Sepsis Must be Stopped
Sepsis results in over 11 million or 1 in 5 deaths worldwide with roughly 40% of sepsis deaths coming from children under 5 years old1. Low to middle income countries account for roughly 85% of sepsis cases and sepsis related deaths2. As sepsis is omnipresent in all ages and countries, our project worked to combat an inability to attain treatment because of high costs, access to hospitals, or a lack of knowledge on sepsis. The team has taken a strong stand in working to increase awareness of sepsis; only 58% of Americans in a 2017 study reported they have heard of the condition3. There has been a large increase in sepsis awareness over the last 15 years, but with a recent increase in sepsis cases, more has to be done. To boost knowledge, facts about the dangers of sepsis were posted on social media (Figure 1) where it reached 736 people, both followers and non-followers.
Videos and pictures of our lab work were uploaded to the Instagram account to share what experiments were being performed. The team collaborated with the Wright State University iGEM team to speak to visitors at The Boonshoft Museum of Discovery in Dayton, Ohio and the Center of Science and Industry (COSI) in Columbus, Ohio about synthetic biology. Beyond just teaching about synthetic biology, the team spoke to museum visitors about sepsis facts and dangers.
Sepsis Impacts Lives Beyond the ICU
There are millions of lives affected by sepsis which has caused many survivors and others to be open about their experiences. A former urologist and septic shock patient, William Lynes, expressed his battle with sepsis to the team over zoom, saying it was a “horrible and frightening experience that I will never forget.” The team learned that Dr. Lynes lost 40 pounds while in the Intensive Care Unit (ICU) for six weeks where he experienced ICU psychosis, a disorder that can occur after patients spend time in the ICU. Symptoms of ICU psychosis include extreme anxiety, paranoia, disorientation, as well as visions and nightmares. It is thought by doctors that playing music, calmly talking to the patient, providing natural light, and having familiar objects near the patient can help prevent ICU psychosis4. He was unable to return to work for 10 months, but retired soon after due to severe mental health effects. William Lynes uses his experience to help others understand the dangers of sepsis. Dr. Lynes was very pleased to hear we were making an attempt to solve the root cause of sepsis as well as making people more aware of the disease. To increase awareness, we created a flier to place in hospital settings to warn patients about the symptoms and ways to prevent sepsis.
The team later spoke to a surgeon, Craig Coopersmith, at the Emory Critical Care Center who has been established as one of the top investigators of sepsis in the country. Dr. Coopersmith informed the group that medicine has come a long way and doctors are now well versed in sepsis cases, but one of the main issues today is the aftermath of sepsis. As well as ICU psychosis being part of the aftermath, the idea of post sepsis syndrome, has been very prominent and it affects roughly 50% of sepsis survivors with a multitude of adverse physical and mental effects including hallucinations, fatigue, memory loss, and hair loss5. Dr. Coopersmith was relatively new to the idea of phage therapy and he was interested in how the lab team planned on attacking sepsis at a very early point in the process which ultimately would prevent post sepsis syndrome. The last thing Craig Coopersmith said was “If you even get one person to learn about sepsis, that can create a chain of events and you may have just saved a life” and that resonated very heavily. In talking to Craig Coopersmith, the team realized that simply spreading sepsis information at popular locations nearby could end up saving a life. The science museums gave the team an opportunity to teach many people about the signs of sepsis and in doing that, there is a hope that lives will be saved. Sepsis is a very dangerous disease and the team worked diligently to inform people about it and to come up with a solution for it.
Integrated Human Practices
We found support of our educational and project efforts through our discussions with professionals in the field. Understanding the experiences of professionals and patients involved with sepsis is a key part of our project. Below are summaries of our conversations with individuals we met with that were influential for our project. These suggestions and comments were either integrated into our project or directly influenced the direction of our project.
June
Dr. Richard Lenksi
Professor, Michigan State University
During the previous iGEM project, the population model relied on a steady state assumption to develop the model. The team asked Dr. Lenski for a way to account for parameters we weren’t able to account for last year and he suggested building the model using the Runge-Kutta method.
Project Impact: We implemented the Runge-Kutta method into the model. In talking to Dr. Lenski, we were able to remove the steady state assumption from the model.
July
Dr. Christina Harsch
PCTE Educator in Biotechnology for Dayton Public Schools at Meadowdale CTC
The Wright State team introduced our team to Christina Harsch who is an educator from Dayton Ohio. Christina helped the team narrow down experimental ideas to use at the science museums.
Project Impact: When the team struggled to decide on the 2-dimensional or 3-dimensional puzzle to use as a model at the science museums, Christina assisted in choosing a 2-dimensional design to use. We agreed that the 2-dimensional design would allow the greatest number of people to use and understand.
Dr. William Lynes
Retired Urologist and Sepsis Survivor
After stumbling upon an article Dr. William Lynes wrote about his experience with sepsis, the team thought it would be very beneficial to speak to him. Dr. William Lynes is very open about his struggles with sepsis and the aftermath of it. The team was not very aware of Intensive Care Unit (ICU) psychosis before speaking with him, and it caused us to research how to combat it.
Project Impact: From speaking to Dr. William Lynes, we heard about the shockingly low knowledge of sepsis by patients in the hospital. To dig further into Dr. Lynes statement, we found that in 2016, 37.2% of severe sepsis hospital discharges in the United States were from cases of hospital and health-care acquired sepsis6. Due to the high percentage of hospital and health-care associated sepsis cases, we decided to create a flier to place into hospitals that will help patients understand the gravity of sepsis and be increasingly aware of the symptoms. The flier was created using a color scheme that the Sepsis Alliance promotes.
Dr. Brian Ahmer
Microbiologist, The Ohio State University
The team wanted to get a professional opinion on the wet lab team’s proposed procedures, so we reached out to Dr. Brian Ahmer, a microbiologist at the Ohio State University. Dr. Brian Ahmer showed our team ways to reduce our workload while improving our results.
Project Impact: Dr. Ahmer recommended that we do less cloning into phage, and instead test our genes in E. Coli bacteria. Cloning into phage is a difficult process with many steps and factors that can go wrong. He further clarified that wet lab should spend more time narrowing down the best candidate genes for fewer phage prototypes, then get clean vectors of DNA through gel extraction. Wet lab agreed with these recommendations, and pivoted away from the previous cloning-heavy plan. Dr. Ahmer also made it clear that we could use him as a resource for E. Coli strains.
August
Dr. Craig Coopersmith
Academic Surgeon, Emory Critical Care Center
As one of the top investigators of sepsis in the country, the team felt it would be extremely helpful to listen to Dr. Coopersmith’s experience with sepsis. Dr. Craig Coopersmith expanded our knowledge of ICU psychosis as well as post sepsis syndrome.
Project Impact: Dr. Coopersmith suggested the best way to promote sepsis knowledge is to educate who is willing to listen. Even one person who understands the signs of sepsis can save a life. This encouraged us to proceed with efforts in spreading the awareness of sepsis through flyers and social media.
Dr. Michael Levy
Professor of Medicine at the Warren Alpert Medical School of Brown University
As the founding member of the Executive Committee of the Surviving Sepsis Campaign, the team thought it would be great to speak with Dr. Levy. He explained the effects of Intensive Care Unit (ICU) Syndrome as well as other general sepsis topics. We learned that 70% of patients with sepsis develop immunosuppression which is the suppression of the immune system’s ability to fight off infections.
Project impact: As Dr. Levy explained the significance of ICU Syndrome, we used the information he gave to us along with Dr. William Lynes’, and created the sepsis awareness poster to place into hospitals to teach patients about the importance of sepsis and its effects.
References
(1) - Wood, Johnny. “This Condition Kills More People Every Year than Cancer, New Study Shows.” World Economic Forum, 20 Jan. 2020, https://www.weforum.org/agenda/2020/01/sepsis-hidden-killer-responsible-for-one-in-five-deaths-disease-vaccination-sanitation/.
(2) - “Sepsis.” World Health Organization, World Health Organization, 26 Aug. 2020, https://www.who.int/news-room/fact-sheets/detail/sepsis.
(3) - “Sepsis: A Word to Know, a Meaning to Learn.” Sepsis Alliance, 16 Feb. 2019, https://www.sepsis.org/news/sepsis-word-know-meaning-learn/.
(4) - “Medical Definition of ICU Psychosis.” MedicineNet, MedicineNet, 3 June 2021, https://www.medicinenet.com/icu_psychosis/definition.htm.
(5) - “Post-Sepsis Syndrome.” Sepsis Alliance, 29 June 2022, https://www.sepsis.org/sepsis-basics/post-sepsis-syndrome/.
(6) - Page, David B, et al. “Community-, Healthcare-, and Hospital-Acquired Severe Sepsis Hospitalizations in the University HealthSystem Consortium.” Critical Care Medicine, U.S. National Library of Medicine, Sept. 2015, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4537676/.