Approaches to inhibit biofilm formation applying natural and artificial silk-based materials

The discovery of penicillin started a new era of health care since it allowed the effective treatment of formerly deadly infections. As a drawback, its overuse led to a growing number of multi-drug resistant pathogens. Challenging this arising threat, material research focuses on the development of microbe-killing or microbe repellent agents implementing such functions directly into materials. Due to their biocompatibility, non-immunogenicity and mechanical strength, silk-based materials are attractive candidates for applications in the biomedical field. Furthermore, it has been observed that silks display high persistency in their natural environment giving reason to suspect that they might be attractive candidates to prevent microbial infestation. The current review describes the process of biofilm formation on medical devices and the most common strategies to prevent it, divided into effects of surface topography, material modification and integrated additives. In this context, recent state of the art developments in the field of natural and artificial silk-based materials with microbe-repellant or antimicrobial properties are addressed. These silk properties are controversially discussed and conclusions are drawn as to which parameters will be decisive for the successful design of new bio-functional materials based on the blueprint of silk proteins.