Responsible Microbiome Engineering In Everyday Spaces

From household mold to hospital-acquired infections, NC State researchers are partnering with communities to ensure microbiome innovations serve society's needs.[/lead]

Launched in 2022 with a five-year, $25 million grant from the National Science Foundation (renewable for another five years), the Precision Microbiome Engineering (PreMiEr) Engineering Research Center is a Duke University-led initiative that brings together multiple institutions, including NC State, UNC-Chapel Hill, UNC-Charlotte, and NC A&T Universities, to explore how microbiomes can be engineered to create healthier indoor spaces. The Center's work spans microbiology, engineering, data science, and the social sciences, with the goal of advancing both fundamental knowledge and practical applications.

An essential part of this effort is the Societal and Ethical Implications (SEI) Core, led by Jennifer Kuzma, professor in NC State's School of Public and International Affairs, co-PI on the PreMiEr grant, and director of the Genetic Engineering and Society (GES) Center. Rather than treating engagement as an afterthought, the SEI Core ensures that ethics, responsibility, and public trust are embedded into every stage of PreMiEr's research. "Integrating ethics and public values into research isn't optional-it's what ensures that innovation aligns with society's needs," said Kuzma.

Building a Framework for Responsible Innovation

Since its launch, the SEI Core has established itself as a hub for reflection and engagement within PreMiEr. Early accomplishments include:

• Shaping research agendas through workshops and interdisciplinary scholarship.
• Developing practical tools, such as an SEI Toolkit now in progress to help researchers integrate questions of responsibility and public trust into project design and implementation.
• Capturing public perspectives through interviews and surveys that surface both enthusiasm and concerns about microbiome interventions.
• Connecting to governance and policy debates by contributing to national and international conversations on biotechnology regulation and responsible innovation.

Together, these efforts illustrate how SEI is not simply an add-on, but a framework that shapes how microbiome engineering is conceived and carried out. This raises larger questions about why these considerations are essential to PreMiEr's mission.

Why SEI Matters

Building accountability and community perspectives into microbiome engineering is not just about process-it is about addressing fundamental questions at the heart of innovation. How should risks be assessed and managed? What kinds of oversight are appropriate for novel interventions? And who gets to decide how and where these technologies are deployed?

"When we talk with communities, we hear both excitement and caution. Our job is to make sure both perspectives, and people's lived experiences, inform how the science moves forward," noted Kristen Landreville, GES research scholar and SEI Core member leading engagement efforts.

These questions take on particular urgency in PreMiEr's applied testbeds, where research on household mold and hospital sinks directly links microbiome engineering to issues of health, safety, and consent.

SEI in Action: Mold and Hospital Sinks

The SEI Core engages most closely with two of PreMiEr's applied research areas, where microbiome engineering approaches are being developed to combat household mold and hospital-acquired infections – both common issues with devastating health and economic impacts.

Household Mold

Mold growth is a persistent challenge in many homes, particularly in communities vulnerable to storm damage, high humidity, and aging infrastructure. To better understand these realities, the SEI team has conducted in-depth interviews and home observations with residents. These conversations highlight both the health concerns and the practical challenges families face when confronting mold. By integrating these lived experiences into the research process, the SEI Core helps ensure that potential microbiome-based interventions for mold mitigation are developed in ways that reflect community needs and values.

Hospital Sinks and Hospital-Acquired Infections

Hospital sinks are a well-documented source of harmful microbes that contribute to hospital-acquired infections (HAIs). PreMiEr researchers are exploring whether introducing beneficial microbes-or even gene-edited approaches such as CRISPR tools delivered via bacteriophages-can help suppress pathogens while protecting beneficial microbial communities. For the SEI Core, these innovations raise critical questions about risk, oversight, and transparency in clinical environments. Through surveys, interviews with ICU nurses, and engagement efforts, the SEI team is investigating how frontline staff and the public perceive these technologies, and what safeguards and communication strategies are needed to build trust.

Together, these case studies demonstrate how PreMiEr's SEI Core integrates ethical reflection and community perspectives into high-stakes, real-world applications of microbiome engineering-ensuring that innovations advance not only technical goals but also social responsibility.

Beyond these testbed projects, the SEI Core has also taken on a convening role-organizing workshops that bring together researchers, policymakers, practitioners, and community members to broaden dialogue and extend PreMiEr's impact.

Convening Dialogue Across Disciplines

These workshops, hosted by NC State's GES Center, have become vital spaces for interdisciplinary exchange, allowing participants to examine the societal dimensions of microbiome engineering and to identify pathways for integrating SEI into ongoing research.

• 2024 workshop: This two-day event was held in person at NC State, with over 80 participants in attendance and additional attendees joining via Zoom. The workshop featured presentations and discussions on the scientific, governance, and community dimensions of microbiome engineering, building connections across disciplines and institutions, and leading to a forthcoming publication on the core principles for responsible development of microbiome engineering in the built environment.
• 2025 workshop: Held virtually, this half-day Zoom workshop convened scholars and practitioners to focus on integrating societal and ethical considerations into ongoing PreMiEr projects. The discussions emphasized practical tools and frameworks for integrating SEI into technical research.

Together, these workshops underscore the SEI Core's role as a convener, fostering dialogue across disciplines while ensuring that diverse perspectives help guide PreMiEr's research agenda.

Advancing SEI Scholarship

The insights and collaborations fostered through these workshops are also reflected in a growing body of peer-reviewed scholarship led by Jennifer Kuzma, together with GES research scholars Kristen Landreville and Christopher Cummings. Their work highlights how societal perspectives can inform microbiome engineering, from public attitudes and national surveys to systematic reviews of SEI-related issues. Recent publications include:

• Public perceptions and support for introduced microbes to combat hospital-acquired infections and antimicrobial resistance - using results from a national survey, offers guidance for developers, policymakers, and hospital leaders on how to responsibly advance microbiome-based infection control with transparent oversight and inclusive education. (Cummings, Landreville, & Kuzma, PLOS ONE, 2025)
• Natural vs. genetically engineered microbiomes: understanding public attitudes for indoor applications and pathways for future engagement - exploring how framing influences perceptions of safety and acceptability. (Cummings, Landreville, & Kuzma, Frontiers in Genetics, 2025)
• Taking the temperature of the United States public regarding microbiome engineering - a national survey on public perceptions, offering insights into awareness, trust, and concerns among diverse communities. (Cummings, Landreville, and Kuzma, Frontiers in Public Health, 2024)
• Can societal and ethical implications of precision microbiome engineering be applied to the built environment? A systematic review of the literature - mapping existing scholarship and identifying areas for future inquiry. (Hecate [formerly published as Hardwick], Cummings, Graves, and Kuzma, Environment Systems and Decisions, 2024)

Several additional manuscripts are in press or under review, underscoring GES's momentum in shaping this emerging field.

These contributions provide a strong foundation for the SEI Core's continued leadership in responsible microbiome innovation.

Shaping the Future of Microbiome Innovation

This work is just beginning. Forthcoming publications and workshops will extend these insights, advancing frameworks for responsible microbiome engineering across scientific, policy, and societal domains. With its interdisciplinary structure and long-term NSF support, PreMiEr provides NC State and the GES Center with a platform to shape the future of microbiome science-demonstrating how ethics and public values can be embedded in transformative research. "When science listens as well as innovates, it shapes discoveries people can trust," said Kuzma.

[pullquote color="innovationblue"]When science listens as well as innovates, it shapes discoveries people can trust.[/pullquote]

This post was originally published in Genetic Engineering and Society Center.