The treatment of orthopedic implant-associated infections (IAIs) faces significant challenges due to increasing resistance. This study reports a virulence-selective trap-capture-kill antibacterial system that effectively treats persistent infections while promoting local bone tissue regeneration by modulating the immune and metabolic microenvironment disorders caused by IAIs. This study is based on TiO2 nanotube arrays modified with a cationic pentacyclic coplanar backbone (fascaplysin derivative 14, F-14) to create a nanostructured antibacterial system (F-14-TNA).The modified surface induces unique virulence-initiating chemotactic behavior, and TiO2 nanostructures selectively capture highly pathogenic bacterial strains within the infected microbial population. These captured bacterial strains are then trapped by the positively charged F-14 surface through electrostatic forces. Subsequently, the virulence-selective bacteria are killed via an oxidant-mediated pathway regulated by the phosphotransferase system through a cyclic AMP receptor protein cascade response.In vitro and in vivo studies have shown that F-14-TNA has multiple biocompatible functions, such as effective antibacterial activity, regulation of the immune microenvironment in bone infections, and restoration of bone metabolic disorders. The nanostructure developed in this study provides a new approach for treating IAIs.

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https://www.x-mol.com/paper/1967726370794270720/t?adv