Effect of antimicrobial peptide conjugated surgical sutures on multiple drug-resistant microorganisms

Surgical site infections are commonly encountered as a risk factor in clinics that increase the morbidity of a patient after a surgical operation. Surgical sutures are one of the leading factor for the formation of surgical site infections that induce bacterial colonization by their broad surface area. Current strategies to overcome with surgical site infections consist utilization of antibiotic agent coatings such as triclosan. However, the significant increase in antibiotic resistance majorly decreases their efficiency against recalcitrant pathogens such as; Pseudomonas aeruginosa and Staphylococcus aureus. Therefore, the development of a multi drug-resistant antimicrobial suture without any cytotoxic effect to combat surgical site infections is vital. Antimicrobial peptides are the first defense line which has a broad range of spectrum against Gram-positive, and Gram-negative bacteria and even viruses. In addition, antimicrobial peptides have a rapid killing mechanism which is enhanced by membrane disruption and inhibition of functional proteins in pathogens without the development of antimicrobial resistance. In the scope of the current study, the antimicrobial effect of antimicrobial peptide conjugated poly (glycolic acid-co-caprolactone) (PGCL) sutures were investigated against P. aeruginosa and methicillin-resistant S. aureus (MRSA) strains by using antimicrobial peptide sequences of KRFRIRVRV-NH2, RWRWRWRW-NH2 and their dual combination (1:1). In addition, in vitro wound scratch assays were performed to evaluate the effect of antimicrobial peptide conjugated sutures on keratinocyte cell lines. Our results indicated that antimicrobial peptide modified sutures could be a potential novel medical device to overcome surgical site infections by the superior acceleration of wound healing.