# Surface Modification of Medical-Grade Titanium and Polyvinyl Chloride with a Novel Catechol-Terminated Compound Containing Zwitterionic Sulfobetaine Functionality for Antibacterial Application

## TL;DR

This paper introduces a new surface modification technique using a zwitterionic compound to make medical devices more resistant to bacterial infections without harming cells.

## Contribution

A novel catechol-terminated zwitterionic compound is developed for simple surface modification of medical materials with strong antibacterial properties and no cytotoxicity.

## Key findings

- ZDS-modified titanium and PVC surfaces achieved antibacterial percentages of 84.2% and 81.7% against S. aureus.
- The modified surfaces showed no cytotoxicity, making them safe for medical use.
- A layer-by-layer immersion method improved modification effectiveness on PVC substrates.

## Abstract

Healthcare-associated infection, mainly through medical device-associated infection, remains a critical issue in hospital care. Bacterial adhesion, proliferation, and biofilm formation on the device surface have been considered the foremost cause of medical device-associated infection. Different means have been explored to reduce microbial attachment and proliferation, including forming a bactericidal or microbial adhesion-resistant surface layer. Fear of limited bactericidal capability if the dead microbes remained adhered to the surface has withheld the widespread use of a bactericidal surface in medical devices if it was intended for long-term use. By contrast, constructing a microbial adhesion-resistant or antifouling surface, such as a surface with zwitterionic functionality, would be more feasible for devices intended to be used for the long term. Nevertheless, a sophisticated multi-step chemical reaction process would be needed. Instead, a simple immersion method that utilized a novel mussel-inspired catechol compound with zwitterionic sulfobetaine functionality, ZDS, was explored in this investigation for the surface modification of substrates with distinctively different surface characteristics, including titanium and polyvinyl chloride. Dopamine, NaIO4 oxidants, and chemicals that could affect ionic interactions (NaCl and polyethyleneimine) were added to the ZDS-containing immersion solution to compare their effects on modifying titanium and PVC substrates. Furthermore, a layer-by-layer immersion method, in which the substrate was first immersed in the no-ZDS-added dopamine-containing solution, followed by the ZDS-containing solution, was also attempted on the PVC substrate. By properly selecting the immersion solution formulation and additional NaIO4 oxidation modification, the antibacterial capability of ZDS-modified substrates can be optimized without causing cytotoxicity. The maximum antibacterial percentages against S. aureus were 84.2% and 81.7% for the modified titanium and PVC substrate, respectively, and both modified surfaces did not show any cytotoxicity.