New Materials May Help Tackle Antibiotic Resistance
According to the World Health Organization (WHO), antimicrobial resistance occurs when “bacteria, viruses, fungi, and parasites do not respond to antimicrobials.” As a result, infections become more difficult...
According to the World Health Organization (WHO), antimicrobial resistance occurs when “bacteria, viruses, fungi, and parasites do not respond to antimicrobials.” As a result, infections become more difficult or impossible to treat, increasing the risk for transmission, severe illness, disability, and death.
In 2014, the WHO’s first global report on antimicrobial resistance warned that the problem was not a future threat but a present reality in all regions of the world. A year later, the World Health Assembly adopted a global action plan to address this growing threat. An analysis published in The Lancet estimated that antimicrobial-resistant bacterial infections were associated with 4.95 million deaths worldwide in 2019, including 1.27 million deaths directly attributable to bacterial resistance.
The analysis focused on six pathogens: Escherichia coli , Staphylococcus aureus , Klebsiella pneumoniae , Streptococcus pneumoniae , Acinetobacter baumannii , and Pseudomonas aeruginosa . Together, these pathogens were associated with 3.57 million deaths related to bacterial resistance and accounted for 929,000 of the 1.27 million deaths directly attributed to resistance.
In its 2026 report, the WHO estimated that antibiotic resistance was associated with more than 4.7 million deaths in 2021 and that approximately 1 in 6 laboratory-confirmed bacterial infections were resistant to antibiotics in 2023. Given these facts, combating antibiotic resistance requires more than developing new antibiotics.
Innovation in infection prevention is needed. Antimicrobial materials are emerging as an area of research aimed at preventing infection before it becomes established. Materials Innovation Since 2010, the Ana Conde del Campo, PhD, group manager of the Corrosion and Protection of Metallic Materials group at the National Center for Metallurgical Research (CENIM-CSIC), part of the Spanish National Research Council, has been developing a strategy to prevent bacteria from colonizing surgical implants, including hip and knee replacements.
The idea emerged from collaboration between physicians and orthopedic surgeons, who suggested modifying the titanium alloys used in prostheses to make their surfaces more resistant to bacterial adhesion. Speaking with Univadis Spain , part of the Medscape Professional Network, Conde del Campo noted that the goal is to ensure that “human cells are able to cover the implant’s surface before bacteria do; to achieve this, a film is created that hinders bacterial adhesion.” Researchers have modified the titanium surface by creating a layer of fluorinated titanium oxide with a tiny tubular structure that reduces bacterial adhesion.
The surface can also serve as a platform for releasing antibiotics that were previously incorporated into the material. The difference from conventional antibiotic use is the timing of treatment. “Normally, an antibiotic is used once you already have an established infection,” Conde del Campo explained.
“In contrast, the group’s strategy aims to hinder colonization from the outset, so that the immune system can eliminate the bacteria before they become established on the implant. Once attached to the biomaterial, the bacteria begin to form a biofilm that provides them with favorable conditions for survival and makes it much harder to combat with subsequent treatments.” The technology was tested in an animal model, and according to Conde del Campo, 99% efficacy was achieved when an infection was induced with bacteria responsible for prosthetic infections.
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The surface can also be used for purposes other than antibiotic release; it can incorporate substances that promote cell adhesion to the implant, thereby extending the period during which bacterial colonization can be prevented. Researchers are also studying another factor that can influence the success of a prosthesis: the mechanical fit between the implant and bone.
An implant that is too rigid can interfere with normal load transmission, eventually leading to loosening. To address this problem, the team is studying titanium alloys with a lower Young’s modulus, a parameter that characterizes the behavior of an elastic material, as well as additive manufacturing techniques that produce implants with porous geometries to reduce stiffness and improve bone integration.
The strategies developed by the CENIM-CSIC group are part of a broader research effort to use the materials themselves to prevent infection and reduce reliance on antibiotics. Other researchers have pursued similar approaches. A 2018 review described strategies ranging from materials that hinder bacterial adhesion and biofilm formation to those that target bacterial virulence mechanisms or act through antimicrobial mechanisms distinct from those of conventional antibiotics.
Technologies studied by researchers at the University of Cambridge in Cambridge, England, include nanoparticles, hydrogels, and surface coatings. Other Approaches Modifying materials offers several ways to combat infections without relying exclusively on antibiotics. One approach involves designing surfaces that alter their interactions with bacteria.
This strategy was pursued by Enrique Martínez Campos’s team at the Institute of Polymer Science and Technology in Madrid, Spain, which has developed polymeric surfaces with microscopic honeycomb-like patterns . These microstructures can alter bacterial adhesion and hinder bacterial colonization.
In other experimental studies, surfaces with patterns measuring approximately 1 μm reduced the adhesion and growth of E coli and S aureus compared with flat surfaces, showing that the material topography itself can serve as an antibacterial tool. Another approach uses light to activate antimicrobial activity.
Rosario Núñez, PhD, senior researcher at the Spanish National Research Council in Madrid, Spain, and colleagues studied antimicrobial photodynamic therapy, in which photosensitive molecules exposed to light in the presence of oxygen generate reactive species capable of damaging and destroying bacteria.
In a study published in 2025, the team developed new molecules based on BODIPY and boron clusters that showed activity against multidrug-resistant gram-positive bacteria, including S aureus and Enterococcus faecium . One molecule completely eliminated S aureus at a concentration of 5 μM under green light, whereas the compounds showed virtually no toxicity in the absence of light.
The third strategy draws on the body’s own defenses. In a 2025 study led by Imma Ratera, PhD, from the Nanomol-bio group at the Institute of Materials Science of Barcelona in Barcelona, Spain, researchers developed a polyurethane surface incorporating human alpha-defensin 5, a human protein with antimicrobial activity.
The surface reduced biofilm formation by P aeruginosa , methicillin-resistant S aureus , and methicillin-resistant Staphylococcus epidermidis , suggesting a potential approach to protecting medical devices from bacterial colonization after implantation. Although the strategies differ, they share the same principle: acting before an infection is established or using mechanisms other than conventional antibiotics.
Instead of waiting for bacteria to multiply before treating an infection, research into new materials aims to modify the environment they encounter by making adhesion more difficult, trapping bacteria, triggering an antimicrobial response with light, or coating surfaces with molecules that mimic the body’s defenses.
These approaches are still at different stages of development, but they illustrate how research on antibiotic resistance is expanding beyond the development of new antibiotics. Conde del Campo reported having no relevant conflicts of interest. This story was translated from Univadis Spain .
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