Conceptualizing antibacterial approach for silk-based implants with electrospun cefiderocol nanofibers and PEO-coated Mg3ZnCa

Antibacterial functionality for silk-based implants remains as a critical area that needs improvement. This study presents a novel, stepwise antibacterial concept for infection-resistant implants. First, a Mg3ZnCa (ZX31) alloy was selected for its biodegradable properties and coated on the silk base, which was further enhanced using plasma electrolytic oxidation (PEO) for corrosion resistance. Next, electrospun nanofibers loaded with the cefiderocol were applied to the PEO-coated surface. Finally, bacteriophages were immobilized onto the nanofibers. The structure and antibacterial performance of each step were characterized using clinical analysis including electron microscopy imaging. Antibacterial testing against E. coli using ATCC 25922 demonstrated that phage–antibiotic co-release achieved complete bacterial eradication within one hour, compared to eight hours for cefiderocol-loaded fibers alone. Additionally, magnesium corrosion contributed to sterilization after ten hours. These results show the strong synergistic potential of combining magnesium degradation, antibiotic delivery, and phage therapy to prevent early-stage infections on silk implants, offering a promising route for future clinical applications.