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In the US alone, 1.7 million individuals develop a hospital-acquired infection (HAI) annually, with one in every 17 of these infections resulting in death1. In addition, it is estimated that the treatment costs for HAIs range from $28 billion to $45 billion annually1,2. These HAIs are predominated by methicillin-resistant Staphylococcus aureus (MRSA)3,4 and Pseudomonas aeruginosa4, which are commonly isolated from chronic wound infections and usually require extensive treatment and time to produce a favorable patient outcome.
Over the past several decades, multiple antibiotic classes have been developed to treat infections related to these and other pathogenic bacteria. For example, rifamycin analogs have been used to treat MRSA, other gram-positive and gram-negative infections, and Mycobacterium spp. infections5. In the 1990s, to effectively treat an increasing number of M. tuberculosis infections, additional drugs were combined with rifamycin analogs to increase their effectiveness. However, approximately 5% of M. tuberculosis cases remain resistant torifampicin5,6, and there is increasing concern regarding multi-drug resistant bacteria7. Currently, the use of antibiotics alone may not be sufficient in the treatment of HAIs, and this has provoked an ongoing search for alternative antimicrobial therapies1.
Heavy metals, such as silver (Ag)8,9,10 and gold (Au)11, and ceramics, such as titanium dioxide (TiO2)12 and zinc oxide (ZnO)13, in nanoparticle (NP) form (AgNP, AuNP, TiO2NP, and ZnONP, respectively) have been examined for their antimicrobial activities and have been identified as potential antibiotic alternatives. In addition, bioresorbable materials, such as magnesium alloys (Mg alloys)14,15,16, magnesium oxide nanoparticles17,18,19,20,21, and magnesium hydroxide nanoparticles [nMgO and nMg(OH)2, respectively]22,23,24, have also been examined. However, the previous antimicrobial studies of nanoparticles used inconsistent materials and research methods, resulting in data that are difficult or impossible to compare and are sometimes contradictory in nature18,19. For example, the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of silver nanoparticles varied significantly in different studies. Ipe et al.25 evaluated the antibacterial activities of AgNPs with an average particle size of ~26 nm to determine the MICs against gram-positive and gram-negative bacteria. The identified MICs for P. aeruginosa, E. coli, S. aureus, and MRSA were 2 µg/mL, 5 µg/mL, 10 µg/mL, and 10 µg/mL, respectively. In contrast, Parvekar et al.26 evaluated AgNPs with an average particle size of 5 nm. In this instance, the AgNP MIC and a MBC of 0.625 mg/mL were found to be effective against S. aureus. In addition, Loo et al.27 evaluated AgNPs with a size of 4.06 nm. When E. coli was exposed to these nanoparticles, the MIC and MBC were reported at 7.8 µg/mL. Finally, Ali et al.28 investigated the antibacterial properties of spherical AgNPs with an average size of 18 nm. When P. aeruginosa, E. coli, and MRSA were exposed to these nanoparticles, the MIC was identified at 27 µg/mL, 36 µg/mL, 27 µg/mL, and 36 µg/mL, respectively, and the MBC was identified at 36 µg/mL, 42 µg/mL, and 30 µg/mL, respectively.
Although the antibacterial activity of nanoparticles has been extensively studied and reported during recent decades, there is no standard for the materials and research methods used to allow for direct comparisons across studies. For this reason, we present two methods, the direct co-culture method (method A), and the direct exposure method (method B), to characterize and compare the antimicrobial activities of nanoparticles while keeping the materials and methods consistent.
In addition to nanoparticles, nanostructured surfaces have also been examined for antibacterial activities. These include carbon-based materials, such as graphene nanosheets, carbon nanotubes, and graphite29, as well as pure Mg and Mg alloys. Each of these materials has exhibited at least one antibacterial mechanism, including physical damage imposed on cell membranes by carbon-based materials and damage to metabolic processes or DNA through the release of reactive oxygen species (ROS) when Mg degrades. In addition, when zinc (Zn) and calcium (Ca) are combined in the formation of Mg alloys, the refinement of the Mg matrix grain size is enhanced, which leads to a reduction in bacterial adhesion to substrate surfaces in comparison to Mg-only samples14. To demonstrate antibacterial activity, we present the direct culture method (method C), which determines bacterial adhesion on and around nanostructured materials over time through the quantification of bacterial colony-forming units (CFUs) with direct and indirect surface contact.
The geometry of nanostructures on surfaces, including the size, shape, and orientation, could influence the bactericidal activities of materials. For example, Lin et al.16 fabricated different nanostructured MgO layers on the surfaces of Mg substrates through anodization and electrophoretic deposition (EPD). After a period of exposure to the nanostructured surface in vitro, the growth of S. aureus was substantially reduced in comparison to non-treated Mg. This indicated a greater potency of the nanostructured surface against bacterial adhesion versus the nontreated metallic Mg surface. To reveal the different mechanisms of the antibacterial properties of various nanostructured surfaces, a focused-contact exposure method (method D) that determines the cell-surface interactions within the area of interest is discussed in this article.
The objective of this article is to present four in vitro methods that are applicable to different nanoparticles, nanostructured surfaces, and microbial species. We discuss key considerations for each method to produce consistent, reproducible data for comparability. Specifically, the direct co-culture method17 and direct exposure method are used for examining the antimicrobial properties of nanoparticles. Through the direct co-culture method, the minimum inhibitory and minimum bactericidal concentrations (MIC and MBC90-99.99, respectively) can be determined for individual species, and the most potent concentration (MPC) can be determined for multiple species. Through the direct exposure method, the bacteriostatic or bactericidal effects of nanoparticles at minimum inhibitory concentrations can be characterized by real-time optical density readings over time. The direct culture14 method is suitable for examining bacteria directly and indirectly in contact with nanostructured surfaces. Finally, the focused-contact exposure16 method is presented to examine the antibacterial activity of a specific area on a nanostructured surface through the direct application of bacteria and the characterization of bacterial growth at the cell-nanostructure interface. This method is modified from the Japanese Industrial Standard JIS Z 2801:200016, and is intended to focus on microbe-surface interactions and exclude the effects of bulk sample degradation in microbial culture on antimicrobial activities.