Critical Review of Nanopillar-Based Mechano-Bactericidal Systems

The rise of multidrug-resistant bacteria is the biggest threat to human health globally, as described by the World Health Organization. Mechanobactericidal surfaces provide a sustainable approach to addressing this concern by eradicating pathogens, especially bacteria, "right-at-the-point" of contacting the surface. However, the lack of a "design to manufacture" approach due to our limited understanding of the mechanobactericidal mechanism has impeded engineering optimization to develop scalable exploitation routes in various healthcare applications. It can be argued that the reason, most particularly, is the limitations and uncertainties associated with the current instrumentation and simulation capabilities, which has led to several streams of test protocols. This review highlights the current understanding on the mechanobactericidal mechanisms in light of the contributing factors and various techniques that are used to postulate these mechanisms. The review offers a critique on the variations observed on how nanostructured surfaces found in the literature have been evaluated such that the test protocols and outcomes are incomparable. The review also shows a strong need for developing more accurate models of a bacterium because the currently reported experimental data are insufficient to develop bacterial material models (constitutive equations). The review also alludes to the scarcity of direct experimental evidence of the mechanobactericidal mechanism, suggesting a strong need for further in situ monitoring as a future research direction.