OliGram: Lighting Up Biofilms

A rapid and affordable test kit for the detection of biofilms, protecting patients from deadly, hospital-acquired infections.

Every year in the United States, 2 million patients suffer hospital-acquired infections, landing them as the fourth leading cause of death in the US. Not to mention, treatment of these infections incurs $5 billion in added costs per annum. The primary culprit in this issue is biofilms, bacterial colonies that can be found virtually anywhere. 

These colonies are complex assemblages of microorganisms encased in tough matrices of extracellular materials. This makes them resistant to antibiotics and other methods of disinfection, allowing them to infect with impunity. Notably, a major problem faced with biofilms is their low profile: even the smallest speck of a biofilm can release deadly pathogens, all without ever being detected. 

In hospital settings, biofilms can anchor themselves on all kinds of surfaces: bathroom sinks, table surfaces, catheters, and even medical implants; in fact, microbial infections have been observed on most, if not all, such devices, including prosthetic heart valves, orthopedic implants, intravascular catheters, artificial hearts, cardiac pacemakers, ventilators, and contact lenses. Infections in such critical places are potentially life-threatening, demanding hospital resources for intensive treatment. Especially in the context of the COVID-19 pandemic, strain on the healthcare system can mean the difference between adequate care and elevated mortality.

Currently, there are many methods available to detect biofilms: test kits, laboratory reactions, and tissue cultures. However, while they each offer advantages (sensitivity, identification of bacteria, etc.), they all possess at least one of the following drawbacks: cost and timescale. Test kits can cost upwards of hundreds of dollars, while laboratory analysis often takes days to yield results. Because of this, testing hospital surfaces for biofilms is currently unfeasible as it simply is not worth the time and money to do so. However, this allows biofilms to slip through and wreak havoc on patients. Thus, a rapid and affordable test for biofilms is badly needed to ensure patient health.

OliGram, the rapid and affordable biofilm test kit, exploits the presence of cellulose in the extracellular matrix of a biofilm. Only produced by plants and bacteria, cellulose is a suitable biomarker for detecting biofilms as plants can likely be ruled out from hospital settings. To indicate the presence of cellulose, OliGram utilizes oligothiophene h-FTAA, a chemical marker which binds to cellulose molecules to create fluorescent complexes. Under a particular wavelength of light, this complex emits light of a corresponding wavelength; on the other hand, if none of the complex was formed, then no light is emitted. Thus, with this rapid chemical reaction, OliGram can alert users to the presence of biofilms.

In practice, this chemical reaction is fully enclosed in a disposable, plastic test kit. It is composed of two halves: one contains a glass vial of the test reagent (i.e. oligothiophene h-FTAA) and an observation window, while the other includes a hole to insert samples. To use it, one first utilizes the included swab to obtain samples of a suspected surface (e.g. medical implants). Next, the user inserts the swab into the test kit for the chemical analysis. Twisting the two halves of the test kit together releases the test reagent to react with any cellulose in the sample. After a short time period, the user shines a manufacturer-provided light (of the appropriate wavelength) into the observation window. If the user sees emitted light from the observation window, then cellulose is present. From this, the user can deduce that biofilms are present on the suspected surface from which the sample was obtained.

OliGram test kits are intended to be used by medical personnel in combination with proper disinfection practices to detect and eliminate biofilms. Reducing hospital-acquired infections from biofilms can benefit both patients and medical personnel. 

Today, patients are at significant risk of developing hospital-acquired infections, resulting in severe complications and, in many cases, death. Not to mention, the steep costs associated with treating these complications may lead to financial instability. OliGram is poised to minimize these problems by addressing the problem at its source, alerting medical personnel to the presence of dangerous biofilms. Patients will be subject to significantly lower risk at hospitals, increasing survival rates and lowering medical fees.

On the other hand, medical personnel would become less burdened from treating hospital-acquired infections, freeing up resources and reducing workload. With fewer total patients (due to reducing infections), medical personnel can lessen their workloads, relieving stress and improving their overall quality of life. Additionally, medical personnel would be able to divert their attention to new patients, allowing hospitals to efficiently serve more people. This is especially important in the wake of the COVID-19 pandemic, when hospitals became overwhelmed by the sheer number of patients.

With an interest in both medicine and engineering, I was drawn into the fascinating technology of medical implants and other such devices. However, as I learned more about them, I was shocked to discover that one of the biggest problems in medical implant technology was biofilm formation and infection. Patients were suffering from the consequences; in one patient story I read, a hospital-acquired infection had rendered a nearly recovered young man to a terminally ill quadriplegic who was dependent on a ventilator to breathe. Stories like these are the result of the resilient and hard-to-detect nature of biofilms, eluding the notice of medical personnel until it's too late. Reading these tragic experiences, I sought to find a way to prevent them by tackling the root of the issue: biofilms. Over the course of many months, these efforts have culminated in OliGram, a simple yet effective solution.

In order to define the problem to solve, the OliGram team contacted a multitude of hospitals for their situations regarding biofilms. In these communications, the team also requested feedback on the OliGram test kit to better understand the needs of medical personnel.  

Currently, there are many methods available to detect biofilms: test kits, laboratory reactions, and tissue cultures. However, while they each offer advantages (sensitivity, identification of bacteria, etc.), they all possess at least one of the following drawbacks: cost and time. Test kits can cost upwards of hundreds of dollars, while laboratory analysis often takes days to yield results. OliGram, on the other hand, excels in both speed and cost, all while matching its competitors’ sensitivity to biofilms. While this method has been demonstrated in detecting biofilms in urine samples, OliGram extends it to an infinitely greater variety of applications.

OliGram’s entry into the biofilm test kit market will catalyze the development of similar products. Competitors, looking to secure the market, will invest their own resources into developing similar products, potentially improving on the original design. In the medical world, this activity will diversify the options available for this task, allowing hospitals to pick the most effective tool for the job.

The small-scale rollout of OliGram’s at select hospitals (in its first year) will, through proper application:

• Substantially decrease the number of hospital-acquired infections

• Bolster patient survival rates

• Boost treatment efficiency

• Cut medical fees

With the valuable insight from the small-scale rollout, a larger rollout to more hospitals will bring these benefits to all of the US and people around the world.

The core technology that powers OliGram is a chemical that highlights biomarkers found in biofilms. This chemical, called oligothiophene h-FTAA, binds to the cellulose molecules found in the extracellular matrix of biofilms, creating a fluorescent complex that can be seen under the appropriate light. This technology has already been demonstrated in urine samples, in which it effectively performed as a rapid indicator of biofilm infections in the urinary tract (Antypas et al.). OliGram builds upon this application by expanding it to all of the surfaces encountered in medical settings, allowing medical personnel to easily detect biofilms. For example, OliGram test kits can be used to check for biofilms on table surfaces, medical instruments, and even medical implants. 

OliGram is currently in its concept phase of development. The OliGram team has contacted a variety of suppliers on product manufacturing, packaging, and distribution. In the next year, we plan to serve three select hospitals in the Chicago area (Rush University Medical Center, Northwestern Memorial Hospital, University of Illinois Medical Center) for a small-scale, three-month trial of OliGram’s effectiveness. Results and feedback obtained from this trial will be valuable for refining the product and scaling it up for greater distribution. At these four hospitals, OliGram test kits will ensure the health and safety of 33,000 patients.

One major technical barrier is fine-tuning the OliGram test kit for effective function in medical settings. Biofilms can be found on a limitless variety of surfaces, lending them all sizes and forms. This poses a problem for universal biofilm test kits like OliGram; its performance may vary with the particular type of biofilm sampled. The specific composition of the test reagent will require reformulation to become applicable to all surfaces that the test kit will encounter. Fortunately, data obtained from the aforementioned 3-month trial will help the OliGram team determine the optimal mixture.

OliGram test kits present hospitals with the opportunity to drastically reduce hospital-acquired infections. Unlike our competitors, OliGram allows for the mass testing of biofilms through its low price and fast results. With this, patients and medical personnel can avoid dangerous and costly treatment for biofilm-related infections. 

OliGram will operate on an "economy-of-scale" business model; the cost per test kit will dramatically decrease with full-scale mass-production.

In its early stages, funding for OliGram will primarily come from donations, grants, and investment capital. Once large-scale production begins, OliGram will be able to finance itself through profits from sales. More specifically, OliGram will first be priced at 200% of its manufacturing cost, eventually lowering to 120%. Revenue will be used for further research and development of the OliGram test kit.