Medical Fabrics with Non-Antibiotic, Supramolecular Antimicrobial Coatings: A Preventive Approach to Combat Biofilm Formation and Bacterial Dissemination.

Infections caused by bacterial colonization and biofilm formation on wounds and dressings present critical challenges to wound care, often impeding healing. Here, we report an antibiotic-free preventive strategy based on medical fabric coated with supramolecular antimicrobial assemblies. Using layer-by-layer dip coating technique, we functionalized medical fabric with polyarginine (PAR30) and hyaluronic acid (HA144) polymers, biopolymers that synergistically exhibited intrinsic antimicrobial activity. Coatings deposition and structural integrity were validated by confocal microscopy and ATR-FTIR spectroscopy. Antibacterial performance was assessed using the AATCC100 standard test method, showed strong efficacy against both Gram-negative and Gram-positive clinical pathogens. In vivo wound infection models, employing bioluminescent methicillin-resistant Staphylococcus aureus (MRSA), were used to evaluate biofilm prevention. Coated and uncoated fabrics were either pre-inoculated with MRSA or applied to pre-infected wounds to assess their antimicrobial and anti-biofilm effects. The coated fabrics showed potent antibacterial activity, achieving ≥6 log-reduction in bacterial load within 24 h compared to uncoated fabrics. Bioluminescence imaging confirmed infection development in wounds covered with uncoated fabrics, while coated fabrics prevented infection with a ≥6 log-reduction in bacterial load on fabrics and a ≥4 log-reduction in wound biopsies. Additionally, coated fabrics inhibited biofilm formation and bacterial proliferation in wound beds inoculated with MRSA. Comprehensive in vitro and in vivo biocompatibility assessments demonstrated the safe profile of the coated fabrics for clinical use. These findings highlight the antimicrobial efficiency of coated fabrics in minimizing bacterial colonization and biofilm formation on wounds and textiles. This safe and effective first-in-class, innovative approach offers a promising preventive strategy against biofilm formation and addresses antimicrobial-resistant strains like MRSA in wound care.