Difference between revisions of "Team:Lethbridge/Integrated Practices"

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           <h3 class="thin white-text">Section One</h3>
 
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           <p class="grey-text text-lighten-4">After completing our literature review, members of our team went on ride alongs with EMS to understand their processes better and to further our knowledge on picking the best locations to sample. We had the following objectives in mind during our ride alongs: to understand the daily cleaning techniques of the ambulances, to choose potential sampling locations, and to see first hand the types of calls that can happen in a night.</p>
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           <p class="grey-text text-lighten-4">The University of Lethbridge iGEM team was approached by our local Fire and EMS department regarding a problem related to safety and cleaning standards in ambulances. Ambulances are the point of contact between sick patients and the hospital, and they have the potential to be reservoirs of pathogens. The incidence of multiple antibiotic resistant pathogens is on the rise which has led to an ongoing reassessment of cleaning standards in order to best prevent transmission. After every patient, only visible bodily fluids are cleaned, and deeper cleans of the ambulance occur once a month.  However, it is unknown whether reservoirs of potentially virulent pathogens exist that are not visible to the naked eye, or whether current cleaning products are doing what they claim. With the current cleaning method it is possible that pathogens are being spread to hospitals, or other places in the community. </p>
           <p class="grey-text text-lighten-4">While speaking to first responders, we learned about what products they currently use to clean the ambulances. They mainly use cleaning wipes, called Caviwipes, to wipe down the ambulance after each call. These wipes are also used during monthly deep cleanings of the ambulances. Deep cleanings involve removing some equipment from the ambulance to get at areas that cannot be cleaned easily during daily cleaning. We also found out that the deep cleans occur when the ambulances are still on call.</p>
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           <p class="grey-text text-lighten-4">Our team consulted current literature in order to determine the best approach for our study. We found no studies in Canada, and from the global studies we were able to pinpoint sample locations and sampling techniques. All of the studies used cell culturing as their method of sample analysis, and found consistent results for pathogens identified. </p>
           <p class="grey-text text-lighten-4">During the calls, we looked for potential spots that could be reservoirs for pathogens based on what we saw paramedics and patients touch. Our findings were taken into consideration when narrowing down what locations we would actually sample.</p>
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           <p class="grey-text text-lighten-4"> In order to design something that would be practical and beneficial for the EMS to implement, and assess the real world applications and implications of our project, we met with first responders and participated in ride alongs. Before and after the ride alongs we surveyed first responder’s to get a better understanding of what areas they felt would be the dirtiest in the ambulance. With this new information, we developed a novel approach to assess the vehicle microbiome and monitor cleaning processes, the first of its kind in Canada.</p>
           <p class="grey-text text-lighten-4">The first hand experiences were also beneficial in understanding what paramedics go through each day. The calls we went on were diverse in their nature. The calls were transferring a patient to another facility, a drug overdose, and a domestic dispute. </p>
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           <p class="grey-text text-lighten-4">Once we determined sampling locations, we designed a two pronged approach to help solve this problem with specific design criteria in mind. Our design strategy involved the following principles: 1) comprehensive; provide a complete picture of the vehicle microbiome, 2) portable; an easily accessible tool that could be transferred to different vehicles, 3) easy to use; no additional training would be required of the first responders, 4) standardized; develop protocols and methods that could be duplicated by others for similar or related applications, 5) rapid; first responders could quickly identify pathogens, and 6) specific; accurate in regards to the types of pathogens identified and detected. </p>
           <p class="grey-text text-lighten-4">Overall, the ride alongs helped us understand what locations would be the best to sample for potential pathogens.</p>
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           <p class="grey-text text-lighten-4">Based on our design criteria, our team developed a single domain antibody library and custom bacterial-two-hybrid selection system to identify sdAb variants that recognize human pathogens. We sequenced our samples collected from the ambulances using the cutting edge MinION sequencing from Oxford Nanopore Technologies. We then surveyed the results of our findings and identified opportunistic pathogens (such as Pseudomonas aeruginosa, Staphylococcus aureus, Enterococcus faecalis, Prevotella intermedia), human commensals, and uncultured bacteria. The results of the microbiome sequencing influenced our choice of targets to select single domain antibodies against. These antibodies would be used in the design of an antibody based detection method to allow first responders to quickly identify the presence of harmful microbes, in turn allowing for the assessment of cleaning standards. </p>
 
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Revision as of 18:41, 19 October 2016

Lethbridge iGEM 2016

Integrated Practices

We took an informed, stakeholder-driven approach to solving a local problem.

Section One

The University of Lethbridge iGEM team was approached by our local Fire and EMS department regarding a problem related to safety and cleaning standards in ambulances. Ambulances are the point of contact between sick patients and the hospital, and they have the potential to be reservoirs of pathogens. The incidence of multiple antibiotic resistant pathogens is on the rise which has led to an ongoing reassessment of cleaning standards in order to best prevent transmission. After every patient, only visible bodily fluids are cleaned, and deeper cleans of the ambulance occur once a month. However, it is unknown whether reservoirs of potentially virulent pathogens exist that are not visible to the naked eye, or whether current cleaning products are doing what they claim. With the current cleaning method it is possible that pathogens are being spread to hospitals, or other places in the community.

Our team consulted current literature in order to determine the best approach for our study. We found no studies in Canada, and from the global studies we were able to pinpoint sample locations and sampling techniques. All of the studies used cell culturing as their method of sample analysis, and found consistent results for pathogens identified.

In order to design something that would be practical and beneficial for the EMS to implement, and assess the real world applications and implications of our project, we met with first responders and participated in ride alongs. Before and after the ride alongs we surveyed first responder’s to get a better understanding of what areas they felt would be the dirtiest in the ambulance. With this new information, we developed a novel approach to assess the vehicle microbiome and monitor cleaning processes, the first of its kind in Canada.

Once we determined sampling locations, we designed a two pronged approach to help solve this problem with specific design criteria in mind. Our design strategy involved the following principles: 1) comprehensive; provide a complete picture of the vehicle microbiome, 2) portable; an easily accessible tool that could be transferred to different vehicles, 3) easy to use; no additional training would be required of the first responders, 4) standardized; develop protocols and methods that could be duplicated by others for similar or related applications, 5) rapid; first responders could quickly identify pathogens, and 6) specific; accurate in regards to the types of pathogens identified and detected.

Based on our design criteria, our team developed a single domain antibody library and custom bacterial-two-hybrid selection system to identify sdAb variants that recognize human pathogens. We sequenced our samples collected from the ambulances using the cutting edge MinION sequencing from Oxford Nanopore Technologies. We then surveyed the results of our findings and identified opportunistic pathogens (such as Pseudomonas aeruginosa, Staphylococcus aureus, Enterococcus faecalis, Prevotella intermedia), human commensals, and uncultured bacteria. The results of the microbiome sequencing influenced our choice of targets to select single domain antibodies against. These antibodies would be used in the design of an antibody based detection method to allow first responders to quickly identify the presence of harmful microbes, in turn allowing for the assessment of cleaning standards.

Section Two

The prevalence of virulent and multiple antibiotic resistant pathogens in healthcare facilities has resulted in ongoing reassessment of best practices to prevent their transmission. However, whether pathogen reservoirs exist in emergency medical services (EMS) vehicles, remains largely unknown. Our iGEM team developed a custom bacterial two hybrid system to select single-domain antibodies (nanobodies) that recognize human pathogens. Informed by our Nanopore next generation sequencing of DNA samples from ambulance vehicles, antibodies targeting important pathogens were then used to develop a rapid and low cost ELISA-based testing kit that may be employed on-site by EMS workers. Our project provides a framework for rapid detection of emergent pathogens and a practical and rapid solution for monitoring their presence in and outside of the healthcare system.

Section 3

The prevalence of virulent and multiple antibiotic resistant pathogens in healthcare facilities has resulted in ongoing reassessment of best practices to prevent their transmission. However, whether pathogen reservoirs exist in emergency medical services (EMS) vehicles, remains largely unknown. Our iGEM team developed a custom bacterial two hybrid system to select single-domain antibodies (nanobodies) that recognize human pathogens. Informed by our Nanopore next generation sequencing of DNA samples from ambulance vehicles, antibodies targeting important pathogens were then used to develop a rapid and low cost ELISA-based testing kit that may be employed on-site by EMS workers. Our project provides a framework for rapid detection of emergent pathogens and a practical and rapid solution for monitoring their presence in and outside of the healthcare system.