Purpose

The Doctoral Training Centre in Oxford was holding a seminar on ‘How to boost your research’. We attended it with the aim of seeking advice on how to improve and develop our idea.

Contribution

It seems as though many projects and companies fail due to poor understanding of their target market - often their technology is great, but the innovators haven’t found the right application for it.

We learned about closed vs open innovation, the latter of which seeks ideas from outside. We also learned about innovation timescales and technology readiness levels (TRLs).

The seminar also gave practical advice on ways to reduce the time gap between idea generation and realization, which questions to ask during the development stage, and crucially, how to lay out a business plan and slide deck.

Implementation

At the end of Peter’s seminar, we went to speak with him in private to ask for specific advice related to our project. We set up a meeting with him for a later date so we could have a more in-depth discussion with the whole of our iGEM team present.

Outlook

We feel reassured that our extensive market research (industry vs healthcare) is crucial for a successful project.

We have better insights into what makes a successful pitch deck and how to make a business model, which will help us make a more effective presentation at the Jamboree.

We will prepare a brief presentation for our following whole-team meeting with Peter.

Purpose

We sent Dr. Leaver a list of questions. We have been considering immobilizing our biosensor on a strip to make a lateral-flow-style kit as this has proven to be highly successful in other areas of diagnostics.

Contribution

Below are the questions/answers:

Q: Do you think there would be applications for an at-home LFT kit for bacterial infections? Are there certain widespread bacterial infections that would benefit from rapid, cheap, at-home testing (like during Covid times) before coming to the hospital?

A: Not for general practice as a whole, but there may be certain patient groups for whom such an approach might be useful - for example, patients with cystic fibrosis might need to know if they have pseudomonas. There might be a role for home testing for MRSA prior to elective admission - but I think the hospitals would prefer to do swabs in the clinic to be sure the swabs have been collected properly.

Q: Are there other conditions that have similar problems to UTIs, where most are caused by one bacterium except a small proportion (e.g 90% E.Coli vs 5% enterococcus as you mentioned earlier)? Would a rapid test specifically for the less prevalent species be useful?

A: I wonder if it would be useful to have a good test for the presence of dermatophytes in skin rashes - sometimes it is difficult to know if a rash is eczema or fungal (in the case of flexures, groins, and axillae) or psoriasis vs. fungal (for scaly scalp). Conjunctivitis in contact lens wearers - it might be useful to know they do not have pseudomonas (which requires a quinolone) - if it can be confidently excluded, the patient should be fine with chloramphenicol eye drops - but the cost/risk of the different drops is only marginal, so it would have to be a very cheap and easy test to be worthwhile. Presence of candida in otitis externa might be helpful (but would not be used very often - maybe once every 6 months per GP - and not if the GP has to pay for it).

Q: What are the cons for rapid antigen tests for bacteria that are currently being used?

A: We don't use any. RAT for strep. in throat swabs is common in other countries. I think there is a reasonable body of evidence saying that it’s not very helpful - too many false positives (colonization) and false negatives (swab not taken properly). We use pH testing for bacterial vaginosis - seems reliable.

Implementation

There doesn’t seem to be a great need for a rapid bacterial testing kit in a GP setting. It has been made clear to us that there are many reliable methods already in place. Also, it would be ideal to be able to test for many bacterial infections at once, so we are considering developing a multiplexing system – possibly by making a lateral flow kit with multiple bands.

Outlook

We asked Dr. Leaver for advice on lateral flow style kits and multiplexing in patient diagnostics. He introduced us to Dr. William James.

Purpose

Dr. James was introduced to us by Dr. Leaver to discuss lateral flow kits in patient diagnostics.

Contribution

He shared a link to a paper about ‘Nano plasmonic amplification in microfluidics to enable accelerated colorimetric quantification of nucleic acid biomarkers from pathogens.’

Dr. James founded Hutano Diagnostics – a diagnostic tool for early disease prognosis, diagnostics, and management. Their patented modular LFD platform can simultaneously detect up to 20 different biomarkers (antigens and nucleic acids). We could use a similar concept, but with different colors of luciferase instead of gold nanoparticles.

Their platform is paired with a smartphone reader which scans and interprets the results.

Implementation

Looking at Hutano Diagnostic’s technology inspired us to reach out to companies that have already developed phone software for detecting and interpreting the light signals that our biosensor will produce.

Outlook

We will develop some designs for the hardware of our kit to multiplex our biosensor.

We will research companies that have developed ways to detect luminescence signals with a phone camera.

We need to further investigate the application of Bac2Glow in water testing to identify which strains to target.

Purpose

Mohammed was introduced to us by Adriana as a field expert on water safety in emergency settings. We wanted to understand more about the need for more efficient bacteriological testing.

Contribution

We spoke extensively about the global water contamination crisis, especially in warzones and areas of extreme poverty.

He shared the water quality mapping activity proposal made by WASH and UNICEF. Under this proposal, they would be testing faecal and total coliforms as part of their biological water tests.

He also shared the statistics of their E.coli test results to give us an idea of the extent of the problem.

Implementation

We have identified the best use-case for our technology: rapid bacterial detection in water, for emergency settings. In these cases (areas that face warzones, poverty, natural disasters) there is an urgent need for fast and accurate results on water quality. The kits that are used at the moment rely on membrane filtration and culturing, which gives results after 24-48 hours. This is the problem we would like to address with our project.

Purpose

We arranged a whole team meeting to properly introduce ourselves, our project, and ask for advice and connections into the industry.

Contribution

Peter said he could introduce us to Bruce Tomlinson, the CEO of HR Wallingford, who could provide insight into water-related innovation.

For phone camera detection of luminescence, Peter told us about i-sense, who are developing digital tools to track, test, and treat infectious disease using smartphone-connected diagnostic tests. This would be very useful for the final stage of our product.

Peter suggested we read Ozcan’s research into optical methods to improve the sensitivity of absorption-based lateral flow tests by background removal. We would like to understand if there are applications for this in luminescence detection.

Implementation

We now have contacts with the CEO of HR Wallingford with whom we will meet, so that he can share his expertise on water-related research. Peter also told us we could use magnetic beads to increase the concentration of pathogens in water samples, in case we encounter challenges with detection limit.

Purpose

To understand how our technology can be tailored for industry water testing. We wanted to learn about the challenges Unilever faced with their current water testing kits and therefore what they were looking for in new technologies. We also wanted to know what may have prevented Unilever R&D from adopting other new technologies on the market.

Contribution

Diana and Rodney explained the importance of legal compliance and validation of new water testing methodologies. They also gave insights into the sampling plans Unilever R&D follow. We signed a confidentiality agreement before having our call, so we are unable to share further details of our conversation.

Implementation

We know what to prioritize in the designing of our final biosensor product.

Outlook

We feel more confident in the direction we would like to take our project and prepared to answer questions at the Jamboree.

Purpose

Following our conversation with Bruce in August, our team was keen to meet him in person. We wanted to gain a better understanding of the work carried out at HR Wallingford and to discuss ways to develop our project.

Contribution

HR Wallingford is involved in researching and designing smart water solutions for communities and industries. Their global vision means that impact and sustainability are at the heart of their work.

We were fortunate enough to have Bruce give us a personal tour of HR Wallingford. He told us about the vast and exciting areas of water-related research they are involved in. We visited their physical modelling facilities for water that they use to educate, investigate, and innovate across the marine and coastal sectors.

The focus of their projects is to understand the behavior and influence of water on communities and industries. Despite their work being more based on physics and engineering rather than bacteriology, we found areas of potential collaboration.

Implementation

Following our conversation with UNICEF at the beginning of September, we learned the importance of testing and validating our results using wild strains of E.coli instead of lab strains. Bruce kindly offered to put us in contact with people that could supply us with wastewater/untreated water samples to test our kit on. We spoke about their projects on flood forecasting and warning systems and saw synergies with our vision for water quality data processing for monitoring and predictive applications.

Outlook

We will keep in contact and will reach out for some water samples when we are ready for product testing and validation.

We believe that the data our kits provide on water quality will one day be able to be combined with their flood prediction systems. If governments can track and predict the movement of contaminated water (from leakages and floods), this will guide the choice of which water source to use during emergency situations, reducing response times.

Introduction

I am a senior specialist in health and management and have a masters’ degree in public health and a BSc in medical technology. I have over 20 years of professional experience in health management, medical technology, monitoring and evaluation, and quality improvement, working as the focal person for the Palestinian Water Authority in the WASH cluster. I am expecting to finalize the requirements for my PhD degree in water technology in September this year. My thesis is about detecting antimicrobial-resistant bacteria and resistance genes in water supplies at healthcare facilities.

Current testing

Could you briefly outline the types of bacterial testing you carry out in emergencies?

We have two main approaches for detecting microbial contamination: medical or environmental screening/surveying. For the environmental surveys, like water testing, the currently used methodology depends on having a sample, filtering it, and culturing it on agar to detect coliforms, whether faecal or total coliforms. [Note: Fecal coliforms include E.Coli and non-faecal include Enterobacter and Klebsiella]

How efficient are the environmental tests? Do they have any limitations?

The tests for microbial contamination based on culturing are done to assess compliance of water quality with the Palestinian national standards, but unfortunately, this is a limitation even for them, as they only test for the presence of coliforms. Pseudomonas, for example, would have to be detected through a second screening test as it is not a coliform. This is one of the challenges. In my thesis, I conducted a large survey which found water samples that contained Pseudomonas without testing positive for faecal coliform or total coliform – clearly a test for coliforms (E.Coli) alone is not comprehensive enough. Another huge limitation is the timing; culturing takes a minimum of 24 hours incubation time in a lab before giving results. Another downside is the time the actual sampling procedures take. There is a time lag between collecting the sample and transporting it to the laboratories where the tests are done. We may only be allowed to transfer it within half an hour, or if we have access to a cooling chain, we might be able to transfer it within two hours to the laboratory. In most areas even two hours is difficult to achieve. So, this is another challenge - we would need a rapid transport system, or even better an on-site detection system. Rapid testing would be very helpful for this. Another issue is also the interruption in supplies and materials for detection and isolation of bacteria. Often different testing kit brands are received from donations which reduce the accuracy of the results, especially if you are using different surveys at different times.

How much time does it take for you to get results usually?

The time for results is usually two days. If it is environmental testing, we might then send it for more confirmatory testing or for biochemical identification.

How is the clinical testing different from the environmental testing?

Clinical testing requires the identification of the bacterial strain more than in environmental testing. The environmental tests usually only depend on the morphological appearance of the colonies on the selective cultured medium. This means they are more rapid, but this comes at the cost of accuracy and specificity. For us to identify the bacteria more accurately, we might need to integrate some biochemical testing, but this would take additional time, especially the incubation time required for the culturing of the bacteria. For the clinical testing, we might need three days to have the final diagnosis, while for environmental testing, only two days because we skip the biochemical testing.

Timing

Is there another more rapid testing method that you have considered using?

You may hear the terms ‘rapid testing’ or ‘on-spot testing’ being used in this field, but this just refers to testing the free residual chlorine after water treatment. Water service providers sometimes substitute bacteriological testing with testing the residual free chlorine after chlorination. But this method is not sufficient and not accurate enough because there are strains that are resistant to chlorine. Also, biofilms form that can hide bacteria and enable Pseudomonas to survive even in highly chlorinated environments. This is another challenge here in Gaza.

Have there been any efforts to develop a more rapid testing method?

From my experience, more rapid methods do not exist. For example, I’ve heard about a new technique that accelerates the incubation period and so also the time to get results, but it is not available here in Palestine and is still quite a slow method. Using PCR technology for routine testing is not cost-effective for such a low resource context and also not realistic given the interrupted and intermittent supply of reagents and other supplies. Even when PCR is available and the technology is here, you would need to maintain the supplies and to provide skilled personnel – doing PCR requires even more skills than for the microbiological tests!

I remember the American University of Beirut organized a webinar on ways to help people in remote locations, or in areas under conflict, to read and interpret the results of the microbiological tests. This would shorten the required time for interpretation, but from my perspective we need to have innovation within the testing methodology itself. If we manage to accelerate the detection with a rapid, on-spot kit, that would be very useful. Also, being able to identify other species like Pseudomonas and Enterococcus, Staph aureus in addition to Enter