Polymer-Based Coatings with Integrated Antifouling and Bactericidal Properties for Targeted Biomedical Applications

One of the most detrimental consequences of surface colonization by bacteria is healthcare-associated infections (HAIs), which contribute to increased patient mortality and morbidity. Medical devices inserted into the body provide a route for bacterial migration and conducive surfaces for their attachment and proliferation. Antibacterial coatings can potentially minimize bacterial colonization and consequently reduce the occurrence of HAIs. Antibacterial coatings function by either inhibiting the attachment of bacteria (antifouling coatings) or killing bacteria attached to the surface and/or in the vicinity (bactericidal coatings). On an antifouling coating, any bacterium that manages to attach will proliferate, while on bactericidal coatings, the accumulation of dead bacteria and debris provides opportunities for other bacteria to colonize the surface. As such, the integration of antifouling and bactericidal functionalities in a single coating combines the advantages of each, increasing the probability that bacterial colonization can be successfully inhibited. This Review highlights recent developments in dual-functional polymer-based antibacterial coatings for specific biomedical applications. General strategies for endowing surfaces with either antifouling or bactericidal polymeric coatings are first discussed, followed by more detailed descriptions of coatings with integrated antifouling and bactericidal functionalities that target the important biomedical applications: blood-contacting devices, orthopedic implants, wound dressings, ocular devices, urinary catheters, endotracheal tubes, and hospital textiles. The importance of tailoring the coatings to meet the specific constraints and requirements of the intended application beyond the antibacterial functionality is emphasized, and finally, the potential challenges in translating such coatings to clinical application are highlighted.