Bacteria that colonize and form biofilms on living tissues and medical devices are a global
healthcare concern. They cause life threatening infections and are associated with increased mortality
and morbidity in the hospitals. Although antibiotics have been successfully applied for treatment of
bacterial diseases, the adaptive and genetic changes of the microorganisms within the biofilms make
them inherently resistant to all known antibacterial agents. Therefore, novel antimicrobial strategies
that do not exert selective pressure on bacterial population and minimize the risk of resistance occurrence
have been sought to prevent and treat biofilm related infections. A critical overview of the numerous
groups and the rationale of advanced materials and surfaces with antibacterial and antibiofilm
properties is the aim of this review. The development of antibiofilm coatings based on molecules interfering
with bacterial cell-to-cell communication and biofilm integrity are discussed. Nano-scale
transformation of obsolete antibiotics and surface functionalization with bacteriophages and natural
antibacterials including enzymes, antimicrobial peptides, and polyphenols are also considered. Finally,
recent efforts to design new generation of integrated antibacterial materials are reported.
Keywords: Biofilm prevention, Antimicrobial peptides, Polyphenols, Bacteriophages, Enzymes, Nanoparticles, Drug resistance.
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