Antimicrobial fibers: therapeutic possibilities and recent advances

The emergence of multi-drug-resistant bacteria such as methicillin-resistant strains of Staphylococcus aureus (MRSA), vancomycin-resistant enterococci, Pseudomonas aeruginosa, Acinetobacter baumannii and extended-spectrum beta-lactamase (carbapenemase)-producing Enterobacteriaceae is becoming a serious threat. New-generation antimicrobial agents need to be developed. This includes the design of novel antimicrobial compounds and drug-delivery systems. This review provides an introduction into different classes of antimicrobial materials. The main focus is on strategies for the introduction of antimicrobial properties in polymer materials. These can be roughly divided into surface modification, inclusion of antimicrobial compounds that can leach from the polymer, and the introduction of polymer-bound moieties that provide the polymer with antimicrobial properties. One of the main challenges in the development of antimicrobial polymers for the use in contact with human tissue is the concomitant demand of non-cytotoxicity. Current research is strongly focused on the latter aspect.