Nature-inspired biomaterial innovations to counter medical device-associated infections

Medical device-associated infections remain challenging in modern medicine because abiotic material surfaces are prone to bacterial colonization and biofilm formation, leading to high-level tolerance to antibiotics. The ineffectiveness of antibiotic therapy and the rapid rise of antimicrobial resistance have driven efforts to develop advanced material designs for medical devices. To meet biocompatibility and long-term performance needs, bio-inspired design has emerged as a promising strategy. From material composition and surface coating to surface texture, numerous designs have been engineered to reduce bacterial adhesion and biofilm formation. To overcome the limitation of static surface modification against established biofilms, dynamic surface designs have also been pursued in recent years. Here, we review current bio-inspired surface designs for biofilm control and highlight emerging dynamic, multifunctional strategies for the next generation of infection-resistant medical devices.