial activity is a well-known property of propolis, making it a candidate for antimicrobial surfaces in biomedical devices. Nevertheless, large-scale use of propolis as an anti-infective agent is limited by the heterogeneity of its chemical composition and consequent variation in antimicrobial activity. The aim of this study was to demonstrate that the multi dynamic extraction (M.E.D.) method produces standardized polyphenolic mixtures from poplar-type propolis, with reproducible chemical composition and anti-microbial activity, independently from the chemical composition of the starting raw propolis. Three raw propolis samples, from Europe, America, and Asia, were analyzed for their polyphenol chemical composition by means of HPLC–UV and then combined to obtain three mixtures of propolis, which werme submitted to the M.E.D. extraction method. The chemical composition and the antimicrobial activity of M.E.D. propolis against bacteria and fungi were determined. The three M.E.D. propolis showed similar chemical compositions and antimicrobial activities, exhibiting no relevant differences against antibiotic-susceptible and antibiotic-resistant strains. The batch-to-batch reproducibility of propolis extracts obtained with the M.E.D. method encourages the design of drugs alternative to traditional antibiotics and the development of anti-infective surface-modified biomaterials. Full article

(This article belongs to the Special Issue Anti-Infective Materials)

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14 pages, 2629 KiB

Open AccessArticle

Zirconium Carboxyaminophosphonate Nanosheets as Support for Ag Nanoparticles

by Morena Nocchetti, Anna Donnadio, Eleonora Vischini, Tamara Posati, Stefano Ravaioli, Carla Renata Arciola, Davide Campoccia and Riccardo Vivani

Materials 2019, 12(19), 3185; https://doi.org/10.3390/ma12193185 - 28 Sep 2019

Cited by 5 | Viewed by 2030

Abstract

A layered insoluble inorganic-organic solid, namely zirconium phosphate glycine-N,N-bismethylphosphonate, was used to prepare dispersions of nanosheets to support active metals such as metallic silver nanoparticles and zinc ions. Zr phosphate-phosphonate microcrystals were first exfoliated with methylamine to produce a stable colloidal dispersion and then the methylamine was removed by treatment with hydrochloric acid. The obtained colloidal dispersion of Zr phosphate-phosphonate nanosheets was used to immobilize silver or zinc cations, via ion exchange, with the acidic protons of the sheets. The layered matrix showed a great affinity for the metal cations up taking all the added cations. The treatment of the dispersions containing silver ions with ethanol yielded metal silver nanoparticles grafted on the surface of the layered host. The samples were characterized by X-ray powder diffraction, elemental analysis transmission electron microscopy, and selected samples were submitted to antimicrobial tests. The nanocomposites based on Ag nanoparticles showed good bactericidal properties against the bacterial reference strain Staphylococcus epidermidis (S. epidermidis). Full article

(This article belongs to the Special Issue Anti-Infective Materials)

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12 pages, 749 KiB

Open AccessArticle

Antibacterial Properties of a Novel Zirconium Phosphate-Glycinediphosphonate Loaded with Either Zinc or Silver

by Davide Campoccia, Stefano Ravaioli, Riccardo Vivani, Anna Donnadio, Eleonora Vischini, Alessandro Russo, Livia Visai, Carla Renata Arciola, Lucio Montanaro and Morena Nocchetti

Materials 2019, 12(19), 3184; https://doi.org/10.3390/ma12193184 - 28 Sep 2019

Cited by 10 | Viewed by 2336

Abstract

A novel compound consisting of a zirconium phosphate-glycinediphosphonate (ZPGly) has recently been introduced. This 2D-structured material forming nanosheets was exfoliated under appropriate conditions, producing colloidal aqueous dispersions (ZPGly-e) which were then loaded with zinc (Zn/ZPGly) or silver ions. Silver ions were subsequently reduced to produce metallic silver nanoparticles on exfoliated ZPGly nanosheets (Ag@ZPGly). In the search for new anti-infective materials, the present study investigated the properties of colloidal dispersions of ZPGly-e, Zn/ZPGly, and Ag@ZPGly. Ag@ZPGly was found to be a bactericidal material and was assayed to define its minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) on the five most prevalent pathogens of orthopaedic implant infections, namely: Staphylococcus aureus ATCC25923, Staphylococcus epidermidis RP62A, Enterococcus faecalis ATCC29212, Escherichia coli ATCC51739, and Pseudomonas aeruginosa ATCC27853. MIC and MBC were in the range of 125–250 μg/mL and 125–1000 μg/mL, respectively, with E. coli being the most sensitive species. Even colloidal suspensions of exfoliated ZPGly nanosheets and Zn/ZPGly exhibited some intrinsic antibacterial properties, but only at greater concentrations. Unexpectedly, Zn/ZPGly was less active than ZPGly-e. Full article

(This article belongs to the Special Issue Anti-Infective Materials)

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13 pages, 1280 KiB

Open AccessArticle

High Bactericidal Self-Assembled Nano-Monolayer of Silver Sulfadiazine on Hydroxylated Material Surfaces

by Angelo Taglietti, Giacomo Dacarro, Daniele Barbieri, Lucia Cucca, Pietro Grisoli, Maddalena Patrini, Carla Renata Arciola and Piersandro Pallavicini

Materials 2019, 12(17), 2761; https://doi.org/10.3390/ma12172761 - 28 Aug 2019

Cited by 12 | Viewed by 2685

Abstract

Anti-infective surfaces are a modern strategy to address the issue of infection related to the clinical use of materials for implants and medical devices. Nanocoatings, with their high surface/mass ratio, lend themselves to being mono-layered on the material surfaces to release antibacterial molecules and prevent bacterial adhesion. Here, a “layer-by-layer” (LbL) approach to achieve a self-assembled monolayer (SAM) with high microbicidal effect on hydroxylated surfaces is presented, exploiting the reaction between a monolayer of thiolic functions on glass/quartz surfaces and a newly synthesized derivative of the well-known antibacterial compound silver sulfadiazine. Using several different techniques, it is demonstrated that a nano-monolayer of silver sulfadiazine is formed on the surfaces. The surface-functionalized materials showed efficient bactericidal effect against both Gram-positive and Gram-negative bacteria. Interestingly, bactericidal self-assembled nano-monolayers of silver sulfadiazine could be achieved on a large variety of materials by simply pre-depositing glass-like SiO₂ films on their surfaces. Full article

(This article belongs to the Special Issue Anti-Infective Materials)

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12 pages, 1638 KiB

Open AccessReview

Copper-Alloy Surfaces and Cleaning Regimens against the Spread of SARS-CoV-2 in Dentistry and Orthopedics. From Fomites to Anti-Infective Nanocoatings

by Claudio Poggio, Marco Colombo, Carla Renata Arciola, Tiziana Greggi, Andrea Scribante and Alberto Dagna

Materials 2020, 13(15), 3244; https://doi.org/10.3390/ma13153244 - 22 Jul 2020

Cited by 57 | Viewed by 7471

Abstract

The latest diffusion of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), responsible for the coronavirus disease (COVID-19), has involved the whole world population. Even if huge efforts to control the pandemic have been done, the viral spread is still continuing. COVID-19 is reported as a zoonosis jumped from bats and pangolins to humans. After infection in humans, SARS-CoV-2 is found in the nasopharyngeal and salivary secretions. The virus has also been detected in the blood plasma of infected patients. The viral spread occurs through droplets exhaled from the nose and mouth of the infected people when they breath or talk, or through droplets propelled as a dense cloud by chough or sneeze. The virus can also be delivered as an aerosol from blood plasma, through surgical procedures. Following these ways, the virus can disperse in the air, then reaching and settling on the exposed surfaces. How long the virus will survive on a surface depends on the material the surface is made from. Infection via high-touch surfaces should be prevented. Copper alloy coatings, combined with efficient hygienic/disinfectant procedures and careful surgical practice, could be helpful to health protection in dental practice and can also be adopted in orthopedic traumatology. Full article

(This article belongs to the Special Issue Anti-Infective Materials)

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