Title:Antimicrobial Peptides as Anti-biofilm Agents in Medical Implants
Volume: 17
Issue: 5
Author(s): Susana Sánchez-Gómez and Guillermo Martínez-de-Tejada
Affiliation:
Keywords:
Biofilm, Antimicrobial peptides, Biomaterial, Surface-functionalization, Medical-implant, Infection.
Abstract: Biofilm-associated infections constitute a daunting threat to human health, since these pathologies
increase patient mortality and morbidity, resulting in prolonged hospitalization periods and
heavy economic losses. Moreover, these infections contribute to the increasing emergence and dissemination
of antibiotic resistance in hospitals and in the community. Although biofilm-associated
microorganisms can proliferate in healthy tissue, abiotic surfaces like those of medical implants
greatly increase the likelihood of biofilm formation in the host. Due to their broad spectrum of bactericidal
activity against multi-drug resistant microorganisms including metabolically inactive cells, antimicrobial
peptides (AMPs) have great potential as anti-biofilm agents. In fact, a clinically available
AMP, polymyxin E (colistin), frequently constitutes the drug of last recourse in biofilm-associated infections
(e.g. cystic fibrosis) when resistance to all the other drugs arises. In this article, we outline the
main strategies under development to combat biofilm-associated infections with an emphasis in the
prevention of microbial colonization of medical implants. These approaches include the use of AMPs
both for the development of anti-adhesive surface coatings and to kill biofilm-forming cells either on
contact or via controlled release (leaching surfaces). Although in vitro results for all these applications
are very encouraging, further research is needed to improve the anti-biofilm activity of these coatings
in vivo. The possibility of exploiting the antibiotic potentiating activity of some AMPs and to combine
several anti-biofilm mechanisms in tandem targeting the biofilm formation process at different stages
is also discussed.
