Not Blood, But Sweat and Tears: Undergrads Design New Sepsis Diagnostic Device

A group of University of Rochester students identified a problem in sepsis diagnosis. They set out to create a device that would solve it.  

Amanda Adams, a senior biomedical engineering major at the University of Rochester, is in the middle of finals week when she speaks with Sepsis Alliance. It’s mid-December, the end of the semester, which is a hectic time of year for college seniors like her. “I’m also applying to grad school right now,” she shares, seemingly chipper despite her heavy workload. “I want to continue to pursue biomedical engineering, and there are some schools that have synthetic biology concentrations. It’s a very up-and-coming field.”   

Adams will be a competitive applicant. In her final two years of college, she and a team of fellow University of Rochester undergraduate students engineered a new device that can detect signs of sepsis. The prototype, which they called the Bio-Spire, is a rarity among sepsis diagnostic tools. It reads for indicators of sepsis not in a person’s blood, but in sweat.   

Teammate Blaine Dillingham, a sophomore and math major from Boise, Idaho, explains: “Treatment is reasonably doable for sepsis, but it’s time-sensitive. If you catch it early, there’s a way better prognosis than if you don’t find out for a while.” The risk of mortality from sepsis increases by 4-9% for every hour treatment is delayed. That is why Sepsis Alliance emphasizes that TIME to diagnosis and treatment saves lives and limbs.   

“But one of the most-commonly used techniques to diagnose sepsis is a blood culture,” Dillingham continues. “And that can take 24 hours to come back.”  

The 12-person team recognized a key problem in sepsis diagnosis: many patients with sepsis don’t have time to wait for answers from a blood culture. Blood just isn’t fast enough. Sweat, they discovered, is a useful alternative. Sweat contains some of the same biomarkers—measurable substances that help scientists understand if a patient has a disease or infection—that blood does. But sweat, unlike blood, can be drawn from a patient’s skin continuously without harm. The continuous flow offers a near-immediate readout on the Bio-Spire.  

“We found the problem, and we knew that we wanted to do something non-invasive, and that’s kind of how we came to the design,” recalls Daniel Nakamura, a junior and chemistry major from Wilmington, Delaware. He adds, “It was a very painstaking process. There were many near tears.”   

The team created the device using the principles of synthetic biology, a field of science that involves using live organisms—in this case, bacteria—in the design of new technologies. They consulted with clinicians at their local hospital to determine what part of the body their device would be best fitted to. They came up with a sleeve that slides over the forearm.   

“We used bacteria, which makes the device less expensive,” summarizes Irinia Ter-Ovanesyan, a Spanish and biochemistry double major from Boston, Massachusetts. “And the sleeve is reusable—basically, we were trying to reduce the cost as well as make it environmentally friendly.” Its reusability makes the Bio-Spire potentially very accessible even to low-resource hospitals. And given the large gaps in sepsis patient outcomes that exist along lines of race, ethnicity, and socioeconomic status, low-priced and sustainable diagnostic tools have the potential to make a big difference.    

Since they began the project in October 2020, the team has also been working to raise sepsis awareness on their campus and in the city of Rochester. They made pamphlets, conducted a social media campaign, and even wrote a children’s book to help raise awareness of sepsis signs and symptoms. And they spoke to lots of people in their community, experts and members of the public alike. “It was interesting how many people we talked to who had some personal connection to sepsis,” Nakamura recalls. “It was familiar to a lot of people.” Perhaps that’s unsurprising as 1.7 million people in the U.S. are diagnosed with sepsis each year, and more than 270,000 of those Americans die—more than from prostate cancer, breast cancer, and opioid overdoses combined. The Rochester community’s familiarity with sepsis only reinforced the team’s determination.  

Once the Bio-Spire was completed, tested with simulated sweat, and proven to work, the team submitted it to the International Genetically Engineered Machine (iGEM) competition. The device won a gold medal and was nominated for awards in three other categories. It was, in all, one of the most-recognized entries from North America.   

“This was my first real research experience, and it was unique because it was very student-led,” Adams reflects. “It was really cool to be able to come up with a project ourselves, plan out all our experiments—every aspect of it. And then it was really satisfying to see the results.”   

The results, plus all that recognition at the iGEM competition, signal good things for the device’s future. “I became a mini expert in FDA approvals for this project,” Ter-Ovanesyan jokes. “We would need to be cleared by the FDA, and then we could actually start doing clinical trials,” meaning they could swap out synthetic sweat for real sweat. If clinical trials and other review processes go well, the FDA could approve the device for commercial distribution, and the Bio-Spire would then be available for hospitals to use on real patients in need.   

But that would be in the future. For now, the University of Rochester team is looking back on their engineering accomplishments, all undertaken while they were full-time college students. “We were doing a novel thing with sweat,” Ter-Ovanesyan says, rightfully proud, “and we were doing everything that the professionals agreed was the future of diagnosis.” Once the semester, and their finals, are behind them, the team will certainly have much to celebrate.    

To learn more about the Bio-Spire and to keep up with the team’s progress, check out their website. Sepsis Alliance wishes them luck in their future research and other endeavors!  

Please note: this article does not constitute an endorsement of any product or technology.