Droolie: Detecting sepsis in babies and mothers

17 February 2018
Written by
Shannon Harmon, digital editor, Longitude Prize
Droolie, a sepsis diagnostic test

Amrita Sukrity is Founder and CEO of Spotsense a competing Longitude Prize team who recently won a Discovery Award. Amrita discusses their test for sepsis in babies, the barriers to behaviour change and the team’s need for various collaborators, including physicians and biotechnologists. Amrita will also be representing teams competing in the Longitude Prize at Nesta’s Challenges of our Era Summit in Milan this 6-7 March 2018.

How did you become involved in antibiotic resistance?

I'm not someone who comes from a medical background, but having had an interest in public health, I was exploring multiple sectors in healthcare. There is a Social Innovation Immersion Programme in India that helps individuals meet up with other people to try to understand the main problems and solutions in public health. By participating in the programme, I realised that the biggest problem right now is infectious diseases and antibiotic resistance.

How can we find a diagnostic solution to bridge the gap between too much antibiotic use and not enough?

I began by seeing two different perspectives: one part of society is not outwardly seeking care, they don’t go to the hospital when they are sick or they can’t afford it. The other part of society gets overmedicated - and seeing these two points of view I had to ask, how can we find a diagnostic solution to bridge the gap between too much antibiotic use and not enough? So we decided to create Spotsense, a company focussed on creating evidence-based diagnostics. As our first product we envisioned ‘Droolie’ which is a device that would diagnose and measure severity of sepsis in newborns.

What is your test for and how exactly does it work?

The current device is for testing sepsis in newborns. The device is based on host-response biomarkers, and so it does not focus on bacteria or if there is an infection alone, but looks at the immune system and how it is trying to react to an infection.. Our prototype is a bit like a thermometer, non-invasive, uses saliva and can be performed in hospital or at home.

What we are trying to develop is an evidence-based diagnostic, so the doctor will always have a score to rate if a baby is getting better or worse.

In most countries, including India, a doctor will start a baby on antibiotics and if, and only if, the doctor is convinced that clinical symptoms are gone, which is a very subjective evaluation, the baby will be taken off antibiotics. What we are trying to develop, however, is an evidence-based diagnostic, so the doctor will always have a score to rate if a baby is getting better or worse, so they can stop antimicrobial therapy at the right time or even avoid it all together, when it is not needed.

Are there plans to expand the test?

We are also trying to develop a similar solution for mothers who may have sepsis. Once we have evaluated Droolie, we can develop the test for a much larger demography.

Why did you decide to apply for a Discovery Award?

We were facing numerous challenges;one of the biggest is the clinical performance evaluation. We want to find ways to collaborate with others as well as carry on our validations. This funding is helping us to do a large scale validation, and we are in touch with 5 different tertiary care hospitals in India with over 400 babies? who will be trialed.

We are looking to collaborate with clinicians and people who can help us make this test better, so biochemists and biotechnologists.

We also have a grant from Biotechnology Industry Research Assistance Council (BIRAC) and also have some funding from Villgro, who are an impact investor.

What are the biggest challenges you’ve faced in developing your point-of-care test so far?  

Based on the discussions we have had with doctors, once we have done the clinical validations, a barrier is that doctors might still be too scared NOT to use antibiotics in case they lose a patient, so they give them just in case. How one changes that behaviour will be the biggest challenge for most Longitude Prize entrants.

We are trying to do more education and collaborations, co-creating this product with hospitals, letting the hospitals decide the best protocol for themselves in including a device like this in their wards.

People tend to want to treat first and diagnose later.

We are trying to do more education and collaborations, co-creating this product with hospitals, letting the hospitals decide the best protocol for themselves in including a device like this in their wards. They are testing their ideas on increasingly larger scales, which will hopefully give us a better way forward in deciding protocols in the future.

How are you working to ensure your test will be available and affordable everywhere it is needed?

Our test is currently priced around $3 per test and is a home/hospital-based that does not require any special reagents. This test can be shipped in large numbers at room temperature. We are also trying to have higher shelf life for our products so that we can easily work with distributors and logistic partners to make our product available even in the remotest of areas.

Who would manufacture your test?

We have two collaborations - one person is doing the assay and analytical part of the manufacturing process and the other person is doing the mechanical design and packaging. The final products will be created in our offices in India, even in larger numbers for distribution.

We are looking to infiltrate the global market and bridge any community that might not have access to healthcare or who can’t afford it, including India, but also Africa and Latin America.

Are you looking for more collaborators?

We are looking to collaborate with clinicians and people who can help us make this test better, so biochemists and biotechnologists.

To get in touch with Spotsense on further collaboration, please contact us here.