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Article

pubs.acs.org/Biomac

Green Synthesis of Silk Fibroin-Silver Nanoparticle Composites with


Effective Antibacterial and Biofilm-Disrupting Properties
Xiang Fei,† Minghui Jia,‡ Xin Du,§ Yuhong Yang,∥ Ren Zhang,∥ Zhengzhong Shao,† Xia Zhao,*,‡
and Xin Chen*,†

State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Laboratory of Advanced
Materials, Fudan University, Shanghai, 200433, People’s Republic of China

Department of Otorhinolaryngology−Head and Neck Surgery and §Department of Laboratory Medicine, Huashan Hospital, Fudan
University, Shanghai, 200040, People’s Republic of China

Research Centre for Analysis and Measurement, Fudan University, Shanghai 200433, People’s Republic of China
*
S Supporting Information

ABSTRACT: Natural polymer Bombyx mori silk fibroin is used as a biotemplate to produce silver nanoparticles in situ under
light (both incandescent light and sunlight) at room temperature. Silk fibroin provides multiple functions in the whole reaction
system, serving as the reducing agent of silver, and the dispersing and stabilizing agent of the resulted silver nanoparticles. As the
reaction needs not any other chemicals and only uses light as power source, the synthetic route of silver nanoparticles reported
here is rather environment-friendly and energy-saving. The silk fibroin-silver nanoparticle composite prepared by this method can
be stably stored in a usual environment (room temperature, exposure to light, and so forth) for at least one month. Such a silk
fibroin-silver nanoparticle composite shows an effective antibacterial activity against the methicillin-resistant Staphylcoccus aureus
(S. aureus) and subsequently inhibits the biofilm formation caused by the same bacterium. Moreover, a maturely formed biofilm
created by methicillin-resistant S. aureus can be destroyed by the silk fibroin-silver nanoparticle composite, which meets the
demand of clinical application. Therefore, the silk fibroin-silver nanoparticle composite prepared by this clean and facile method
is expected to be an effective and economical antimicrobial material in biomedical fields.

■ INTRODUCTION
There has been increasing interest in the development of clean
preparation of novel biomaterials and nanodevices in the form
of inorganic−organic hybrid composites.7,10,12−14
synthetic procedures for nanoproducts targeted for biomedical Silk fibroin derived from Bombyx mori silkworm silk is a
applications.1 Utilization of nontoxic chemicals, environ- commonly used biomacromolecule with unique sequence-
mentally benign solvents, and renewable materials are some specific self-assembly behavior and substrate recognition
of the key issues that merit important consideration in a green properties.15 Silk fibroin has been used as a biomedical material
synthetic strategy. In nature, biological systems have developed for long a time because of its good biocompatibility,
biomineralization approaches in the combination of the biology controllable biodegradability, and easy fabrication into different
and nanotechnology, offering unparalleled opportunities for forms, such as fibers, films, gels, and three-dimensional
excellent physicochemical properties in natural biomaterials2 scaffolds.16,17 As other proteins, silk fibroin is also a good
and providing inspiration for material scientists to design candidate for a soluble template for biomineralization. In our
advanced nanomaterial.3−5 As an important component in previous works, we have proved that silk fibroin plays an
biomineralization, various biological systems, such as viruses,6
proteins,7 and peptides7−11 broaden the possible application Received: September 22, 2013
fields of the biomineralization in electronics and nano- Revised: October 20, 2013
biotechnology. They often act as a biotemplate during the Published: October 30, 2013

© 2013 American Chemical Society 4483 dx.doi.org/10.1021/bm4014149 | Biomacromolecules 2013, 14, 4483−4488
Biomacromolecules Article

important role in the biomineralization process for inducing clinical laboratory of Huashan Hospital affiliated to Fudan University,
and regulating the morphologies and lattice structures of which has the ability to form biofilm. A single isolated colony of the
different inorganic nanostructures.18−22 target bacteria was inoculated in 4 mL of Muller−Hinton broth
Nowadays, the development of antibiotic-resistant bacteria (MHB) and was cultured to a midlog phase at 37 °C with shaking
has created a myriad of new challenges within the healthcare (220 r/min). Then, the bacteria liquid in midlog phase was
field. In terms of public health, the methicillin-resistant resuspended in the physiological saline to an optical density (OD)
Staphylcoccus aureus (MRSA) accounts for a considerable part of 0.5 at 600 nm, which corresponds to the concentration of 1.5 × 108
of the reported cases of S. aureus infections all over the world. colony forming units per milliliters (CFU/mL).
Minimum Inhibitory Concentration (MIC) and Minimum
People estimate 20 000 deaths occurred in the United States Bactericidal Concentration (MBC) Determination. The anti-
annually because of MRSA infections.23 On the other hand, microbial activity of RSF-AgNPs composite was evaluated by
planktonic bacteria in the nosocomial environment or during determination of MIC and MBC against Sa006 in vitro. MIC and
the manufacturing processes of medical supplies can form MBC testing were performed according to the Clinical and Laboratory
colonies on their surfaces to create biofilms, leading to the Standards Institute (CLSI, 2011) guidelines for macro-dilution in
wide-spreading of infectious diseases by contacting those broth.38 The bacterial suspension was resuspended in MHB to 2 × 105
contaminated surfaces. Bacterial biofilms consist of bacteria CFU/mL and dispensed into nine tubes (1 mL per tube), then equal
and self-secreted extracellular polymeric substances (EPS),24 volume of the 2-fold serially diluted concentrations of RSF-AgNPs
which are extremely resistant to conventional antibiotics composite solution were added into the tubes. The final concentration
because of acquired resistance, limited diffusion, and of AgNPs in these tubes was from 0 to 153.6 mg/L, using pure MHB
inactivation of antibiotics in EPS.23,25 medium as a control. MIC was defined as the lowest concentration
Silver nanoparticles (AgNPs) are well-known for their that yielded no visible growth of bacteria after 24 h incubation at 37
antibacterial property to a broad spectrum of bacteria and °C. MBC was determined by plating 100 μL suspension collected from
have been used increasingly in detergents, plastics, food storage the MIC test tubes without visible bacteria growth onto the Muller−
containers, antiseptic sprays, catheters, bandages, and textiles, Hinton (MH) agar plates and then incubated at 37 °C for another 24
and so forth.26 Nevertheless, practical applications of AgNPs h. The lowest concentration for monoclonal number in the plate was
are often hampered by their easy oxidization weakness, which five or less and defined as the MBC.38 All the tests were performed at
may cause the loss of the antibacterial activity.27 To overcome least in triplicate.
this problem, different organic27−29 and inorganic tem- Antibacterial Activity of RSF-AgNPs Composite against
Biofilm. In order to test the antibacterial activity of RSF-AgNPs
plates30−36 have been employed to stabilize AgNPs through
composite against the maturely formed biofilm, the bacteria
the formation of nanocomposites. However, those methods suspension was diluted in tryptic soy broth supplemented with 0.5%
always need complex and tedious procedures, and face the glucose (TSBg) to approximately 1 × 105 CFU/mL. Then, 1 mL of
problems of high cost and poor biocompatibility. such bacteria suspension was transferred to a cell culture dish (NEST
In this article, we introduce an easy and environmentally Biotechnology Co., Ltd.) to incubate for 24 h at 37 °C without
friendly route to in situ preparation of AgNPs using silk fibroin shaking. After the biofilms were formed in the dishes, the previous
as a biotemplate at room temperature under light exposure. TSBg media were changed by the fresh TSBg containing different
Then, we report the antibacterial and biofilm-disrupting amount of RSF-AgNPs composite and continued to incubate for
properties of the resulted silk fibroin-AgNPs composite. another 10 h. The concentration of AgNPs was set as MIC, MBC, 2 ×


MBC, and 5 × MBC, respectively. After 10 h incubation, the dishes
EXPERIMENTAL SECTION were sequentially rinsed with physiological saline three times to
remove the planktonic bacteria. The viability and structure of the
Preparation of Regenerated Silk Fibroin (RSF) Solution. The
biofilms were detected by means of confocal laser scanning microscopy
raw B. mori cocoon silk consists of fibroin fibers that are bound
(CLSM) and scanning electron microscopy (SEM).
together by sericin, a hydrophilic gumlike coating protein. The
degumming (removing the sericin) and dissolving process of B. mori Characterizations. Transmission electron microscopy (TEM) was
silk followed the established procedures.37 In brief, the silk fibers were performed with a Hitachi H-600 transmission electron microscope
degummed twice with 0.5 wt % NaHCO3 aqueous solution at 100 °C (Japan) at 75 kV. High-resolution transmission electron microscopy
for 30 min, washed with distilled water, and allowed to air-dry at room (HRTEM), selective area electron diffraction (SAED) and energy
temperature. The degummed B. mori silk fibers were dissolved in 9.3 dispersive X-ray spectroscopy (EDX) were performed on a JEM-
mol/L LiBr aqueous solution at 60 °C. The silk fibroin-LiBr solution 2010F transmission electron microscope (JEOL, Japan) at an
was dialyzed against deionized water for 72 h at room temperature accelerating voltage of 200 kV. UV−vis spectra were measured by a
with a semipermeable membrane (MEMBRA-CEL, 12 000−14 000 Hitachi U-2910 spectrophotometer. For SEM detection, the biofilm
MWCO) to remove the salt. The dialyzed silk fibroin solution was samples were placed in 2.5 wt % glutaraldehyde solution for 24 h, and
centrifuged at 6000 r/min for about 5 min and the supernatant was then dehydrated in a series of ethanol aqueous solutions with the
collected and then stored at 4 °C for further use. The final increased concentration until the specimens were placed in absolute
concentration of RSF solution was about 4 wt % and was diluted to ethanol. Afterward, the specimens were critical-point dried in carbon
1 wt % by adding deionized water. dioxide, mounted on the scanning electron microscope stubs, sputter
Preparation of RSF-AgNPs Composite Solution. Five to eighty coated with gold palladium, and then examined with a Hitachi SU8010
milligrams of AgNO3 powders were added into 5 mL of 1 wt % RSF
scanning electron microscope (Japan) at an accelerating voltage of 20
solution to form a transparent RSF-AgNO3 mixture solution. The final
kV. For CLSM detection, the biofilm samples were immersed in 1 mL
AgNO3 concentration in the mixture was 1−16 mg/mL. Then, the
RSF-AgNO 3 solution was exposed under the light with an of physiological saline in which contained 1.5 μL aliquots of
incandescent bulb (40 W, from Philips) and incubated at room component A (Syto 9) and component B (propidium iodide) from
temperature for 24 h to produce RSF-AgNPs composite solution. the BacLight LIVE/DEAD kit (Invitrogen, Molecular Probes) to stain
Afterward, RSF-AgNPs composite solution was stored at 4 °C for in darkness at room temperature for 15 min, Then, they were analyzed
further use. with a Leica TCS SP5 confocal scanning laser microscope (Leica
Preparation of Bacterial Suspension. The bacterial strain used Microsystems, Germany) at certain wavelengths (for Syto 9 at 515−
in this study was Sa006, a clinical isolate of MRSA obtained from the 530 nm, and for propidium iodide, >600 nm).

4484 dx.doi.org/10.1021/bm4014149 | Biomacromolecules 2013, 14, 4483−4488


Biomacromolecules Article

nature of Try residues (Figure 1a). In the current study, we set


the RSF concentration to 1 wt % in the reaction system, so we
need to determine the suitable concentration of AgNO3 to be
reduced. Fluorescence analysis was chosen as an effective
method to do this because the loss of fluorescence from Tyr
residues reflected the oxidation degree of the phenolic groups
in them. The more Ag+ ions were reduced, the more Tyr
residues were oxidized, and the less fluorescence intensity was
observed. Figure 1b indicates that the fluorescence intensity
does not change when the AgNO3 concentration is larger than
8 mg/mL. This means almost all of the Tyr residues in silk
fibroin were used (oxidized) at [AgNO3] = 8 mg/mL, so we
decided to set [AgNO3] = 4 mg/mL in our reaction system to
make sure that all the Ag+ ions can be reduced to Ag.
The initial RSF-AgNO3 solution was colorless, but after the
exposure to the light, the color gradually turned to yellow (see
inset in Figure 3b). Such a change was attributed to the size-
and shape-dependent surface plasmon resonance (SPR) of
AgNPs44 formed in the solution in the visible region and was
characterized by UV−vis spectroscopy (Figure 2a). The main
SPR band was at 440 nm, but a small shoulder can be found at
347 nm, suggesting the possible existence of different size and
morphology of AgNPs.45 TEM images (Figure 2b,c) show the
Figure 1. (a) Possible mechanism of the reduction of Ag+ ion by Tyr particle size distribution of the AgNPs. The average size of
residues in silk fibroin chain. (b) Fluorescence spectra of RSF/AgNO3 AgNPs was 12.0 ± 2.1 nm, which was obtained by measuring
reaction systems with different AgNO3 concentrations (from 0 to 16
mg/mL) after 24 h at room temperature ([RSF] = 1 wt %). 100 nanoparticles. HRTEM image of an individual nanoparticle
indicates the d-spacing of the crystallographic plane is 0.23 nm,

■ RESULTS AND DISCUSSION


In Situ Prepared RSF-AgNPs Composite Solution. B.
which agrees well with the distance of (111) lattice plane of Ag
(Figure 2d).46 The electron diffraction patterns (inset in Figure
2d) prove the single crystal nature of the synthesized AgNPs.
mori silk fibroin contains 18 amino acid residues, among which The local elemental composition of the product was confirmed
the tyrosine (Tyr) has strong electron donating property. On as Ag element by EDX microanalysis at a single nanocrystal
the basis of the previous studies on the synthesis of noble metal level (Supporting Information Figure S1). The explanation
(Ag and Au) nanoparticles with either single Tyr molecule or about how polypeptides like silk fibroin reduce Ag+ to Ag and
polypeptides and proteins containing Try residues in both our subsequently form AgNPs can be found in the literature.47,48
laboratory39 and other research groups,40−43 we believe that silk Figure 3a is the time-resolved UV−vis spectra recorded from
fibroin is also capable of reducing Ag+ to Ag by the redox-active beginning of the reaction to 32 h. The main absorption at 440

Figure 2. UV−vis spectra (a) and TEM (b−d) images of the synthesized RSF-AgNPs composites ([RSF] = 1 wt %, [AgNO3] = 4 mg/mL).

4485 dx.doi.org/10.1021/bm4014149 | Biomacromolecules 2013, 14, 4483−4488


Biomacromolecules Article

a rapid growth period from 0 to 20 h and then levels off.


Therefore, we set the reaction time as 24 h in the present study
to make sure the formation of AgNPs is complete. We should
point out that AgNPs can be also formed if the RSF-AgNO3
solution was exposed under sunlight.49 However, it is not
controllable to use sunlight, so we chose an incandescent lamp
for this fundamental research. For real applications, it would be
no problem to use sunlight and would probably need a long
time to allow the reaction to be completed.
Individual AgNPs are easily oxidized and/or aggregated in air
that may affect their practical uses,50,51 so the stability of AgNPs
has been considered as a critical key for the real application. In
our case, RSF-AgNPs composite formed a stable yellow
colloidal solution and almost had no change for at least one
month. Figure 3c shows the UV−vis spectra as well as the
appearance of RSF-AgNPs composite solutions, which scarcely
change after 30 days storage either in the dark or in the light.
During the AgNPs formation process, silk fibroin chains
connect to the surface of nanoparticles.47,48 Silk fibroin is a
protein, a natural nonionic surfactant, so it surely enhances the
stability of AgNPs in the aqueous dispersions.52 Therefore, silk
fibroin also acts as a dispersing and stabilizing agent of the
synthesized AgNPs like soy protein39 and bovine serum
albumin.53
Antibacterial Property of RSF-AgNPs Composite. In
this article, we evaluated the antibacterial activity of our RSF-
AgNPs composite with a clinical isolated MRSA. We cultured
the bacteria in MHB liquid media containing different amount
of RSF-AgNPs composite for 24 h, and the result was shown in
Figure 4a. It can be found that the bacteria suspension became
turbid if there was no RSF-AgNPs composite in the mixture,
suggesting the bacteria proliferated rapidly in MHB medium.
With the increase in concentration of RSF-AgNPs composite in
MHB medium, the bacteria suspension was still turbid until the
AgNPs concentration in the mixture reached 19.2 mg/L. As the
Figure 3. (a) Time-resolved UV−vis spectra of RSF-AgNO3 reaction MIC is defined as the lowest concentration of an antimicrobial
solution. (b) The change of the absorption at 440 nm at different material that can inhibit bacteria growth, so the MIC of AgNPs
reaction time, and the inset is the corresponding digital photos of the in our RSF-AgNPs composite solution is 19.2 mg/L.
reaction system. (c) Comparison of UV−vis spectra of RSF-AgNPs Subsequently, we plated the bacteria suspensions in which
composite solutions: black line, fresh synthesized; red line, stored in the AgNPs concentration was larger than MIC onto the MH
the dark for 30 day; green line, stored in the light for 30 days (the inset agar plates and incubated at 37 °C for another 24 h. The result
is the corresponding digital photos).
showed that when the AgNPs concentration increased to 76.8
mg/L, the monoclonal number of the bacteria growing on the
MH agar plate was less than 5 (Figure 4b). Therefore, the MBC
of AgNPs in our RSF-AgNPs composite was identified as 76.8
mg/L.
As our RSF-AgNPs composite exhibited quite effective
antimicrobial activity to MRSA, as shown above, in the next
step we tested its effect on the inhibition of the biofilm
formation. The result showed that the biofilms were formed if
the concentration of RSF-AgNPs was no more than a quarter of
MIC (Supporting Information Figure S2a−c). When the
concentration increased to half of MIC, although the bacteria
still grew, the biofilm was failed to form (Supporting
Figure 4. Antibacterial activities of RSF-AgNPs composites. (a) MIC Information Figure S2d). Of course, it was understandable
test shows the MHB liquid medium turbidity assays of bacteria that MRSA bacteria were killed or their growth was inhibited
suspensions after incubation with RSF-AgNPs composite for 24 h at
when the concentration of RSF-AgNPs reached MIC
37 °C. (b) MBC test shows the colonies of the bacteria suspensions
taken from the MIC test tubes and incubated for another 24 h on the (Supporting Information Figure S2e).
MH agar plate. In comparison with the inhibition effect on the biofilm
formation by the bacteria, the ability to destroy of RSF-AgNPs
composite toward the maturely formed biofilm created by
nm was plotted as a function of time in Figure 3b and the MRSA is more promising in real clinical application. Here, we
corresponding optical photos were shown as an inset. It shows used SEM and CLSM to examine the structures of the biofilms
4486 dx.doi.org/10.1021/bm4014149 | Biomacromolecules 2013, 14, 4483−4488
Biomacromolecules Article

Figure 5. SEM (small magnification, a1−d1; large magnification, a2−d2) and CSLM images (a3−d3, with the same magnification of a1−d1) of
maturely formed MASA biofilm after contact with RSF-AgNPs composite with different concentration at 37 °C for 24 h (a1−a3, MIC; b1−b3,
MBC; c1−c3, 2 × MBC; d1−d3, 5 × MBC). In the CSLM image, the live MASA emit green light, while the dead MASA emit red light.

and the corresponding bacterial activities after these biofilms our RSF-AgNPs composite had an obvious effect to destroy the
were contacted with a different concentration of RSF-AgNPs structure of a maturely formed biofilm and kill the
composite. The MRSA created a thick and dense biofilm under corresponding bacteria.


the experimental condition (Supporting Information Figure
S3). In the meantime, the proportion of the live MRSA in the
CONCLUSIONS
biofilm was very high. When the biofilm contacted the RSF-
AgNPs composite with the concentration of MIC (Figure 5a1− In this article, silk fibroin was used in situ to synthesize AgNPs
a3), the structure of the biofilm and the proportion of the live by adding AgNO3 powders into RSF solution and exposing
bacteria in the biofilm seemed to have little difference from the under 40 W incandescent light at room temperature. The
control. With the increase of AgNP’s concentration to MBC, reaction was found to happen under the sunlight as well. In the
the structure of the biofilm became loose, showing an island-
whole synthetic process, silk fibroin acted as the reducing,
like distribution (Figure 5b1−b3). Although there were still
quite a lot of biofilm structures remaining, the number of dead dispersing, and stabilizing agent, so no other chemical reagent
bacteria significantly increased, indicating the strong bacter- was needed. Tyr residues in the silk fibroin backbone were
icidal ability of RSF-AgNPs composite at MBC. When the thought to be responsible for the reduction of Ag+ into AgNPs
concentration of RSF-AgNPs composite further increased to 2 in situ. The prepared RSF-AgNPs composite exhibited an
× MBC (Figure5c1-c3), the biofilm started to break, so most of effective antibacterial activity against MRSA and showed strong
the bacteria were washed away by the physiological saline ability to destroy the maturely formed biofilm created by the
before the SEM and CLSM observation. Meanwhile, it can be
seen that the bacteria that remained in the cracked biofilm were same bacterium. Therefore, it is a rather green route to produce
almost dead. If we continuously increased the concentration of AgNPs compared to the reported method, and the product has
RSF-AgNPs composite to 5 × MBC, the biofilm was totally the great potential as an antibacterial and biofilm-disrupting
destroyed (Figure 5d1−d3). Therefore, it clearly indicated that agent in real clinic applications.
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Biomacromolecules


Article

ASSOCIATED CONTENT (20) Wang, T.; Che, R.; Li, W.; Mi, R.; Shao, Z. Z. Cryst. Growth Des.
2011, 11, 2164−2171.
*
S Supporting Information
(21) Fei, X.; Shao, Z. Z.; Chen, X. J. Mater. Chem. B 2013, 1, 213−
EDX spectrum of the synthesized RSF-AgNPs composite, 220.
photos of biofilm formation phenomenon at different RSF- (22) Fei, X.; Shao, Z. Z.; Chen, X. Nanoscale 2013, 5, 7991−7997.
AgNPs composite concentration, and SEM and CSLM images (23) Taubes, G. Science 2008, 321, 356−361.
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(26) Benn, T. M.; Westerhoff, P. Environ. Sci. Technol. 2008, 42,
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AUTHOR INFORMATION
(27) Kumar, R.; Münstedt, H. Biomaterials 2005, 26, 2081−2088.
Corresponding Authors (28) Wang, R.; Wang, L.; Zhou, L.; Su, Y.; Qiu, F.; Wang, D.; Wu, J.;
*E-mail: (X.C.) chenx@fudan.edu.cn. Fax: +86 21 5163 0300. Zhu, X.; Yan, D. J. Mater. Chem. 2012, 22, 15227−15234.
Tel: +86 21 6564 2866. (29) Wang, Y.; Cao, L.; Guan, S.; Shi, G.; Luo, Q.; Miao, L.;
*E-mail: (X.Z.) zhaoxiaabc2@126.com. Fax: +86 21 6564 7072. Thistlethwaite, I.; Huang, Z.; Xu, J.; Liu, J. J. Mater. Chem. 2012, 22,
Tel: +86 21 5288 7073. 2575−2581.
(30) Chen, C.; Gunawan, P.; Lou, X. W.; Xu, R. Adv. Funct. Mater.
Author Contributions 2012, 22, 780−787.
The manuscript was written through contributions of all (31) Lv, M.; Su, S.; He, Y.; Huang, Q.; Hu, W.; Li, D.; Fan, C.; Lee,
authors. All authors have given approval to the final version of S. T. Adv. Mater. 2010, 22, 5463−5467.
the manuscript. X.F. and M.J. contributed equally. (32) Cai, X.; Lin, M.; Tan, S.; Mai, W.; Zhang, Y.; Liang, Z.; Lin, Z.;
Zhang, X. Carbon 2012, 50, 3407−3415.
Notes (33) Akhavan, O.; Abdolahad, M.; Abdi, Y.; Mohajerzadeh, S. J.
The authors declare no competing financial interest.


Mater. Chem. 2011, 21, 387−393.
(34) Liu, J.; Zhao, Z.; Feng, H.; Cui, F. J. Mater. Chem. 2012, 22,
ACKNOWLEDGMENTS 13891−13894.
(35) Xu, W. P.; Zhang, L. C.; Li, J. P.; Lu, Y.; Li, H. H.; Ma, Y. N.;
This work is supported by the National High Technology
Wang, W. D.; Yu, S. H. J. Mater. Chem. 2011, 21, 4593−4597.
Research and Development Program of China (863 Program) (36) Cui, J. H.; Hu, C. F.; Yang, Y. H.; Wu, Y. J.; Yang, L. F.; Wang,
(No. 2012AA030309) and the National Natural Science Y. L.; Liu, Y. L.; Jiang, Z. Y. J. Mater. Chem. 2012, 22, 8121−8126.
Foundation of China (No. 21034003, 21274028, and (37) Chen, X.; Shao, Z. Z.; Knight, D. P.; Vollrath, F. Proteins 2007,
81271094). We thank Dr. Jinrong Yao and Dr. Lei Huang for 68, 223−231.
their valuable suggestions and discussions. (38) Performance standards for antimicrobial susceptibility testing;


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