## 5 Conclusions  
Along with the development of modern surgical techniques as well as of invasive diagnostic and monitoring tools, nosocomial infections became one of the leading causes of morbidity and mortality [151]. Therefore, preventing surface colonisation of implantable prostheses and indwelling medical devices by dangerous pathogens and subsequent biofilm formation on such surfaces is critically important first of all for the patient's condition but also for cutting down the financial and social costs of treating healthcare-associated infections. Furthermore, biofilm formation must be disrupted, since in the biofilm lifestyle, bacteria develop microbial community interactions [152]. This cooperative social behavior is regulated and coordinated through QS mechanisms and contributes to biofilm increased recalcitrance towards antimicrobial agents as compared to free-floating planktonic counterparts, which is mainly due to the enhanced rate of mutations and to altered gene expression in biofilms [153]. Therefore, the study and understanding of the complex processes occurring during different stages of biofilm development and the molecular mechanisms underlying these processes are of crucial importance for the discovery and implementation of new and innovative antibofilm strategies targeting these processes.  
Over time, scientists developed various nanostructured antibiofilm coatings that can be roughly classified as passive and active. Both strategies have advantages as well as drawbacks, as illustratively depicted in Figure 7[154].  
Although remarkable progress has been made in understanding the bioufouling mechanisms and clear and comprehensible qualitative structure-function/performance relationships such as hydrophilicity-- \"fouling resistance\" and surface energy-- \"fouling release\" have been established, many important aspects still remain to be unveiled. For instance, a precise quantitative relationship between functional moieties and antifouling properties is still lacking. Surface nanoengineering is a powerful tool in manipulating surface chemical composition and functionality, as well as morphology and topography at the hierarchical micro- and nanoscale, in order to achieve higher performances in impeding bacterial adhesion to biotic and abiotic surfaces. Nanotechnology also provides innovative solutions for the practical implementation of multiple antibiofouling mechanisms in a simultaneous synergistic manner.  
The active antibiofilm strategies targeting the molecular mechanisms and processes that govern the maturation and dispersal stages of the biofilm life cycle will be addressed in the second part of this review.  
Figure 6: Amphiphilic block copolymer F127-\(b\)-PDMS\({}_{n}\)[113]. Reprinted with permission from Comparison of the Fouling Release Properties of Hydrophobic Fluorinated and Hydrophilic PEGylated Block Copolymer Surfaces: Attachment Strength of the Diatom Navicula and the Green Alga Ulva. Copyright (2006) American Chemical Society. PDMS: polydimethylsiloxane.  
**Author Contributions:** [PERSON] and A.M.G. designed and wrote the paper. All authors have read and agreed to the published version of the manuscript.  
**Funding:** This paper was published with the financial support of University Politehnica of Bucharest, Romania.  
**Conflicts of Interest:** The authors declare no conflict of interest.