Disclosed is a medical device having a substrate having an exposed surface and a texture over at least part of the exposed surface. The texture includes a plurality of nanofeatures that inhibit bacterial adhesion on the surface and that also inhibit bacterial growth on the surface and have a size range between about 0.01 nanometers and about 1,000 nanometers. The texture can include a plurality of nanofeatures applied thereto such that the texture has a first particle size at a first location, a second particle size at a second location, and a gradient of particle size from the first particle size to the second particle size between the first location and the second location.