Five Questions and an Elevator Pitch: Baby MACK
1. What is the need that your project seeks to address?
Chris: We found that the leading cause of neonatal sepsis is a Group B Strep [GBS] infection. In low-resource settings, there is no way for women to get tested for the presence of GBS bacteria. The lack of testing for GBS was the limiting factor that prevented treatment or prevention of GBS transfer from mother to baby. [Neonatal sepsis can lead to newborn meningitis and subsequent death if left untreated.]
2. How does your solution work?
Karsten: We started by thinking about what out need criteria would be for an effective solution, and we identified cost, usability, and accuracy as three areas that we wanted our solution to hit. For example, we wanted it to be inexpensive and something that could be done at home by the mother, and be highly accurate in detecting GBS.
It had to be inexpensive because the alternative to affordable, accurate testing is to prescribe antibiotics, which can create resistance and a host of other problems. We wanted mothers to be motivated to take the test. Accuracy was critical so that antibiotics would only be given to those who actually need them.
The concept that we came up with is a vaginal/rectal swab that the mother can use herself. She places the swab into a solution that has our engineered bacterial phages, which are viruses that infect bacteria. If GBS cells exist on the swab, the phages infect those GBS bacterial cells and release a certain enzyme that causes the solution to turn yellow.
3. What motivated you to take on this project? And what activities have you done?
Chris: I think by expanding accessibility, you change what's possible in the field, and you can make a very big impact by simply optimizing detection. All of us were inspired by the work that the Prakash Lab is doing, and wanted to combine the idea of “frugal science” with the Biodesign components of this course.
Karsten: As a group, we talked about what kind of impact this project could have and came up with an estimate of the number of newborns that could be saved in just Africa alone. It was 48,000 babies each year.
Michelle: Most of the diagnostics in use today are antibody driven, like the COVID-19 test, but antibody-based tests are pretty hard to generate. Using a phage that is already a naturally occurring organism was really interesting to me.
Chris: Phage engineering can exist as a platform for diagnostics. The principle of taking a phage that's specific to a certain bacteria of interest and making slight alterations to enable it to catalyze the production of a visual readout could be applied, in theory, to any bacterial infection.
4. What’s the most important thing you learned in advancing your project:
Alex: We did a good job as a team of following what was exciting to us and letting that be one of the main drivers in narrowing in on this need area. Our concept changed over time and every change has been driven in equal parts by improvement in iteration and our excitement in seeing a way to move the project forward.
5. What advice do you have for aspiring health technology innovators?
Karsten: Share even fledgling ideas with as many other people as possible. When the project was first getting going, we mentioned this moonshot idea to Professor Jan Liphardt [in the Stanford Bioengineering department]. He made an offhand comment that blossomed into this whole project that we have now.
Michelle: Begin with an end in mind. We had the need space identified and we knew what our tests needed to do.
Alex: Don’t be afraid to take your time to find the right need statement. It feels like a race to find your space as quickly as possible, but we made revisions in our first quarter [during the two-quarter course] that set us up well to create a meaningful project and narrow it appropriately.
Original Team Members: Alex Bradfield, Karsten Householder, Chris Neimeth, Michelle Shen
Course: Senior Bioengineering Capstone
Biodesign NEXT Funding: Awarded for spring quarter 2022