Enhancing the antibacterial effect of chitosan to combat orthopaedic implant-associated infections.

The development of antibacterial resistance imposes the development of novel materials to relieve the burden of infection. Chitosan, a material of natural and sustainable origin, possesses ideal characteristics to translate into a novel biomaterial with antibacterial properties, as it already has these properties and it allows easy and scalable chemical modification to enhance its activity. The aim of the present work was that of producing low molecular weight chitosans that have higher solubility and can remain protonated at physiological pH, thus enhancing the antimicrobial action. This was achieved by reacting acid hydrolysed low molecular weight chitosan with 2-bromoethyleneamine hydrobromide or Fmoc-Lys(Fmoc)-OH to elicit N-(2-ethylamino)-chitosan and N-2(2,6-diaminohexanamide)-chitosan polymers. The latter derivative, CS3H Lys, that was synthesised for the first time, showed superior efficacy against Staphylococcus aureus, supporting further studies for its inclusion in implant coating materials to tackle the burden of orthopaedic implant-associated infections.