How could smart surfaces help tackle infection and antimicrobial resistance?

With the increasing threat of antimicrobial resistance, researchers at Imperial are investigating new solutions to combat this ever growing threat.

One solution includes antimicrobial surfaces - surfaces that have the potential to reduce microbial attachment, have an antimicrobial effect, and disrupt the habitat of microbes.

The Institute for Molecular Science and Engineering has brought together world leading experts within Imperial College London in bio-mechanical engineering, surface engineering, medicine, infection control, and microbiology to investigate the potential for these surfaces to tackle antimicrobial resistance in clinical settings.

Why do we need antimicrobial surfaces?

Contaminated surfaces and medical devices contribute to the transmission of healthcare-associated infection and the spread of antimicrobial resistance. In fact, in 2016 there was a 1 in 15 chance that you would pick up an infection from being a patient in hospital. Introducing surfaces that kill bacteria at points where patients are likely to touch, could bring this number down.

If we do nothing there will be 10 million deaths due to antimicrobial resistance by 2050. Dr Gerald Larrouy-Maumus Senior Lecturer, Department of Life Sciences

Antimicrobial surfaces could also play an important role in tackling antimicrobial resistance. When attached to a surface, communities of microbes, termed biofilms, can support microbial survival and protect them from attack by biocides and antibiotics. This can lead to severe infections in medical devices (e.g. catheter-associated urinary tract infections), prosthesis (e.g. infected hip joints), and water-borne infections (e.g. Pseudomonas and Legionalla contamination of hospital water systems).

How can antimicrobial surfaces help?

The Institute for molecular Science and Engineering has commissioned a Briefing Paper to look at how we can make surfaces antimicrobial. At the Briefing Paper's launch yesterday, author Dr Gerald Larrouy-Maumus outlined how antimicrobial surfaces could disrupt the microbial habitat by reducing microbial attachment or kill attached microbes.

You can watch the full launch of the Briefing Paper here.

One way to make a surface antimicrobial is by physically altering the properties of a surface. Cicada, a large group of insects whose wings have antimicrobial properties, are a good example of this. The surface of a cicada’s wing consists of nanoscale spikes that can puncture the cell walls of bacteria. These nanoscale spikes have been shown to be particularly effective against some types of bacteria, including E. coli.

You can read other ways in which a surface can be made antimicrobial in the Briefing Paper "Smart surfaces to tackle infection and antimicrobial resistance".

Where can antimicrobial surfaces be of use?

At the launch, Dr Jon Otter, Honorary Senior Lecturer at the Department of Infectious Diseases, and lead author of the Briefing Paper, spoke on the four key potential application areas. These are touch surfaces, medical devices, indwelling prosthesis, and hospital plumbing systems. However, according to Dr Otter, the four application areas are at a very different stage of development. In the case of indwelling prosthesis, there’s a wide range of antimicrobial surfacing strategies on the market. Whereas in the case of touch surfaces, some options (most commonly copper) have been taken through to clinical trial, but adoption has been limited.

Why we need a multidisciplinary approach

One of the key conclusions of the Briefing Paper is that the spread of infection and antimicrobial resistance cannot be tackled by antimicrobial surfaces alone, but as part of a combined approach involving the responsible distribution and use of antibiotics, and hospital staff following procedures to prevent the spread of microbes.

We need to see antimicrobial surfaces as a part of the solution and not a “silver bullet”. Dr Jon Otter Honorary Senior Lecturer, Department for infectious Diseases

The final part of the launch involved a panel discussion with Imperial researchers and speakers from the Department of Health and Social Care, and Innovate UK. There was an interesting discussion touching on some of the challenges facing the development of the technology, including the need to consider a wide range of applications from the outset, consider the needs of low-and-middle-income settings and the idea of creating some sort of flexible platform technology. But most importantly, the panel stressed that more multidisciplinary collaboration between science, engineering and medicine was needed to design, build and test future antimicrobial surfaces.

You can read a blog written by lead author Jon Otter on antimicrobial surfaces here.

Fellow panel member Chiara Heide, a PhD student in the Department of Chemical Engineering and Co-Founder of BrightCure, a company that seeks to treat Urinary Tract infections (UTIs), where antimicrobial resistance is common, gave her own personal account of antimicrobial resistance.

Other members of the panel included:

Professor Alison Holmes - Professor of Infectious Diseases at Imperial College, a Fellow of the Academy of Medical Sciences and a National Institute for Health Research Senior Investigator.

Tracy Parker - Head of Policy for antimicrobial resistance, healthcare associated infection and Sepsis at the Department of Health and Social Care.

Phil Packer - Innovation Lead, Antimicrobial Resistance & Vaccines, Innovate UK.