Nosocomial infections (Nis) are a major concern for public health. As more and more of the pathogens responsible for these infections are antibiotic resistant, finding new ways to overcome them is a major challenge for biomedical research. We present a method to reduce Nis spreading by hindering bacterial adhesion in its very early stage. This is achieved by reducing the contact interface area between the bacterium and the surface by nanoengineering the surface topography. In particular, we studied the Escheria Coli adhesion on titanium surfaces exhibiting different morphologies, that were obtained by a combination of mechanical polishing and chemical etching. Scanning Electron Microscopy (SEM) and Atomic Force Microscopy (AFM) characterization revealed that the titanium surface is modified at both micro- and nano-scale. X-ray Photoelectron Spectroscopy (XPS) revealed that the surfaces have the same composition before and after piranha treatment, consisting mainly of TiO2. Adhesion tests showed a significant reduction in bacterial accumulation on nanostructured surfaces that had the lowest roughness over large areas. SEM images acquired after bacterial culture on different titanium substrates confirmed that the polished titanium surface treated one hour in a piranha solution at a temperature of 25 degrees C has the lowest bacterial accumulation among all the surfaces tested. This suggests that the difference observed in bacterial adhesion between the different surfaces is due primarily to surface topography. (C) 2014 Elsevier B.V. All rights reserved.