Establishing a Centre for Plasma Microbiology

Lead Research Organisation: University of Liverpool
Department Name: Electrical Engineering and Electronics

Abstract

Biofilms are groups of microorganisms that stick to each other on a surface, becoming an organised colony that is surrounded by a slimy substance to form a diverse and well protected community. A common example of a biofilm that everyone can relate to is the formation of plaque on teeth, which left untreated causes tooth decay. While biofilm formation in the mouth is mostly harmless, it has been estimated that up to 80 % of all infections worldwide are biofilm-related. In particular, biofilm colonisation of implanted devices such as Endotracheal tubes presents a particularly resilient reservoir of infection, shielded from systemic antibiotics, that often leads to the emergence of multidrug-resistant colonies. Patients contracting such infections have a particularly bleak outlook, with mortality rates for diseases such as Ventilator Associated Pneumonia (VAP) exceeding 50 % in certain patient groups. Quite simply, establishing a management strategy for these organisms is a global priority.

Cold plasma technology has recently attracted global attention as it provides an effective means to destroy biofilm contamination, including biofilms containing multidrug resistant bacteria. A major barrier to the implementation of this promising technology is a lack of innovation in plasma source development. This award will tackle the challenge by developing novel power sources and systems that produce an output tailored specifically to manage biofilm contamination on implanted devices in situ; these efforts will be driven by a closely interacting team of specialists in microbiology and translational medicine, clinicians and patients. Key to this will be the unique methods and understanding uncovered on my previous EPSRC funded research which addressed the Physical Sciences grand challenge area of Emergence and Physics Far From Equilibrium (EP/J005894/1).

My long term research vision is to establish a multidisciplinary centre of excellence focused on the development of novel plasma based physical interventions as part of my ambition to revolutionise technology driven approaches to global health challenges. The Centre will act as a hub to facilitate new thinking/methodologies/technology in this area driven by novel engineering and physical sciences research and will be a catalyst to explore new scientific horizons. Delivering this vision will demand a transformative approach that pushes the frontiers of plasma science and breaks-down traditional discipline boundaries. Success will require creativity, ambitious plans, high levels of flexibility and the necessary taking of risks balanced against the scope for reward. I will manage these aspects within the framework of a coherent research programme, and activities will be underpinned by a hand-picked team of research leaders. At the heart of my approach is the sustained and active involvement of end-users to inform research design and research goals. My approach will ensure priorities focus on clinical need, an essential factor to drive innovation and ensure successful translation.

The average timeline for translation of new technologies in to the healthcare sector ('bench to bed') is 17 years; given the immediate clinical need for the proposed technology, accelerating the translational process will be a key priority of the Centre. Drawing on the wealth of expertise available in the project team and the unique innovation eco-system in Liverpool, which includes the North West Coast Academic Health Science Network (AHSN - www.nwcahsn.nhs.uk), a translational plan has been established to see the introduction of plasma decontamination technology in the healthcare sector within a 10 - 12 year timeframe. The introduction of this technology will have a significant impact in a market sector valued at $14 billion; directly contributing to the UK's strong life sciences industry, which employs an estimated 183,000 and generates a combined estimated turnover of £56bn.

Planned Impact

My vision for the Centre falls directly within the Frontiers of Physical Interventions Healthcare Grand Challenge. The technologies developed within the Centre will address an urgent clinical need that is a blight to patients and places an enormous economic burden on the NHS. Infected indwelling lines can have catastrophic consequences for many patients groups (i.e. those in critical care), with mortality rates for diseases such as Ventilator Associated Pneumonia (VAP) exceeding 50 %. The challenge is not specific to the UK and any technology to prevent infections on implanted devices would have enormous impact in a market sector valued at $14 billion.

In order to make a transformative advance in this Grand Challenge the activities of the Centre will push boundaries in many of the cross-cutting themes and RCUK priority areas. Disruptive technologies for sensing and analysis of complex biofilms will be developed; these will provide a real-time indication of infection. The devices developed within the Centre will provide a minimally invasive means of intervention and monitoring, addressing another of the cross-cutting activities. The fundamental plasma science to be harnessed within the Centre falls directly within the Physics Grand Challenge area of 'Matter Far from Equilibrium'. The synergy arising within the Centre will ensure the UK plays a leading role in this innovative, yet fiercely competitive, research area and will provide a means to significantly shorten the pathways to clinical adoption of plasma technology in the healthcare sector. Given that the average time for translation of new technologies in to the healthcare sector (bench to bed) is 17 years; accelerating this process will be a key impact of the Centre. Using the unique innovation eco-system available in Liverpool, which includes the North West Coast Academic Health Science Network (AHSN - www.nwcahsn.nhs.uk), resources and support have been committed to accelerate the translational process, yielding translation in a 10-12 year timeframe.

Key impacts that will be realised through this award:
(1) A hub will be created for research leaders to come together facilitating the generation of new thinking/methodologies/technology (Year 1).
(2) The Centre will have an ethos that nurtures innovation, through continuous stakeholder involvement and by supporting exploratory projects (Year 1- 5).
(3) The synergy arising within the Centre will help establish new translational pathways for plasma technology in to the healthcare sector (Year 1 - 5).
(4) The Centre will act as an interface between UK academia, Public Health England, End-users, ethical/regulatory bodies and healthcare device manufacturers (Year 1-5).
(5) A tailored package of training and mentoring will provide the PI with the skills necessary to accelerate his career and become a leader in the healthcare sector (Year 1-5).
(6) Technologies will be developed with translation in mind; with continuous stakeholder involvement, minimising barriers to introduction in to the healthcare sector (Year 1 -5).
(6) The Centre will become a self-sustaining activity that produces lasting academic and societal impact (5+ Years).

Publications

10 25 50

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Dickenson A (2021) Electromechanical coupling mechanisms at a plasma-liquid interface in Journal of Applied Physics

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Gilbart B (2022) Mutual interaction among multiple surface barrier discharges in Plasma Processes and Polymers

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Gilbart B (2021) Dominant heating mechanisms in a surface barrier discharge in Journal of Physics D: Applied Physics

 
Description We have demonstrated that the composition of plasma can be tailored to maximise its efficacy against clinically relevant biofilm forming pathogens. We have published several papers focusing on the use of cold air plasma for microbial decontamination on various surfaces (metallic, polymeric etc) with clinically relevant biofilms.

We have used the advanced plasma source developed through this award to tailor the composition of plasma species arriving at the biofilm so we can assess the impact of individual components and tailor the plasma for maximum inactivation. The results of his study have recently been accepted for publication in Plos One.

Using an optimised plasma source we have investigated the impact of plasma treatment on the underlying surface and the potential of modifying the surface to prevent future recolonization. Furthermore, we have investigated the emergence of resistance in plasma treated strains of Staphylococcus aureus and are preparing a study for publication.

We have developed several novel plasma devices that are capable of transporting highly antimicrobial chemical species generated in the plasma to a downstream surface and embarked on several industry funded research projects to explore these (e.g. Sterafill ltd, Olympus, 5D Health protection group...).

We have built a relationship with Olympus and secured funding (EPSRC Impact acceleration award) to further develop the technology created on this award to accelerate clinical adoption.

We have recently completed a study using genomics to identify resistant phenotypes resulting from multiple sub-lethal plasma treatments.
Exploitation Route The results uncovered so far are being used to realise a useable plasma decontamination device for use in the healthcare sector. We have recieved additional funding from several industry partners to further develop the antimicrobial plasma technology and accelerate its translation in to the healthcare sector.
Sectors Agriculture, Food and Drink,Financial Services, and Management Consultancy,Healthcare,Pharmaceuticals and Medical Biotechnology

URL https://www.liverpool.ac.uk/science-and-engineering/interdisciplinary-research/healthcare-technologies/centre-for-plasma-microbiology/
 
Description Based on published studies from this activity, the team was approached by a medical device manufacturer to provide expert guidance on the optimisation of an endoscopic electrosurgery device. The company has reported that the consultancy provided has made a significant improvement to their product line and a long-term collaborative relationship has been built with the company. Currently, the device manufacturer and PI are exploring opportunities for translation of plasma technology for the disinfection of endoscopic devices. Results from the project were used to develop a plasma system for the decontamination of food packaging, the technology has subsequently been used to leverage a further £500k for the SME Sterafill to further develop and test the device under real-world conditions, with a view to commercialisation in the near future. Results from the project have been used to develop a technology that is suitable for the decontamination of food-contact surfaces and food products. This has generated IP and enabled a PDRA within the group to receive funding to establish a spin-out company.
First Year Of Impact 2018
Sector Agriculture, Food and Drink,Healthcare
Impact Types Cultural,Economic

 
Description Campden BRI PhD studentship (Plasmas for microbial decontamination).
Amount £23,000 (GBP)
Organisation Campden BRI 
Sector Private
Country United Kingdom
Start 10/2017 
End 10/2021
 
Description EPSRC Engineering for a prosperous nation
Amount £221,688 (GBP)
Funding ID EP/R041849/1 
Organisation Engineering and Physical Sciences Research Council (EPSRC) 
Sector Public
Country United Kingdom
Start 04/2018 
End 03/2020
 
Description ICURe award
Amount £35,000 (GBP)
Funding ID I-I-003 
Organisation Innovate UK 
Sector Public
Country United Kingdom
Start 11/2022 
End 03/2023
 
Description ISCF Pump Priming: Plasma for healthcare: Establishing a new measurement capability.
Amount £21,300 (GBP)
Organisation University of Liverpool 
Sector Academic/University
Country United Kingdom
Start 09/2017 
End 03/2018
 
Description PhD studentship: Plasma Activated Liquids for microbial decontamination
Amount kr 30,000,000 (NOK)
Organisation NOFIMA Ås 
Sector Private
Country Norway
Start 04/2018 
End 04/2022
 
Description Plasma decontmaintion of endoscopic deivces
Amount £11,000 (GBP)
Organisation Engineering and Physical Sciences Research Council (EPSRC) 
Sector Public
Country United Kingdom
Start 01/2020 
End 01/2020
 
Description TiPToP - TaIlored Pulse excitation for TailOred Plasma chemistries
Amount £499,302 (GBP)
Funding ID EP/S025790/1 
Organisation Engineering and Physical Sciences Research Council (EPSRC) 
Sector Public
Country United Kingdom
Start 10/2019 
End 09/2022
 
Description UK Industry: Proof of Concept project
Amount £60,000 (GBP)
Organisation Sterafill Ltd 
Sector Private
Country United Kingdom
Start 04/2018 
End 11/2018
 
Description UK industry: Plasma activated liquids for surface decontamination
Amount £10,000 (GBP)
Organisation Unilever 
Sector Private
Country United Kingdom
Start 06/2017 
End 06/2018
 
Description 5D health protection group 
Organisation 5D Health Protection Group Ltd
Country United Kingdom 
Sector Private 
PI Contribution Staff from my team have worked directly with scientists from 5D HPG to develop plasma technologies for wound healing. Knowledge of plasma science has been exchanged with staff from 5D.
Collaborator Contribution Staff from my 5D have undertaken experiments to assess plasma action on a wound model and provide knowledge on biofilm formation to my team.
Impact This collaboration was award a proof of concept project from the national biofilms Innovation Centre and an Innovate UK application is currently being written.
Start Year 2017
 
Description Aintree Hospital Critical Care Dept. 
Organisation Aintree University Hospital
Country United Kingdom 
Sector Academic/University 
PI Contribution Members of the team discussed infection control with critical care consultants and nurses.
Collaborator Contribution Critical care consultants and nurses discussed biofilm formation on indwelling lines (i.e. ET tubes) and outlined the major challenges they face on a day to day basis. The visit was extremely useful for members of the Centre for Microbiology to see the real issues faced in a hospital setting and the devastation caused by biofilm related.
Impact It is very difficult to identify a tangible output from this activity. Certainly the experience and insgiht gained through interaction with NHS staff is being used by the research team to guide research design.
Start Year 2016
 
Description Link with Public Health England 
Organisation Public Health England
Country United Kingdom 
Sector Public 
PI Contribution A PhD student funded through a university contribution to this award spent three months on secondment at Public Health England, Porton Down. During his time he trained members of PHE staff in the use of a cold plasma system for the decontamination of clinical pathogens (ESKAPE) in liquid droplets.
Collaborator Contribution During the secondment the student was trained in several aspects of microbiology by PHE staff, this included aseptic working practice, culture and recovery of pathogens. On return to the university, the student subsequently trained other members of the Centre for Plasma Microbiology in the various aspects he had learnt.
Impact A PhD student with electrical engineering background gained valuable microbiology skills. A senior PHE researcher gained valuable plasma science skills and insight in to a novel decontamination technology. A journal article is being prepared to disseminate the findings uncovered during the visit.
Start Year 2017
 
Description Olympus medical technologies 
Organisation Olympus
Country Global 
Sector Private 
PI Contribution During a series of research visits, team members discussed with researchers from Olympus on the use of cold plasma for infection control, specifically in the area of decontamination of long and narrow lumens, such as ET tubes and Endoscopes.
Collaborator Contribution Olympus staff discussed the challenges faced in the sterilisation of medical devices and their approaches to successfully achieve a suitable level of microbial inactivation. The requirements of a successful decontamination technology were established and an experimental plan was established for a joint package of work.
Impact No direct output yet, but it is intended that proof of concept testing will be carried out and used to secure follow on funding for the translation of plasma technology for the purposes of microbial decontamination of medical devices.
Start Year 2017
 
Title Decontamination of Food by Plasma 
Description Description of a technique to manipulate plasma species for the purpose of microbial decontamination 
IP Reference P44601GB1 
Protection Patent / Patent application
Year Protection Granted 2023
Licensed No
Impact Used as the basis for a spin-out company.
 
Title Low temperature plasma for the removal of airborne contamination 
Description Patent on plasma based system to degrade organic contamintion in air flows. 
IP Reference GB2208962.7 
Protection Patent / Patent application
Year Protection Granted 2022
Licensed No
Impact Is forming the basis of a spibn-out company.
 
Description EPSRC announcement of HTCA 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Both EPSRC and UoL press releases related to HTCA award of Walsh, announcement by health and life sciences minister.
Year(s) Of Engagement Activity 2016