Biofilm-associated infections continue to present a formidable clinical challenge, as surface-adhered microbial communities exhibit remarkable tolerance toward conventional antibiotics. Polymeric materials have emerged as a versatile platform for combating biofilms, offering chemical tunability and enabling diverse antimicrobial strategies. This feature review article highlights recent advances in polymeric materials designed to prevent biofilm-associated infections by resisting bacterial adhesion (passive inhibition) or exerting bactericidal effects (active inhibition). These approaches include antifouling surfaces, polymer–nanoparticle composites, and bioinspired materials. Particular attention is given to how polymer structure and functionality (e.g., hydrophobicity, charge, and network architecture) govern bacterial adhesion and viability at interfaces. Emerging glycomaterials are also discussed, where glycan motifs are integrated with nanoparticles or cationic domains to enhance biofilm penetration and antimicrobial efficacy. Collectively, these studies underscore the potential of polymeric materials to modulate microbe–surface interactions, thereby guiding the design of next-generation antibiofilm materials.

Biofilms develop in sequential steps resulting in the formation of three-dimensional communities of microorganisms that are encased in self-produced extracellular polymeric substances. Biofilms play a key role in device-associated infections, such as catheter-associated urinary tract infections (CAUTIs), because they protect microorganisms from standard antimicrobial therapies. Current strategies to prevent biofilm formation in catheter-related infections, including prophylactic antibiotics and antibiotic-coated catheters, have been unsuccessful. This finding highlights a need for novel approaches to address this clinical problem. In this study, biofilm-forming phenotypes of common Gram-negative bacteria associated with CAUTIs were treated with antisense peptide nucleic acids (PNAs), and biofilm biomass and bacterial viability were quantified after 24 h of treatment. A cocktail of PNAs targeting the global regulator genes rsmA, amrZ, and rpoS in Pseudomonas aeruginosa significantly reduced viability and thus appropriately eliminated biofilm biomass. Antisense-PNAs against these same gene targets and the motility regulator gene motA inhibited biofilm formation among isolates of Klebsiella pneumoniae, Enterobacter cloacae, and Escherichia coli but did not reduce bacterial viability. These results suggest that antisense-PNAs are a promising new technology in preventing biofilm formation in urinary catheters, especially as a potential complement to conventional antimicrobials.

Indwelling urinary catheters frequently develop intraluminal biofilms, increasing the risk of catheter-associated urinary tract infections and systemic infections. Current prophylactic strategies, including antibiotics and antimicrobial coatings, have not consistently reduced the risk of infection. Histotripsy, a focused ultrasound ablation method, offers a promising non-invasive approach to mechanically disrupt biofilms and has demonstrated efficacy against catheter-associated biofilms in vitro. This study evaluated the ability of histotripsy to disrupt clinically derived intraluminal biofilms. Explanted urinary catheters were segmented and treated ex vivo with histotripsy, with matched untreated segments serving as controls. Following treatment, catheter segments were assessed for microbial viability by culture and for biofilm biomass using a crystal violet assay. Three silicone catheters were collected, each with four treated and four matched control segments. Based on Gram stain morphology, the three catheter tip cultures were consistent with Staphylococcus aureus, mixed Gram-positive and Gram-negative organisms, and a budding yeast suggestive of a Candida species, respectively. A single histotripsy treatment with a pulse repetition frequency of 200 Hz and estimated peak negative pressure of 31.6 MPa resulted in an 81.7% reduction in biofilm biomass compared with untreated controls (p < 0.001). Viable organisms remained detectable after treatment under the tested parameters. These findings support further investigation of histotripsy as an approach for managing catheter-associated biofilm infections. Additional studies are needed to optimize treatment parameters and explore potential clinical applications.