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Quaternary Ammonium Compounds

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Biomaterials Associated Infection

Abstract

The main cause of failure of biomedical implants is bacterial infections. Despite all efforts, it will never be possible to completely free operating theaters from bacteria, as human bodies contain already 1014 bacteria. Once on a surface, bacteria start proliferating, while protecting themselves with a slime layer against the immune system and administered antibiotics. A promising route to prevent or at least reduce bacterial infections caused by implants is by making surfaces of the devices antibacterial. One way to eradicate bacteria on implants is by contact killing.

Quaternary ammonium compounds (quats) are very potent biocides. The generally accepted mechanism is that quats destabilize the cytoplasmic membrane, which leads to leakage and eventually to cell death. Unfortunately, a similar mechanism provokes cytotoxicity. Fortunately, it is feasible to optimize the balance between biocidal activity and cytotoxicity by adapting the chemical structures.

Low molecular weight quats are effective, but leachable and thus only temporarily effective. Moreover, leachable quats will be transported throughout the whole body and may cause cell lysis. A more sustainable approach is to immobilize quats on surfaces. Although this development is still in an early stage in the last decade much progress has been made. There is a vast amount of literature describing successful in vitro experiments, and a number of papers have shown antibacterial activity in vivo.

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Acknowledgments

The author wants to thank Dr. T. Dirks and Dr. A. Piermattei from DSM (in the Netherlands) for reading the manuscript carefully and for their comments.

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Authors and Affiliations

  1. Zernike Institute for Advanced materials, Polymer Chemistry Department, University of Groningen, Nijenborgh 4, Groningen, 9747AG, The Netherlands

    J. A. Loontjens

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  1. J. A. Loontjens
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Correspondence to J. A. Loontjens .

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Editors and Affiliations

  1. AO Research Institute Davos, Clavadelerstrasse 8, Davos Platz, 7270, Switzerland

    T. Fintan Moriarty

  2. , Medical Microbiology, Academic Medical Center, Meibergdreef 15, Amsterdam, 1105 AZ, Netherlands

    Sebastian A.J. Zaat

  3. University Medical Center Groningen, A. Deusinglaan 1, Groningen, 9713 AV, Netherlands

    Henk J. Busscher

Glossary

Coatings

Are polymer compositions that cover surfaces that determine the interfacial properties.

Polymers (macromolecules, plastics)

Are high molecular materials comprising numerous monomers units.

Quaternary ammonium compounds

Are compounds that comprise positively charged nitrogen moieties (R4N+X−).

Leachable antibacterial compounds

Are low molecular compounds that are able to release from a surface into the surroundings.

Contact-killing

Is the operating mechanism if bacteria are only killed upon direct contact with a surface.

Cytotoxicity

Determines the damage on human cells.

Biocompatibility

Is a measure for the acceptance of the body of foreign entities.

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Loontjens, J.A. (2013). Quaternary Ammonium Compounds. In: Moriarty, T., Zaat, S., Busscher, H. (eds) Biomaterials Associated Infection. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-1031-7_15

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