Staphylococcus aureus are frequently associated with biofilm formation on intravascular devices. Biofilms limit antimicrobial penetration and promote phenotypic resistance, challenging conventional treatment strategies. Vancomycin (VAN) and gentamicin (GEN) have been used clinically, but their combined antibiofilm activity remains underexplored. This study evaluates the efficacy of VAN and GEN, alone and in combination, against biofilms formed by methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-sensitive S. aureus (MSSA) on polyurethane. MICs were determined for VAN and GEN. Biofilm biomass and metabolic activity were quantified using crystal violet and MTT assays, respectively. Biofilm viability was assessed through fluorescence microscopy and a modified Calgary Biofilm Device. A continuous-flow peristaltic model was developed to test treatment under simulated catheter conditions. While monotherapy with VAN or GEN had modest effects, their combination significantly reduced biomass and metabolic activity. VAN 20 mg/L + GEN 8 mg/L and VAN 40 mg/L + GEN 8 mg/L achieved over 70% reduction in MRSA biofilm viability and complete eradication in MBEC assays. Dynamic model assays confirmed biofilm reduction with combination therapy. The combination of VAN/GEN exhibits synergistic antibiofilm activity against S. aureus, particularly MRSA. These findings support its potential application in catheter salvage strategies, including antibiotic lock therapy.

Oropharyngeal candidiasis/candidosis is a common and recurrent opportunistic fungal infection. Fluconazole (FLZ), one of the most used and effective antifungal agents, has been associated with a rise of resistant Candida species in immunocompromised patients undergoing prophylactic therapy. Sulforaphane (SFN), a compound from cruciferous vegetables, is an antimicrobial with yet controversial activities and mechanisms on fungi. Herein, the in silico and antifungal activities of SFN against C. albicans were investigated. In silico analyzes for the prediction of the biological activities and oral bioavailability of SFN, its possible toxicity and pharmacokinetic parameters, as well as the estimates of its gastrointestinal absorption, permeability to the blood-brain barrier and skin, and similarities to drugs, were performed by using different software. SFN in vitro anti-Candida activities alone and in combination with fluconazole (FLZ) were determined by the broth microdilution method and the checkerboard, biofilm and hyphae formation tests. Amongst the identified probable biological activities of SFN, nine indicated an antimicrobial potential. SFN was predicted to be highly absorbable by the gastrointestinal tract, to present good oral availability, and not to be irritant and/or hepatotoxic. SFN presented antifungal activity against C. albicans and prevented both biofilm and hyphae formation by this microorganism. SFN was additive/synergistic to FLZ. Overall, the data highlights the anti-Candida activity of SFN and its potential to be used as an adjuvant therapy to FLZ in clinical settings.

The increasing demand for orthopedic and neurosurgical implants has driven advancements in biomaterials, additive manufacturing, and antimicrobial strategies. With an increasingly aging population, and a high incidence of orthopedic trauma in developing countries, the need for effective, biocompatible, and infection-resistant implants is more critical than ever. This review explores the role of polymers in 3D printing for medical applications, focusing on their use in orthopedic and neurosurgical implants. Polylactic acid (PLA), polycaprolactone (PCL), and polyetheretherketone (PEEK) have gained attention due to their biocompatibility, mechanical properties, and potential for antimicrobial modifications. A major challenge in implantology is the risk of periprosthetic joint infections (PJI) and surgical site infections (SSI). Current strategies, such as antibiotic-loaded polymethylmethacrylate (PMMA) spacers and bioactive coatings, aim to reduce infection rates, but limitations remain. Additive manufacturing enables the creation of customized implants with tailored porosity for enhanced osseointegration while allowing for the incorporation of antimicrobial agents. Future perspectives include the integration of artificial intelligence for implant design, nanotechnology for smart coatings, and bioresorbable scaffolds for improved bone regeneration. Advancing these technologies will lead to more efficient, cost-effective, and patient-specific solutions, ultimately reducing infection rates and improving long-term clinical outcomes.

The increasing demand for orthopedic and neurosurgical implants has driven ad-vancements in biomaterials, additive manufacturing, and antimicrobial strategies. With a growing aging population and a high incidence of orthopedic trauma in developing countries, the need for effective, biocompatible, and infection-resistant implants is more critical than ever. This review explores the role of polymers in 3D printing for medical applications, focusing on their use in orthopedic and neurosurgical implants. Polylactic acid (PLA), polycaprolactone (PCL), and polyetheretherketone (PEEK) have gained at-tention due to their biocompatibility, mechanical properties, and potential for antimi-crobial modifications. A major challenge in implantology is the risk of periprosthetic joint infections (PJI) and surgical site infections (SSI). Current strategies, such as antibi-otic-loaded polymethylmethacrylate (PMMA) spacers and bioactive coatings, aim to reduce infection rates, but limitations remain. Additive manufacturing enables the cre-ation of customized implants with tailored porosity for enhanced osseointegration while allowing the incorporation of antimicrobial agents. Future perspectives include the in-tegration of artificial intelligence for implant design, nanotechnology for smart coatings, and bioresorbable scaffolds for improved bone regeneration. Advancing these tech-nologies will lead to more efficient, cost-effective, and patient-specific solutions, ultimately reducing infection rates and improving long-term clinical outcomes.

Background: Central venous catheters (CVCs) are essential in intensive care units (ICUs) for monitoring and administering treatments; however, catheter-related bloodstream infections (CRBSIs) are significant complications, leading to severe outcomes and increased healthcare costs. The objective of this study was to evaluate the effectiveness of a simple and inexpensive impregnated dressing (intervention) compared to a non-impregnated dressing in reducing catheter-related infections among critically ill patients using vancomycin and chlorhexidine. Methods: This was a randomized, double-blind, controlled clinical trial in a university hospital in Brazil with 207 beds from June 2022 to October 2023. Patients over 18 years old admitted to the ICU and needing a CVC for a period exceeding 72 h were included. A CVC inserted outside the ICU and the need for two CVCs in the same patient simultaneously were exclusion criteria. One group received an impregnated dressing (intervention) compared to the other group, which received a standard dressing (comparator). The incidence of CRBSIs and the microbiological outcomes were evaluated. The primary endpoint was CRBSI. Results: The clinical trial included 516 patients randomized to receive either the new antimicrobial dressing or a control dressing. The dressing significantly reduced CVC colonization but not CRBSI rates. Conclusions: This new dressing provides enhanced antimicrobial protection but does not decrease CRBSI incidence. Future studies should further explore the cost-effectiveness and long-term benefits of this approach.