ANTIBACTERIAL EFFICACY EVALUATION OF SILVER NANOPARTICLES AND CHITOSAN COATINGS ON TITANIUM SURFACES OF GRAM-POSITIVE AND GRAM-NEGATIVE BACTERIAL RESISTANCE: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract

Aim: to evaluate the antibacterial efficacy of silver nanoparticles (AgNPs) and chitosan (CH) coating on titanium (Ti) surfaces against gram-positive and gram-negative bacteria
Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were used and registered in PROSPERO- CRDXXXX. Electronic databases were searched from January 2000 till September 2024 for studies evaluating theantibacterial efficacy of silver nanoparticles and chitosan coating on titanium surfaces against gram-positive and gram -negative bacteria in terms of colony forming units (CFU) and cell viability on (Ti) surfaces. Screening process was done by two independent authors. Quality assessment of included studies was evaluated using the Cochrane risk of bias (ROB)-2 tool. The standardized mean difference (SMD) was used as summary statistic measure with random effect model (p<0.05).
Results: Four studies were included in review and three studies for meta-analysis. Quality assessment revealed a moderate to low ROB. The antibacterial efficacy was assessed in terms of colony forming units (CFU) for Staph. Aureus and cell viability.Meta-analysis showed that reduction in CFU of Staph. aureus was (SMD-12.66 (-19.54 – 5.78) more by silver nanoparticles and chitosan coated group (p<0.05) while greater cell viability on Ti surface was (SMD - 0.41 (-1.10 – 1.91) more by silver nanoparticles and chitosan coated group (p>0.05).Funnel plot did not show any presence of possible publication bias in meta-analysis. More in -vitro studies or comparative analytical studieswith should be conducted to validate the findings of this study.
Conclusion:it was found that antibacterial coating is highly effective in preventing implant associated infections and these coatings showed good anti-bactericidal property by inhibiting surface adhesion of gram positive and gram- negative bacteria with minimal cytotoxicity.