Human Practices

Antibiotics serve an important role in controlling infectious diseases. However, public concerns about the dangers caused by “superbugs” is growing in recent years, which is resistant to the majority of known antibiotics. This is probably due to the incorrect use of antimicrobial agents which may cause environment contamination. After a series of brainstorming as well as literature research, we decided to design a smart device to solve this antibiotic-related problems. In order to comfirm the operability of our project, we launched the human practice research carefully, including general background investigation, public survey, field trip, and professional interview.

General Background Investigation

β-lactam antibiotics are a class of antibiotics consisting of all antibiotics agents that contain a β-lactam ring in their molecular structure. Some medical professionals have concerns that people are overusing antibiotics. They also believe that this overuse contributes toward the growing number of bacterial infections that are becoming resistant to antibacterial medications^[1], called antimicrobial resistance, which is a worldwide concerning problem.^[2-4] Moreover, antibiotics are also used in livestock industry, including animal husbandry, bee-keeping, fish farming and so on. This provides multiple opportunities for the selection and spread of antibiotic-resistant bacteria.^[5] The use of antibiotics in livestock industry aiming for growth promoting or infection prevention and treatment has all significantly elevated the consumption of antibiotics, which, in turn, boosted antibiotic-resistant. Also, the antibiotics in the animal body can be disseminated to the environment through animal waste, causing antibiotic pollution.^[6] Traditional detection methods such as chromatographic analysis, ELISA, often require large instruments to operate with and non-specific interference^[7-9]. Additionally, the use of antibiotics in medical industry facing a harsh condition of antibiotics resistance too. According to the information above, our team determine to design a β-lactam antibiotic detection and degradation system.

[1] What to know about antibiotics. (n.d.). Retrieved from medcialnewstoday.com/articles/10278.php

[2] Tran, Ngoc Han, Hongjie Chen, Martin Reinhard, Feijian Mao, and Karina Yew-Hoong Gin. "Occurrence and removal of multiple classes of antibiotics and antimicrobial agents in biological wastewater treatment processes." Water research 104 (2016): 461-472.

[3] Centres for Disease Control and Prevention (US). Antibiotic resistance threats in the United States, 2013. Centres for Disease Control and Prevention, US Department of Health and Human Services, 2013.

[4] Varadi, Linda, Jia Lin Luo, David E. Hibbs, John D. Perry, Rosaleen J. Anderson, Sylvain Orenga, and Paul W. Groundwater. "Methods for the detection and identification of pathogenic bacteria: past, present, and future." Chemical Society Reviews 46, no. 16 (2017): 4818-4832.

[5] Meek R W , Vyas H , Piddock L J V . Nonmedical Uses of Antibiotics: Time to Restrict Their Use?[J]. PLoS Biology, 2015, 13(10):e1002266.

[6] Economou V, Gousia P. Agriculture and food animals as a source of antimicrobial-resistant bacteria[J]. Infection and Drug Resistance, 2015:49.

[7] Shelver, Weilin L., Nancy W. Shappell, Milan Franek, and Fernando R. Rubio. "ELISA for sulfonamides and its application for screening in water contamination." Journal of agricultural and food chemistry 56, no. 15 (2008): 6609-6615.

[8]Gros, Meritxell, Mira Petrovic, and Damia Barcelo. "Tracing pharmaceutical residues of different therapeutic classes in environmental waters by using liquid chromatography/quadrupole-linear ion trap mass spectrometry and automated library searching." Analytical chemistry 81, no. 3 (2008): 898-912.

[9] Sacher, Frank, Frank Thomas Lange, Heinz-Jürgen Brauch, and Iris Blankenhorn. "Pharmaceuticals in groundwaters: analytical methods and results of a monitoring program in Baden-Württemberg, Germany." Journal of Chromatography A 938, no. 1-2 (2001): 199-210.

Public Survey

A total of 1023 questionnaires have been successfully received through online and offline surveys. The results revealed that majority of the public has a general knowledge and growing concern about antibiotics and the problem aroused by abuse of antibiotics. However, it seems that the public does not know much about the scope of antibiotics used, so that the harm caused by antibiotic contamination is not fully understood. More detailed analysis would be displayed as followed.

In general, only 1.27% of public had never heard of antibiotics. Among the people who have heard of antibiotics, 91.89% of them hold the view that abuse of antibiotics will cause serious problems. However, there is a certain one-sideness cognition among them. The access to antibiotics is limited. 82.6% of public understand antiobiotics through the use of antibiotic drugs (Figure 1).

Figure 1 The results of Question 7

As for the application of antibiotics, 99.21% believe that it will be used for medical treatment, and 57.50% and 60.28% of them think that the antibiotics can be applied to scientific research and animal husbandry, but only 36.74% and 24.03% of them believe antibiotics are considered for using in agriculture and food, respectively (Figure 2).

Figure 2 The results of Question 6

69.00% and 69.78% of the public believe that the danger of antibiotics is to reduce human health and produce drug resistant strains, but it also causes serious problems for ecology and environment (Figure 3). To raise people’s awarenesss of the abuse of antibiotics, we held a lecture on antibiotics to the children and their parents in Hangzhou Low-Carbon Science & Technology Museum China.

Figure 3 The results of Question 9

In terms of solutions, the public’s view is mainly focused on prevention and control, especially hoping the government will intervene. 94.59% of the people think that the government should supervise it, and 69.39% consider that the relevant laws should be enacted (Figure 4). It can be seen that there are few scientific methods for the antibiotic treatment, and our projects are novel in science and technology. 55% of the public hope that researchers will focus on methods for degrading antibiotics. For other words, it is revealed that the public has an insufficient understanding of antibiotics, such as the biodegradation of antibiotics. From our background research, we got that we need to do more, not only strengthen government supervision, but also develop some promising methods to improve the current problems caused by the accumulation of antibiotics.

Figure 4 The public expectation on antibiotic research

From the results of Question 14, we noticed that synthetic biology is still an emerging discipline for the public. 81.13% participants have never heard of this or only know the name of it (Figure 5). Yet, after reading the brief introduction to synthetic biology, 86.02% of the public chose to support research in this field, and believe that the technology can be widely applied in various practical fields. In the following activities in Hangzhou Low-Carbon Science and Technology Museum China, we also let children to touch and understand this new technology by playing games.

Figure 5 Results of Question 14

Field Trip

Nongfu Spring factory research

Four members of our team visited the the Chun’an factory base of Nongfu Spring, the Chinese famous manufacturer of drinking water. The factory take water from deep underneath Thousand-island Lake. After walking down the 550 assembly line, which comprises of water treatment, blown bottle, bottle washer and canning machine, we had a chance to talk to the factory’s workers of quality assurance department. Through this conversation, we got that they would evaluate the environment around the water source to ensure water quality and eliminate pollution problems such as antibiotics pollution. After recognizing that the human drinking water has been treated and regulated under a rigorous procedure, which basically prevent them from contaminated by antibiotics in the environment, therefore, we have narrowed down our research direction toward the antibiotic pollution in water from hospital and livestock industry.

Professional interviews

We conducted face-to-face interviews with professors in livestock industry, physicians in hospitals, a group of students in Zhejiang University focusing on antibiotic degradation, and telephone interviews with some other professors.

Interview to a group of undergraduate students in Zhejiang University

We found a group of undergraduates at Zhejiang University guided by a professor who also focus on antibiotics degradation. Through face to face communication, we gained some useful information that listed below:

1. The concentration of β-lactam antibiotics in the natural environment is lower than that in the laboratory, so it is important for us to test and amplify the sensitive range of our β-lactam sensor. They suggested us to switch a strong promoter to amplify the sensitivity.

2. It is also important to accurately test the concentration in which our β-lactam biosensors can withstand in order to better cope with the changing environment.

3. β-lactam antibiotic is a type of antibiotics which can be easily decomposed under sunlight. Hence, we need to prove the value of our degradation system by testifying that β-lactam antibiotics may slip into rivers or other environmental settings before they completely collapsed.

Interview to Prof. Xu in Zhejiang University

Professor Yingke Xu from Zhejiang University really encouraged on our project, and pointed out that our system lacked a unique feature that distinguished it from the other existing method. Thus, we came up with an idea that our system of testing and degrading antibiotics would be much more efficient and cheap. While many existing methods requires large instruments to operate with, we decided that our final product would be incorporated into a water treatment production line. In this way, the cost is much cheaper, and water will be already clean of antibiotics when consumed by human beings.

Interview to Prof. Wang in Zhejiang University

To confirm our background investigation that livestock industry would use antibiotics on farmland animals, which might potentially lead to antibiotics leaking into the environment, we have the honor to interview to Prof. Wang of College of Animal Science and Technology of Zhejiang University. The listed points are our findings:

1. Professor Wang indicated that in recent years, the use of antibiotics in the farmland animals was under strict regulations. To improve the health of farm animals by regulating the microbe content in their diet instead of resorting to antibiotics, the livestock industry has tried their best to avoid using antibiotics as possible. However, the professor also indirectly pointed out that the current progress on this goal is inadequate to completely replace the role of antibiotics in farmland animals.

2. It is common for animals getting sick. so the use of antibiotics to cure the disease is inevitable. Also, the excrements from animals containing antibiotics, though treated with special procedures, may still be excreted into the environment by infiltration into the soil and water by mixing with rainfall.

Interview physician Jin in a hospital in Ningbo.

One of our team members conducted an interview with a physician in a hospital located in Ningbo, China. The following points are the summary of the interview:

She told us that β-lactam, the antibiotics we chose to focus on, generally acquires a very unstable chemical structure, which means it would not be preserved in the environment and cause river pollutions. She suggested to study the half-life period of β-lactam. Later, we found essays indicating that the half-life period of β-Lactam could last for 2-3 days, which is enough to leak and flow through the river streams.

Meet up in Hangzhou

Apart from interviews and surveys, ASTWS-China also hosted a Meet-Up event at Hangzhou with ZJU-China and Worldshaper-XSHS, open to all teams globally, but targeting high school teams. We also had the honor to invite some specialists in the field of Synthetic Biology and also advisors from iGEM High School Committee.

From the advices we received from specialists we interviewed and from the Meetup event, we concluded two main concerns they addressed on. First, the safety aspect of our design. Since one of our detecting system, the Mec system, is a biosensor, preventing bacteria leakage should definitely be paid full attention to. On the other hand, our goal was to produce blaCMY-10 protein and use it to degrade β-Lactams. But there is a certain degree of risks of leaking these bacterias carrying resistance genes. Thus we need to design a plan that can efficiently kill and regulate these bacterias. Secondly, the efficiency of our design was also questioned by some of the specialists such as Pharmacist Jin. We decided that the best way to solve this problem was to detect and degrade the polluted water sources as early as possible.

Conclusion

1. Antibiotics pollution is a severe environmental problem caused by the overuse or accidental leakage into the environment, which could have caused serious problems,such as generating super-bacteria which are immune to any forms of antibiotics.

2. The drinking water production plant will carry out strict quality control in the water source, so our device should be designed for specific industry, such as medical industry and livestock industry.

3. Safety need to be paid full attention to the engineered super bacteria in the lab.

4. General public has a general knowledge and growing concern about antibiotics and the problem aroused by abuse of antibiotics. However, it seems that the public does not know much about the scope of antibiotics used, so that the harm caused by antibiotic contamination is not fully understood.

5. General public lacked knowledge on synthetic biology and biodegradation of antibiotics.

Integrated Human Practices

To sum up, according to the research results mentioned above, the project was improved in the following aspects: Public Science Activities, adjusting our research project, and adjusting our applied design.

Adjust our research project

We adjust our research project in several ways in response to public concerns and professional suggestions.

1. According to the advice from Professor Yingke Xu, we came up with an idea that our system of testing and degrading antibiotics would be much more efficient and cheap.

2. Narrow down our research direction toward the antibiotic pollution in water from hospital and livestock industry.

3. Recheck the half life period of β-lactams which could last for 2-3 days. It is enough for it to leak and flow through the river streams. We adjusted our product design to located at the export of the polluted waste water to prevent the antibiotics pollutants from leak and flow through the river streams or groundwater.

4. Safety is the first! We strictly control the leakage of engineering super bacteria and efficiently kill these bacteria according to the lab rules.

Public Science Activities / surveys

Since the beginning of July, we have been collecting a fair amount of data by sending out survey forms randomly and we received upto 1021 valid answers. As we analyzed the datas collected, we found that except from professional workers in the biomedical field, the general public’s knowledge on the understandings of antibiotics and synthetic biology is minimal, and a majority of their understandings stayed on a level of “used it before” or “heard of it before”. Thus concluding the great importance of educating the general public on antibiotics. We thought that in such a short period of time, it is very hard for us to cover all the populations, thus we targeted the young children in Hangzhou and held a science fair for them to learn about the different projects different teams are doing, including our antibiotics project. More importantly, we designed fun activities about synthetic biology and it attracted thousands of children that day. Meanwhile, we introduce our project about antibiotics and synthetic biology to their parents.

Team:ASTWS-China/Human Practices