Biofilm formation by human bacterial pathogens on implanted medical devices causes major morbidity and mortality among patients, and leads to billions of dollars in healthcare cost. Biofilm is a complex bacterial community that is highly resistant to antibiotics and human immunity. As a result, novel therapeutic solutions other than the conventional antibiotic therapies are in urgent need. In this review, we will discuss the recent research in discovery of alternative approaches to prevent or treat biofilms. Current anti-biofilm technologies could be divided into two groups. The first group focuses on targeting the biofilm forming process of bacteria based on our understanding of the molecular mechanism of biofilm formation. Small molecules and enzymes have been developed to inhibit or disrupt biofilm formation. Another group of anti-biofilm technologies focuses on modifying the biomaterials used in medical devices to make them resistant to biofilm formation. While these novel anti-biofilm approaches are still in nascent phases of development, efforts devoted to these technologies could eventually lead to anti-biofilm therapies that are superior to the current antibiotic treatment.

Trimethylsilane (TMS) plasma nanocoatings were deposited onto stainless steel coupons in direct current (DC) and radio frequency (RF) glow discharges and additional NH₃/O₂ plasma treatment to tailor the coating surface properties. The chemical stability of the nanocoatings were evaluated after 12 week storage under dry condition (25 °C) and immersion in simulated body fluid (SBF) at 37 °C. It was found that nanocoatings did not impact surface roughness of underlying stainless steel substrates. X-ray photoelectron spectroscopy and Fourier transform infrared spectroscopy were used to characterize surface chemistry and compositions. Both DC and RF nanocoatings had Si- and C-rich composition; and the O- and N-contents on the surfaces were substantially increased after NH₃/O₂ plasma treatment. Contact angle measurements showed that DC-TMS nanocoating with NH₃/O₂ treatment generated very hydrophilic surfaces. DC-TMS nanocoatings with NH₃/O₂ treatment showed minimal surface chemistry change after 12 week immersion in SBF. However, nitrogen functionalities on RF-TMS coating with NH₃/O₂ post treatment were not as stable as in DC case. Cell culture studies revealed that the surfaces with DC coating and NH₃/O₂ post treatment demonstrated substantially improved proliferation of endothelial cells over the 12 week storage period at both dry and wet conditions, as compared to other coated surfaces. Therefore, DC nanocoatings with NH₃/O₂ post treatment may be chemically stable for long-term properties, including shelf-life storage and exposure to the bloodstream for coronary stent applications.