Dual-Action Biomaterial Surfaces with Quorum Sensing Inhibitor and Nitric Oxide To Reduce Bacterial Colonization

Bacterial biofilms on implanted medical devices are a serious problem. At present, no effective strategies are available and the emergence of multidrug resistance has highlighted the need to develop novel antibacterial coatings to combat device-related infections. One approach is to interfere with the bacterial communication pathway or quorum sensing (QS), which is responsible for biofilm formation and virulence factors, by incorporating QS inhibitors (QSIs) such as dihydropyrrolones (DHPs) on biomaterial surfaces. The endogenous biological signaling molecule nitric oxide (NO) is also a potential candidate for prevention of biomedical infections due to its antibiofilm activity. In this study, we have developed dual-action surface coatings based on DHPs and NO. X-ray photoelectron spectroscopy (XPS) and contact angle measurements confirmed successful immobilization of DHPs and NO, and the Griess assay revealed NO release from the coatings at 24 h. Bacterial colonization on the surfaces was assessed by confocal laser scanning microscopy (CLSM), where the DHP+NO surfaces demonstrated significantly higher efficacy in reducing colonization of Staphylococcus aureus and Pseudomonas aeruginosa via a nonbactericidal mechanism than the DHP or NO-releasing coatings alone. The excellent antibacterial activity of the novel coatings suggests the combination of DHP and NO has great potential to combat device-related bacterial infections.