Pharmacuetical Microbiology Manual 2014 PDF
Pharmacuetical Microbiology Manual 2014 PDF
Pharmacuetical Microbiology Manual 2014 PDF
0
DATE: 04-25-2014
Pharmaceutical
Microbiology
Manual
2014
Table of Contents
i. Introduction..iv
ii. Pharmaceutical Microbiology Editorial Board................v
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iii
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i. Introduction
The Pharmaceutical Microbiology Manual (PMM) evolved from the Sterility Analytical
Manual and is a supplement to the United States Pharmacopeia (USP) for pharmaceutical
microbiology testing, including antimicrobial effectiveness testing, microbial examination of
non-sterile products, sterility testing, bacterial endotoxin testing, particulate matter, device
bioburden and environmental monitoring testing. The goal of this manual is to provide an
ORA/CDER harmonized framework on the knowledge, methods and tools needed, and to
apply the appropriate scientific standards required to assess the safety and efficacy of
medical products within FDA testing laboratories. The PMM has expanded to include
some rapid screening techniques along with a new section that covers inspectional
guidance for microbiologists that conduct team inspections.
This manual was developed by members of the Pharmaceutical Microbiology Workgroup
and includes individuals with specialized experience and training.
The instructions in this document are guidelines for FDA analysts. When available,
analysts should use procedures and worksheets that are standardized and harmonized
across all ORA field labs, along with the PMM, when performing analyses related to
product testing of pharmaceuticals and medical devices. When changes or deviations are
necessary, documentation should be completed per the laboratorys Quality Management
System. Generally, these changes should originate from situations such as new products,
unusual products, or unique situations.
This manual was written to reduce compendia method ambiguity and increase
standardization between FDA field laboratories. By providing clearer instructions to FDA
ORA labs, greater transparency can be provided to both industry and the public.
However, it should be emphasized that this manual is a supplement, and does not replace
any information in USP or applicable FDA official guidance references. The PMM does
not relieve any person or laboratory from the responsibility of ensuring that the methods
being employed from the manual are fit for use, and that all testing is validated and/or
verified by the user.
The PMM will continually be revised as newer products, platforms and technologies
emerge or any significant scientific gaps are identified with product testing.
Reference to any commercial materials, equipment, or process in the PMM does not in
any way constitute approval, endorsement, or recommendation by the U.S. Food and
Drug Administration.
U.S. FDA, Office of Regulatory Affairs
Office of Regulatory Science
Medical Products and Tobacco Scientific Staff
iv
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Special Appreciation:
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A.
Media
B.
For the cultivation of the test organisms, select agar medium that is favorable to
the rigorous growth of the respective stock culture. The recommended media are
Soybean Casein Digest Agar/Broth and Sabourauds Dextrose Agar/Broth. Add a
suitable inactivator (neutralizer) for the specific antimicrobial properties in the
product to the broth and/or agar media used for the test procedure if required.
Media used for testing needs to be tested for growth promotion by inoculating the
medium with appropriate microorganisms. It is preferable that test microorganisms
be chosen for growth promotion testing (Section D).
Solid media tested for growth promotion is to be set up using pour plate method in
order to determine a microbial plate count (CFU) which must be 70% of the
microorganism inoculums calculated value.
C.
For all product types, follow current USP methodology in chapter <51>, with the
following additional instructions.
Prior to the Antimicrobial Effectiveness testing, determine if any antimicrobial
properties exist by performing a Suitability testing utilizing microorganisms used for
product testing (section D). Should the Suitability Test fail, the results of Suitability
test are invalid and will need to be repeated with proper method modification to
neutralize the inhibiting property.
If multiple samples of the same product from the same manufacturer (same
amount and form) are collected, one sample may be used for method suitability for
all the samples collected.
D.
Test Organisms
All cultures must be no more than 5 passages removed from the original stock
culture.
Candida albicans (ATCC No. 10231)
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E.
Preparation of Inoculum
Preparatory to the test, inoculate the surface of the appropriate agar medium from
a recently grown stock culture of each of the above test microorganisms. Use
Soybean-Casein Digest medium for Escherichia coli ATCC 8739, Pseudomonas
aeruginosa ATCC 9027 and Staphylococcus aureus ATCC 6538 and incubate at
32.5 2.5 C for 3 5 days. Use Sabouraud Dextrose medium for Candida
albicans ATCC 10231 and Aspergillus brasiliensis ATCC 16404 and incubate at
22.5 2.5 C for 3 5 days for Candida albicans and 3 - 7 days for Aspergillus
brasiliensis.
Harvest the cultures by washing the growth with sterile saline to obtain a microbial
count of about 1x108 CFU/mL (see Microbial Enumeration Tests <61> and Tests
for Specified Microorganisms <62>). For the A. brasiliensis ATCC 16404 culture,
use sterile saline containing 0.05% polysorbate 80.
Alternatively, cultures may be grown in a liquid medium, i.e. Soybean Casein
Digest Broth or Sabourauds Dextrose Broth, (except for the A. brasiliensis ATCC
16404 culture) and harvested by centrifugation, washing and suspending in sterile
saline to obtain a count of about 1 X 108 colony forming units (CFU) per mL.
The estimate of inoculum concentration may be obtained by turbidimetric
procedures for the challenge microorganisms and later confirmed by plate count.
Refrigerate the suspension if not used within 2 hours at 2-8 C.
Determine the number of CFU/mL in each suspension using the appropriate media
and recovery incubation times to confirm the CFU/mL estimate.
Use bacterial and yeast suspensions within 24 hr. of harvest. The mold
preparation may be stored under refrigeration (2-8 C) for up to 7 days.
Note: Alternative commercially available standardized cultures may be used in lieu
of in-house prepared cultures.
F.
Procedure
The procedure requires that the test be conducted with a suitable volume of
product. It is advisable to begin with at least 20 mL of product. Use the original
product containers whenever possible or five sterile, capped bacteriological
containers of suitable size into which a suitable volume of product has been
transferred. If the diluted product exhibits antimicrobial properties, specific
neutralizers may need to be incorporated into the diluents or the recovery media.
For purposes of testing, products have been divided into four categories:
Category 1 Injections, other parenteral including emulsions, otic products,
sterile nasal products, and ophthalmic products made with aqueous bases
or vehicles.
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G.
Interpretation
The criteria for microbial effectiveness are met if the specified criteria are met, see
table below. No increase is defined as not more than 0.5 log10 unit higher than the
previous value measured.
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Category 1 Products
Bacteria:
Not less than 1.0 log reduction from the initial calculated
count at 7 days, not less than 3.0 log reduction from the
initial count at 14 days, and no increase from the 14 day
count at 28 days.
No increase from the initial calculated count at 7, 14, and
28 days.
Category 2 Products
Bacteria:
Yeast and Molds:
Bacteria:
Yeast and Molds:
Not less than a 2.0 log reduction from the initial count at 14
days, and no increase from the 14 day count at 28 days.
No increase from the initial calculated count at 14 and 28
days.
Category 3 Products
Not less than a 1.0 log reduction from the initial count at 14
days, and no increase from the 14 day count at 28 days.
No increase from the initial calculated count at 14 and 28
days.
Category 4 Products
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A.
B.
1. Samples are to be held under the same storage conditions required by the package
label or insert.
2. Prior to product testing, the exterior of the unit container should be disinfected before
transfer to the work station or HEPA filtered laminar flow hood. If the product
container is not hermetically sealed do not soak the product container in a
disinfection solution which may allow the ingress of bactericidal solution into the
product.
3. The work area for opening the unit container should be either a HEPA filtered
laminar flow hood or an alternate controlled environment to safeguard the exposure
of open media and product to either environmental or personnel contamination.
4. If the sample is an aqueous based product, the unit(s) should be shaken prior to
transfer to work area to maximize microbial dispersement.
5. All subsequent manipulation of test tubes with product or sub-culturing can be
conducted on the laboratory work bench or within a Biological Safety Cabinet (BSC)
if filamentous fungi are suspected.
Gowning Requirements
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1. When conducting the testing, the analyst should wear a clean lab coat, sterile
sleeves and sterile gloves. Gloves should be frequently disinfected especially
between opening and handling sample (product) units.
2. Depending on the type of Laminar Flow Hood or equipment barriers in a particular
laboratory, it might be beneficial to also wear a surgical mask and hair net.
C.
D.
Test each batch of ready-prepared medium and each batch of medium prepared either
from dehydrated medium or from ingredients following USP <61> and <62>. Each
chapter provides guidance on test strains to be used for each type of media, refer to
Table 1 of USP <61> and <62>. Ensure that seed-lot cultures used are not more than
five passages removed from the original master seed-lot. Test strains suspensions
should be used within 2 hours, or within 24 hours if refrigerated between 2C and 8C.
Spore suspensions (A. brasiliensis, B. subtilis, and C. sporogenes) refrigerated between
2C and 8C may be kept for a validated period of time. Additionally, all bacterial and
spore suspensions should be prepared to yield 100 cfu. Growth promotion (and
suitability test) plates and tubes should not be incubated in the same incubators used for
product testing. If this cannot be avoided because of limited space, it is preferable to
store the spiked samples in the lower half of the incubator below the sample inoculated
plates and tubes.
Suitability demonstrates that the products tested do not exhibit inhibitory effects on the
growth of microorganisms under the conditions of the tests. Although the intent is to
perform the suitability test before performing the analysis of the product, it is acceptable
to run the product test and the suitability test concurrently. However, it should be noted
that if the suitability test is run concurrently with the product test and the suitability test
should fail, the results of the product test are invalid and the suitability test as well as the
product test will need to be repeated with proper method modification to neutralize the
inhibiting property.
Neutralizing agents may be used to neutralize the activity of antimicrobial agents in
products, see USP <61> Table 2 for a list of potential neutralizing agents/methods. The
appropriate neutralizing agent should be added preferably before sterilization of the
media. Include a blank control with neutralizer and without product to demonstrate
efficacy and absence of toxicity for microorganisms.
USP <61> and <62> describe the suitability tests necessary for each analysis. The
correct inoculum of not more than 100 CFU is required as are specific incubation
temperatures and durations. Ensure that seed-lot cultures used are not more than five
passages removed from the original master seed-lot. Test strains suspensions should
be used within 2 hours, or within 24 hours if refrigerated between 2C and 8C. Spore
suspensions (A. brasiliensis, B. subtilis, C. sporogenes) refrigerated between 2C and
8C may be kept for a validated period of time. USP <61> and <62> require a control
which is without test material to be included in the suitability test. The following viable
ATCC derived cultures may be used. Please be aware that under the revised
harmonized Microbial Limits chapters <61> and <62> users are allowed alternative
sources of the below listed strains. The organisms below are recommended for FDA
use in order to have a consistent and standard worksheet format:
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USP <61> and <62> each contain the acceptance criteria for their respective suitability
test. For USP <61> the Results and Interpretation section requires the inoculated
product to have a mean count of any of the test organisms not differing by a factor
greater than 2 from the control which was without test material. USP <62> requires the
specified microorganisms to be detected with the indicated reactions.
E.
Test Procedure
F.
Regarding USP <61> the acceptance criterion for microbiological quality as it pertains to
quantitative analyses has an allowable variability of the final colony forming units
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(CFUs). There is a two-fold tolerance in the final results. For example, if the monograph
requires a 100 cfu/ml limit, the acceptable upper limit for these results would be 200
cfu/ml. Additional information is included in the Interpretation of the Results section of
USP <61> that should be read and understood when reviewing quantitative test results.
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For all product types, follow current USP methodology in <71>, with the following
additional instructions.
Prior to or concurrently with the sterility test, determine if any bacteriostatic or fungistatic
residue has been retained on the filter membrane. The Method Suitability Test can be
run concurrently with the sterility test per USP. However, it should be noted that if the
Method Suitability Test is run concurrently with the product test and the Method
Suitability Test should fail, the results of the product test are invalid and the Method
Suitability Test as well as the product test will need to be repeated with proper method
modification to neutralize the inhibiting property.
Units selected for suitability testing should be subjected to the same disinfection
procedure utilized in the sample analysis.
In all cases, even if the product does not include a preservative, the product itself may
have growth inhibiting properties. All products should undergo a prescribed Method
Suitability test.
If multiple samples of the same product from the same manufacturer (same dosage and
form) are collected, one sample may be used for method suitability for all the samples
collected.
1.
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2.
Filtration:
i. Inoculate the same microorganism using the same medium without the
product as a positive control.
ii. For bacteria and fungi, incubate tubes/bottles according to USP
requirements. Ensure that seed-lot cultures used are not more than five
passages removed from the original master seed-lot. Test strains
suspensions should be used within 2 hours, or within 24 hours if
refrigerated between 2C and 8C. Spore suspensions (A. brasiliensis, B.
subtilis, C. sporogenes) refrigerated between 2C and 8C may be kept
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B.
Sample Analysis
1. Sample Containers
a. Open the sample package on a laboratory bench disinfected with a sporicidal /
viricidal antimicrobial agent such as 2% glutaraldehyde or equivalent solution
Refer to the AOAC and available literature for choosing suitable antimicrobial
agents for use in your facility.
b. Count the number of units received. Compare this number with the number of
units collected.
c. Inside the clean room preparation area located outside the certified class 100
areas (if available), remove all outer containers from sample units that will be
tested without compromising the sterile integrity of the product. Remove sample
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units and place them on a tray or cart disinfected with an effective antimicrobial
agent.
Note: One or more units can be sacrificed for sample exploration if the number of
the units received is sufficient.
d. Examine all units visually for container closure integrity, for the presence of any
foreign matter and other defects present in the product. Note findings on
analyst's worksheet.
e. If foreign matter is observed within the primary container, discuss with supervisor
the employment of ORS procedure Document ORA-LAB.015 entitled Screening
Protocol for Direct Staining on Products with Appearance of Visible
Contamination (see QMiS for Procedure).
2. Sample Identification
If sample units are not identified by the collector, the analyst should identify unit with
sample #, initials, date, and sub sample # as appropriate for sample traceability.
Otherwise, date and initial each unit.
3. Unit Container Disinfection
Cleanse the exterior of all product primary containers using antimicrobial agents
meeting requirements described under step 1. These suggested disinfection
procedures can be performed on commonly encountered units as follows:
a. Ampoules can be wiped with lint free sterile towel/wipes saturated with
disinfectant. Ampoules may be soaked in disinfectant for 1 hour.
b. Vials should only be wiped with disinfectant. Vials should not be soaked due
to the possibility of migration of disinfectant under the closure and into the
product.
c. Laminated Tyvek package: Disinfect polyethylene/plastic laminate with sterile
towel/wipes soaked in disinfectant. Tyvek portion lightly scrubbed with sterile
particle free dry wipe and air cleanse in a HEPA filtered laminar flow hood for
several hours before testing.
d. Paper Package: Disinfect with UV light if possible. Scrub with sterile particle
free dry wipes and air cleanse as above.
1. Depending on the clean room design, immediately move the sample to the clean
room on a disinfected designated stainless steel cart or place it inside the clean
room pass thru for final preparation. If conducting the sterility test in an isolator
place the sample on a designated stainless steel cart. Allow the sample to react
with the disinfectant for 1 hour before further handling.
2. Number of units and/or amount of product tested:
Follow the current edition of the USP to determine the correct number of units to
be tested and the amount of product to be analyzed from each unit. It is
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preferable to test the entire contents of each unit if possible. Follow laboratory
policy if it requires testing more units than the USP requires.
If the number of units collected is less than the USP requirements, discuss with
the laboratory supervisor before proceeding. Samples collected in a for-cause
situation may be analyzed with a number of units less than the USP
requirements.
C.
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b. Growth promotion test; follow the current USP using recommended strains of
organisms (Table 1, USP <71>). Do not use cultures that are more than five
passages removed from the original master seed lot. Commercially prepared
and certified pre-counted cultures of the recommended organisms can also
be used. Test strains suspensions should be used within 2 hours, or within 24
hours if refrigerated between 2C and 8C. Spore suspensions (A.
brasiliensis, B. subtilis, and C. sporogenes) refrigerated between 2C and 8C
may be kept for a validated period of time. Additionally, all bacterial and
spore suspensions should be prepared to yield 100cfu.
4. Equipment Preparation
Analytical equipment and tools used in sterility analysis and suitability should be
cleaned and sterilized using a validated sterilization procedure. Commercially
purchased equipment and tools should be labeled sterile and accompanied by a
certificate of analysis for sterility.
D.
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E.
Method of Analysis
1. Filtration
Follow the current edition of the USP for the amount of sample to be tested.
2. Direct Inoculation
Follow the current edition of USP for the amount of sample and media to be used.
For example: Use 200 ml of each medium when analyzing solid form products. If the
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F.
i.
Not less than 14 days except for products sterilized using ionizing
radiation. If tubes are not read on day 14 due to holiday or weekend
then record the results, even if positive, on the first available day to
observe the tubes.
ii.
The USP method for analysis of purified cotton, gauze and surgical dressings does not
require testing the entire unit. The USP method for the analysis of purified cotton, gauze
and surgical dressings calls for portions no larger than 500 mg, from the innermost part
of the unit, to be tested in each medium. The entire unit shall be tested for individually
packaged single-use articles.
a. Using media containers as large as quart jars analyze entire unit of product.
b. If unit is too large for the container, analyze as much of unit as can be placed
in container and covered by the medium.
Due to the limited availability of media and glassware that occurs when a large
number of samples are collected for analysis, it would be expedient to perform
compositing of device samples. This would allow the samples to be completed in
a timely manner.
2. Compositing of Medical Devices
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G.
Control Systems
The objective of a control system is to ensure the sterility, within designated limits, of all
items, media, rinsing fluids, and equipment used in a sterility test. The control systems
which will accompany all sterility analyses are outlined below.
1. System Control
A "system control" is used to demonstrate maintenance of sample integrity during all
analytical manipulations. Any piece of equipment that comes in contact with the
product under analysis, along with any manipulations by the analysts, must be
controlled. Thus, all equipment, fluids, and culture media for the "system control"
must be handled in a manner which duplicates, as closely as possible, the
manipulations of the actual sample being analyzed. All materials used as system
controls must be sterilized by the analyzing laboratory. However, the method of
sterilization need not be the same as for the product, but must render the material
sterile.
The first choice for the system control is the actual product, if enough test units are
available. When complex medical devices must be sacrificed in order to design a
suitable sterility test, consider using them for a system control after cleaning,
repacking and sterilizing.
When there are viable alternatives, a product unit should not be sacrificed for use as
a system control if this will reduce the number of units available for sterility testing
below USP requirements or FDA policy requirements, except as provided in the
preceding paragraph. If using a product unit would reduce the subsamples
examined below the number required by USP or FDA policy, the analyzing
laboratory should prepare a control from other material than a unit of the sample
product whenever possible.
a. Membrane Filtration: The filter funnel furthest from the vacuum source
connection on each manifold used in the test is used for the system control.
Alternatively if a closed canister system is used to conduct the sterility test a
canister set from the same lot used during the analysis should be used for the
system control.
i. Filterable Materials (liquids, soluble solids, etc.)
Use material similar to product under test. Control material must be of
the same volume, and similarly packaged as test product. Filter-sterilized
and autoclaved Peptone water (USP Fluid A) may be useful for this
purpose in many cases.
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Chest
Left Forearm
Right Forearm
H.
Daily observations of primary test media (THIO and SCD) containing product should be
performed without unnecessary disturbance. All handling of positive tubes, streaked
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plates, or subsequent inoculations of additional media will be done outside the clean
room. These culture transfers are to be performed within a HEPA filtered biosafety
cabinet or equivalent outside the clean room which has been cleansed with an effective
anti- microbial agent. The analyst should be gowned with at least sterile gloves, sterile
sleeves and a mask to minimize any possible cross contamination.
1. Record on Analyst's worksheets the day the primary isolation media, Fluid
Thioglycollate Broth (THIO), or Soybean-Casein Digest Broth (SCD) is "positive,"
and inform supervisor. Streak tubes on the day they first appear positive and again
at 14 days to determine the presence of other possible slow-growing (i.e., fungi)
microorganisms.
2. Within a HEPA filtered biosafety cabinet or equivalent outside the clean room, streak
positive tubes onto Modified Soybean-Casein Digest Medium [SCD broth + 1.5%
agar] (Modified SCDA).
a. Fluid Thioglycollate Broth: Streak two plates; incubate one aerobically, and
one anaerobically, each at 32.5 2.5oC. NOTE: It is suggested to pipet an
aliquot of media from close to the bottom of the tube to maximize the
recovery of strict anaerobes.
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Following the protocol above for Anaerobic Modified SCDA Plate, using
growth from the single colony pick, inoculate duplicate Modified SCDA
slants, and one SCDA slant. Incubate one Modified SCDA slant
aerobically and one anaerobically. Note the oxygen requirements of the
pure culture isolate from this test, and if indicated, preserve the culture
from the aerobic modified slant. Determine the Gram reaction from the
USP SCDA slant.
b. Soybean Casein Digest Broth
From the aerobic Modified SCDA plate, or from the anaerobic plate if aerobic
growth fails to develop, pick a single colony representative of each type to
duplicate Modified SCDA slants. Incubate one Modified SCDA slant
aerobically and one anaerobically. Report the oxygen requirements of the
aerobic or anaerobic slant culture. Determine the Gram stain reaction of the
culture isolate from the sugar-free USP SCDA agar slant.
5. Identify each isolate as to oxygen requirement, gram reaction, presence or absence
of spores, and whether the organism is a yeast or mold. If possible, the isolate can
be further identified to genus and species using a rapid identification kit such as
VITEK or API. Additionally DNA sequencing may be used when necessary. Follow
the subculture chart in the WS section.
I.
strict anaerobe
strict aerobe
facultative anaerobe
facultative aerobe
gram-positive organism
gram-negative organism
yeast or mold
spore forming organism
Preservation of Isolates
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of conidia (i.e., spores). This will minimize contamination of work environment and
risk to analyst.
2. Subculture of original test tubes to another set of tubes containing the same
medium:
In case the product reacts with the media and shows turbidity due to the nature of
the product, subculture the original tubes after 14 days of incubation. Incubate both
original and subculture vessels for not less than 4 days.
J.
Worksheet Notations
1. Recording Dates
a. Form FD 431, Front Page
Block 4, Date Received- Enter in this space the date the sample was
received from the sample custodian. This date must be the same as that
entered in the FACT system screen for sample received.
All laboratory data, observations and findings resulting from the analysis of a
sample will be recorded using worksheets, continuation sheets and
attachments as described in the ON LINE ORA LAB MANUAL (LPM), Vol. III,
Sec. 3 (Recording of Results- Analyst Worksheets). These include;
The analyst worksheet (FD-431)
The general continuation sheet (FD-431a)
All preprinted and computer generated worksheets
b. Form FD 431a, General Continuation Sheet
On modification of this form resulting in a pre-printed worksheet used for daily
observations of sample tests and controls, the following information should be
included:
In the space provided at the top of the Form enter the date primary test media
were inoculated with product, which also indicate the date when incubation
began.
Describe whether each test was a subsample or a composite.
At space provided of each column for notation of "Daily Observations," enter
the date observations were made, and validate with analyst's initials.
For the days that observations were not made, the following entries will be
made:
Weekend - W
Holiday - H
Leave - L
Other - O (describe)
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When a direct inoculation protocol is used for sample products that cause turbidity of
the medium upon inoculation, the following systems for recording daily observations
of incubating media should be used.
a. Record "T" for any subsample which is turbid due to product-medium mixture.
b. On the daily observation page, indicate the meaning of "T" as: "T = product
induced turbidity.
c. At the end of the initial 14 days of incubation, transfer portions of the medium
(not less than 1 ml) to fresh vessel of the same medium and then incubate
the original and transferred vessels for not less than 4 days. Note: Follow the
current edition of the USP for any changes concerning subculturing and
incubation of turbid samples.
d. Examine original product inoculated media and the subculture media for
growth daily when possible for not less than 4 days of incubation and record
the results on a new daily observation continuation sheet.
K.
The most common methods for preserving cultures are Lyophilization and Ultrafreezing. ATCC recommends the following procedure for the rehydration of
Freeze-Dried cultures. In all cases follow any specific manufacturers instructions
if provided.
1. Opening Ampoules
Score the ampoule once briskly with a sharp file about one inch from the tip.
Disinfect the ampoule with alcohol-dampened gauze. Wrap gauze around ampoule
and break at the scored area. Care should be taken not to have the gauze too wet
or alcohol could be sucked into the culture when the vacuum is broken.
2. Opening Vials
Care should be taken so that the freeze-dried material does not aerosolize and
contaminate the working area.
3. Rehydrating the freeze-dried culture
a. Rehydrate the culture using the medium and incubation temperature
specified for that organism.
b. Aseptically add 0.3 to 0.4 mL of the specified medium to the freeze-dried
culture with a sterile Pasteur pipette.
c. Mix well and transfer the mixture to a test tube containing 5-6 mL of the
recommended broth.
d. Cultures in stoppered vials should be rehydrated with 0.5 mL of the
appropriate broth, mixed and transferred to 5mL of the recommended broth.
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e. Mold cultures should be rehydrated with sterile water since fungi must be
soaked for at least 30 minutes before being transferred to an agar surface.
f. Incubate at the appropriate temperature.
g. Most cultures grow in a few days. However, some may exhibit a prolonged
lag phase and should be given twice the normal incubation before discarding
as not viable.
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A.
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The Bacterial Endotoxin test <85> does not directly address the issue of combining
product units (compositing). The risk of unit composites is that one unit (vial,
ampoule, etc) may have bacterial endotoxin contamination at a higher level but the
dilution of this one unit with endotoxin-free units of product may reduce the
detectable level of endotoxin below the sensitivity of the lysate or dilute the level of
endotoxin below the acceptable monograph level. Therefore, when using a
composite format for screening drug products for endotoxin it is important to
adjust the MVD calculation to account for this reduced lysate sensitivity.
Secondly, when compositing is performed for product screening, if a positive
result is detected a repeat test is acceptable under the conditions stated by the
Interpretation section of the USP chapter.
It would be advisable when performing the repeat test from a composite mixture that,
if remaining product is available and had been opened aseptically under controlled
conditions, the repeat test be performed on the original individual units. It is strongly
advised that the individual units be adequately shaken to assure that the endotoxin is
re-suspended back into solution before taking the sample test aliquot. If any of the
original individual units fail the USP test at this point, the compendium does
not allow any additional repeat testing unless the test can be proven not to be
suitable as defined by the USP chapter.
7. Frequently asked questions: (derived from the FDA Industry Guidance for Pyrogen
and Bacterial Endotoxin testing)
Question 1: Can FINISHED product units (vials, ampoules, pre-filled syringes, etc)
be "Pooled" into a composite and screened for bacterial endotoxin?
Response 1:
Yes. With some exceptions (see below), finished drug product units may be pooled
into a composite sample and assayed for bacterial endotoxins. The composite
sample may be represented by the entire unit or partial aliquots (equal volumes) of
finished product containers from one manufactured lot of aqueous-based
pharmaceuticals. Pooling would generally be accepted for small-volume parenterals
(those with volumes of 100 mL or less) as long as the MVD is adjusted to a
proportional, lower value because of the potential for diluting a unit containing
harmful levels of endotoxins with other units containing lower, less harmful, levels of
endotoxins. This adjusted MVD is obtained by dividing the MVD computed for an
individual sample by the total number of samples to be pooled. FDA suggests
pooling no more than three units per composite in keeping with the concept of testing
representative beginning, middle, and end finished product containers. If this
reduction in MVD results in an inability to overcome product-related assay
interference because of an insufficient dilution, then the samples should be tested
individually.
Finished medical devices may also be pooled into a composite sample and assayed
for bacterial endotoxins. Testing for medical devices should be conducted using
rinsing/eluting and sampling techniques as described in ISO 10993-1 and ISO
10993-12, as also used for inhibition/enhancement. Sampling can be adjusted for
special situations. After a suitable eluate/extract pool is obtained from a finished
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production lot, this pooled extract should be kept under conditions appropriate for
stability until it is tested in duplicate.
FDA recommends that pooled samples be a composite of aseptically removed
aliquots (after at least 30 seconds of vigorous mixing) from each of the product
containers. In this way, the original, individual containers will be available for possible
Some product types should not be pooled. Two examples are drug products that
have an initial low MVD (see discussion above of adjusted MVD) and products that
Response 2:
FDA does not recommend pooling in-process samples from different in-process
Response 3:
When conflicting results occur within a test run, the analyst should consult USP
Chapter <85>, Gel Clot Limits Test, Interpretation, for guidance on repeat testing. As
specified in Chapter <85>, if the test failure occurred at less than the maximum valid
dilution (MVD), the test should be repeated using a greater dilution not exceeding the
MVD. A record of this failure should be included in the laboratory results. If a test is
performed at the MVD and an out-of-specification (OOS) test result occurs that
cannot be attributed to testing error, continue product dilution until the actual
your worksheets.
B.
Kinetic Assays
Kinetic assays are quantitative assays used for the detection of bacterial endotoxins.
Kinetic assays may utilize turbidimetric or chromogenic formats.
This section provides procedural information that can be applied to the QCL
chromogenic assay. The Kinetic QCL Chromogenic Assay may be purchased as a kit.
A certificate of analysis is provided with each kit along with testing procedures, control
standard endotoxin, Limulus Amebocyte Lysate (LAL), and pyrogen free water. Other
materials such as pyrogen free pipettes, micropipettor tips, test tubes, and 96-well
microplates may be purchased from various vendors.
1. Kinetic QCL Assays: The kinetic QCL software program is designed to run the
following assays.
i. Initial qualification of the testing analyst
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2. Procedure
Perform the assay according to the instructions that enclosed with the LAL test kit.
Additional instructions may be found in references 8 and 9 listed below.
C.
Medical Devices
The analytical approach for testing medical devices is sparsely covered in USP. A
collaborated method prepared by an FDA field laboratory is available for extraction of
endotoxin from devices. Modification of testing may be necessary depending on the
product configuration. Analytical validation of the final version should be conducted by
the responsible laboratory. The protocol is summarized below for convenience:
1. Extraction and analysis of Endotoxin from Medical Devices:
This section applies to sterile disposable syringes and cartridges, transfusion and
infusion assemblies, implants, etc.
a. Preparation of 1% SLS solution
Prepare a 1% stock solution by placing one (1) gram of sodium lauryl sulfate
(SLS) into a depyrogenated glass flask and add 99 ml of pyrogen free water.
Allow the SLS to fully dissolve. This should be followed by filtration through a 10,
000 MW depyrogenation membrane filter into a pyrogen free glass or plastic
container.
b. Equipment needed: Ultrasonic bath with a range of 150 to 440 watts.
c. Extraction procedure
i. Dilute 2mL of 1% SLS stock solution to 20mL (0.1%) using LAL reagent
water in a 20 x 150 mm screw-cap tube.
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ii. Dilute 1.5mL of the 0.1% SLS solution to 15 mL (0.01%) using LAL
reagent water in a 20 x 150 mm screw-cap tube.
iii. Prepare the appropriate number of tubes (one tube for each device)
and one as a negative / system control. Preheat in a waterbath to
40C.
iv. Aseptically remove the device from its packaging and cut it diagonally
into pieces less than 5mm in length. Metal pieces such as needles and
luer-locks should be tested whole.
v. Place all pieces into the 20 x 150 mm tube containing 15 mL of
preheated (40C) 0.01% SLS rinse solution.
vi. Vortex the tubes for 30 60 seconds or until all pieces of the device are
immersed in the rinse solution.
vii. Sonicate the test containers for 60 minutes (wattage range 150 480
watts) at 40C. Do not sonicate more tubes than can be vortexed within
15 minutes of completion of the sonication. Make sure the water in the
sonicator covers the rinse solution in the 20 x 150 mm tubes. Do not
allow the water in the sonicator to exceed 50C.
viii. Vortex the tubes for 2 minutes. Remove a portion of the eluate (5 10
mL) for LAL testing. If the eluates are not tested immediately for
endotoxin, they should be refrigerated. All eluates must be tested within
24 hours of extraction. Prior to analysis vortex at least one minute.
ix. Screen all eluates for endotoxin content using 10-fold dilutions to the
10-3 dilution. Prepare dilutions using pyrogen free water in pyrogen
free tubes. Positive and negative controls must be run simultaneously
with all LAL tests.
x. Quantitate the eluate by making 1:2, 1:4, 1:6, 1:8 dilutions of the last
positive 10-fold dilution in step 8.
D.
Endotoxin References
1. United States Pharmacopeia (USP) Chapter <85> Bacteria Endotoxins Test. Official
December 1, 2012
2. The U.S. Food and Drug Administration, Guidance for Industry, Pyrogen and
Endotoxins Testing: Questions and Answers, June 2012
3. Guilfoyle, D.E., Yager, J.F. and S.L. Carito. 1989. The effect of refrigeration and
mixing on detection of endotoxin in parenteral drugs using the Limulus Amebocyte
Lysate (LAL) test. J. Parenteral Science & Technology. Vol 43, No 4, p. 183-187
4. Novitsky, T.J., Schmidt-Gengebach, J. and J.F. Remillard. 1986. Factors affecting
recovery of endotoxin adsorbed to container surfaces. J. Parenteral Science &
Technology. Vol 40, No 6, P. 284-286
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5. Twohy, C.W., Duran, A.P. and J.T. Peeler. 1986. Extraction of bacterial endotoxin
from medical devices. J. Parenteral Science & Technology. Vol 40, No 6, p. 287-291
6. Guilfoyle, D.E. and T.E. Munson. 1982. Procedures for improving detection of
endotoxin in products found incompatible for direct analysis with Limulus amebocyte
lysate, in Endotoxins and Their Detection with the Limulus Amebocyte Lysate Test.,
Watson, S.W., Levin, J., and Novitsky, T.J. (eds), Alan R. Liss Inc., NY, p. 79-90
7. Guilfoyle, D.E., Munson, T. and J.P. Schrade. 1981. Use of Pyrospheretm for
Reducing Product Interference in the Limulus Amebocyte Lysate Test, Laboratory
Information Bulletin, U.S. Food and Drug Administration, Washington D.C., No. 2503
(115), p. 1-8
8. Tepedino, A., Guilfoyle, D.E. and Munson, T. 1980. A Condensed Procedure for
Diluting Product in Determining Compatibility (Inhibition / Enhancement test) with the
Limulus Amebocyte Lysate Test for Endotoxin, Laboratory Information Bulletin, U.S.
Food and Drug Administration, Washington D.C., No. 2433, p. 1-17
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A.
The test applies to large-volume injections labeled as containing more than 100 mL and
single-dose or multiple-dose small-volume injections labeled as containing 100 mL or
less that are either in solution or in solution constituted from sterile solids, where a test
for particulate matter is specified in the individual monograph or drug product
specification. It counts suspended particles that are solid or liquid. Products for which
the labeling in the individual monograph specifies that the product is to be used with a
final filter are exempt from these requirements.
1. Test Apparatus
The apparatus is an electronic, liquid-borne particle counting system that uses a lightobscuration sensor with a suitable sample feeding device. A variety of suitable devices
of this type are commercially available. It is the responsibility of those performing the test
to ensure that the operating parameters of the instrument are appropriate to the required
accuracy and precision of the test result and that adequate training is provided for those
responsible for the technical performance of the test. It is the responsibility of the user to
apply various methods of standardization applicable to the specific instrument.
Critical operational criteria consist of the following:
a. Sensor Concentration Limits
Use an instrument that has a concentration limit (the maximum number of
Text in portions of this document chapter was selected from the current United States Pharmacopeia (USP).
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particles per ml) identified by the manufacturer that is greater than the
concentration of particles in the test specimen to be counted. The vendorcertified concentration limit for a sensor is specified as that count level at which
coincidence counts due to simultaneous presence of two or more particles in the
sensor view volume comprise less than 10% of the counts collected for 10
micron particles.
b. Sensor Dynamic Range
The dynamic range of the instrument used (range of sizes of particles that can be
accurately sized and counted) must include the smallest particle size to be
enumerated in the test articles.
2. Instrument Standardization
The following discussion of instrument standardization emphasizes performance
criteria rather than specific methods for calibrating or standardizing a given
instrument system. This approach is particularly evident in the description of
calibration, where allowance must be made for manual methods as well as those
based of firmware, software, or the use of electronic testing instruments.
Appropriate user validation of software and firmware systems is essential to
performance of the test according to requirements. Since different brands of
instruments may be used in the test, the user is responsible for ensuring that the
counter used is operated according to the manufacturer's specific instructions. The
principles to ensure that instruments operate within acceptable ranges are defined
below.
The following information for instrument standardization helps ensure that the
sample volume accuracy, sample flow rate, particle size response curve, sensor
resolution and count accuracy are appropriate to performance of the test.
a. Sample Volume Accuracy
Since the particle count from a sample aliquot varies directly with the volume of
fluid sampled, the sampling accuracy must be known to be within a certain range.
i. For sample volume determination, determine the dead (tare)
volume in the sample feeder with Water for Injection or distilled
water that has been passed through a filter having a porosity of
1.2 microns or finer.
ii.
iii.
iv.
v.
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Verify that the flow rate is within the manufacturer's specifications for the sensor
used. This may be accomplished by using a calibrated stop watch to measure
the time required for the instrument to withdraw and count a specific sample
volume (i.e. the time between beginning and ending of the count cycle as
denoted by instrument indicator lights or other means). Perform the Test
Procedure at the same flow rate as that selected for calibration of the instrument.
c. Calibration and Sensor Resolution
There are three methods of choice depending on the type of system used:
Manual, Automated and Electronic methods. Please refer to the current USP for
guidance.
i.
Prepare the suspension and blank using the USP Particle Count
RS.
Set the instrument to count at 10 and 25 microns (the apparatus is
calibrated using dispersions of spherical particles of known sizes
between 10m and 25m), according to USP <788>.
ii.
iii.
Remove the closure from the container and gently stir the
contents by hand-swirling or by mechanical means, taking care
not to introduce air bubbles or contamination. Stir continuously
throughout the analysis. Note: Electronic Particle Analyzers have
a mixing stand attached to the instrument for this purpose.
iv.
v.
Obtain particle counts and discard the data from the first portion.
NOTE: Complete procedure within five minutes.
vi.
vii.
From the averages of the counts resulting from the analysis of the
two portions of the suspension at 10 microns and from the
analysis of the two portions of the blank at 10 microns, calculate
the number of particles in each ml taken as follows: Subtract the
average particle count of the blank from the average particle count
of the suspension, then divide the result by the average volume of
the 4 portions tested. This can be summarized in the following
formula:
(Ps - Pb)/V
in which Ps is the average particle count obtained from the
suspension, Pb is the average particle count obtained from the
blank, and V is the average volume, in ml, of the 4 portions tested.
viii.
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ix.
x.
xi.
If the results of the second test are within the limits given above,
the instrument meets the requirements of the Particle Counting
Accuracy Test. If on the second attempt the system does not
meet the requirements of the test, determine and correct the
source of the failures and retest the instrument.
3. Test Environment
a. Perform the test in an environment that does not contribute any significant
amount of particulate matter. Note: Glassware from Qorpack come in particle
free packages which is a suitable particulate free vehicle for compositing
liquid samples.
b. Specimens must be cleaned to the extent that any level of extraneous
particles added has a negligible effect on the outcome of the test.
c. The test specimen, glassware, closures and other required equipment
preferably are prepared in an environment protected by high efficiency
particulate air (HEPA) filters.
d. It is preferable to wear non-shedding garments and powder-free gloves
throughout the preparation of samples.
e. Cleanse glassware, closures and other required equipment preferably by
immersing and scrubbing in warm water, nonionic detergent solution. Rinse
in flowing tap water and then rinse again in flowing filtered water. Organic
solvents may also be used to facilitate cleaning. Note: Particle free glassware
is available which reduces the chance of contamination with environmental
particles.
f. Finally, rinse the equipment in filtered water using a hand-held pressure
nozzle with final filter or other appropriate water source, such as distilled
water passed through a capsule filter. The filter used should have a porosity
of 1.2 microns or finer.
g. To collect background counts:
i. Use a clean vessel of the type and volume representative of that
to be used in the test.
ii.
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iv.
v.
vi.
4. Test Procedure
For containers having volumes of less than 25 mL, test a solution pool of 10 or more
units to obtain a volume of no less than 25 mL. Single units of small-volume injections
may be tested individually if the individual unit volume is 25 mL or greater.
Prepare the test specimens in the following sequence:
a. Agitate the contents of the sample by inverting the container 20 times.
b. Remove outer closures, sealing bands, and any loose or shedding paper
labels.
c. Rinse the exterior of containers with particle free water as described under
Test Environment, and dry. Take care to protect the contents of the
containers from environmental contamination.
d. Allow the container to stand for 2 minutes or sonicate in order to remove gas
bubbles.
e. Withdraw the contents of the containers in the normal or customary manner
of use, or as instructed in the package labeling. Containers with removable
stoppers may be sampled directly by removing the closure. Optional: If test
specimens are being pooled, remove the closure and empty the contents into
a clean container.
5. Determination of Particle Counts
a. Method for Small Volume Parenterals
NOTE: Because of the small volume of some products, it may be necessary to
agitate the solution more vigorously in order to suspend the particles completely
and homogeneously.
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i.
ii.
iii.
iv.
Withdraw not less than 4 aliquot portions, each not less than 5 mL
in volume, into the light obscuration counter sensor.
v.
Obtain the particle counts, and discard the data from the first
portion.
ii.
Obtain particle counts, discarding the data from the first portion.
iii.
iv.
v.
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vi.
vii.
Obtain the particle counts, and discard the data from the first
aliquot.
For products packaged in containers that are constructed to hold the drug
product and a solvent in separate compartments, mix each unit as directed in the
labeling, activating and agitating each unit so as to ensure thorough mixing of the
separate components. Analyze the solutions as described under methods for
large or small volume parenterals depending on container volume.
e. Multiple-dose Containers
For products labeled Pharmacy Bulk Packages, proceed for each unit as directed
under method for small volume parenterals, calculating the results on the basis of
a sample volume that is equal to the maximum dose stated in the labeling. For
the calculations below, consider a maximum-dose volume to be the equivalent of
the contents of one full container.
6. Calculations
a. Pooled Samples (Small-volume Injections)
Average the counts from the 2 or more aliquot portions analyzed. Calculate the
number of particles in each container by multiplying the average particle count
obtained from the portion by the volume of the pooled sample in mL, and divide
by the product of the volume of each portion analyzed and the number of
containers pooled. This calculation is summarized by the formula:
PVt/Van
in which P is the average particle count obtained from the portion analyzed, Vt is
the volume of pooled sample, in mL, Va is the volume, in mL of each portion
analyzed, and n is the number of containers pooled.
b. Individual Samples (Small-volume Injections)
To calculate the number of particles in each container, average the counts
obtained for the 5 mL or greater aliquot portions from each separate unit
analyzed, multiply by the volume in mL of the unit tested, and divide this result by
the volume in mL of each portion analyzed. This calculation is summarized by
the formula:
PV/Va
in which P is the average particle count obtained from the portions analyzed, V is
the volume, in mL, of the tested unit, and Va is the volume, in mL, of each portion
analyzed.
c. Individual Unit Samples (Large Volume Injections)
To calculate the number of particles in each mL, average the counts obtained for
the two or more 5 mL aliquot portions taken from the solution unit, then divide by
the volume in mL of the portion taken. This calculation is summarized by the
formula:
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P/V
in which P is the average particle count for an individual 5 mL or greater sample
volume, and V is the volume, in mL, of the portion taken.'
7. Interpretation
The injection meets the requirements of the test if the calculated number of particles
present in each discrete unit tested or in each pooled sample tested does not exceed
the appropriate value listed in Table 1. If the average number of particles exceeds
the limit, test the article by the Microscopic Particle Count Test.
Table 1. Light Obscuration Test Particle Counts
10 microns
25 microns
Small volume
6000 per
600 per container
Injections:
container
Large-volume
25 per mL
3 per mL
Injections:
8. Particulate Matter in Ophthalmic Solutions
Every ophthalmic solution for which the monograph or drug product specification
includes a test for particulate matter is subject to the particulate matter limits set forth
for the test being applied, unless otherwise specified in the individual monograph or
specification. When higher limits are appropriate, they will be specified in the
individual monograph or specification. Ophthalmic preparations that are
suspensions, emulsions, or gels are exempt from these requirements, as are medical
devices. Refer to the specific monograph when a question of test applicability
occurs.
Light obscuration and microscopic procedures for the determination of particulate
matter in ophthalmic solutions are identical to those for injections; therefore, where
appropriate, USP <788> Particulate Matter in Injections is cross-referenced.
a. Light Obscuration Particle Count Test
This test applies to ophthalmic solutions, including solutions constituted from
sterile solids, for which a test for Particulate matter is specified in the individual
monograph. The test counts suspended particles that are solid or liquid.
i.
Test Apparatus, Instrument Standardization, Test Environment,
Test Procedure, and Calibrations: Proceed as directed for Light
Obscuration Particle Count Test under USP <788> Particulate
Matter in Injections.
ii.
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B.
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The test is carried out under conditions limiting particulate matter, preferably
in a laminar flow cabinet.
Very carefully wash the glassware and filter assembly used, except for the
membrane filter, with a warm detergent solution, and rinse with abundant
amounts of water to remove all traces of detergent. Immediately before use,
rinse both sides of the membrane filter and the equipment from top to bottom,
outside and then inside with particle free water. In order to check that the
environment is suitable for the test, that the glassware and the membrane
filter are properly cleaned, and that the water to be used is particle-free, the
following test is carried out. Determine the particulate matter of a 50-ml
volume of particle-free water according to the method described below. If
more than 20 particles of 10um or larger in size or if more than five particles
25 um or larger in size are present within the filtration area, the precautions
taken for the test are not sufficient. The preparatory steps must be repeated
until the environment, glassware, membrane filter and water are suitable for
the test.
5. Method
Mix the contents of the samples by slowly inverting the container 20 times
successively. If necessary, cautiously remove the sealing closure. Clean the
outer surfaces of the container opening using as jet of particle-free water, and
remove the closure, avoiding any contamination of the contents.
For large volume parenterals, single units are tested. For small volume
parenterals less than 25 ml in volume, the contents of 10 or more units are
combined in a cleaned container; the test solution may be prepared by jixing
the contents of a suitable number of vials and diluting 25 ml with particle-free
water or with an appropriate particle-free solvent when particle-free water is
not suitable. Small volume parenterals having a volume of 25 ml or more may
be tested individually.
Powders for parenteral use are constituted with particle-free water or with an
appropriate particle-free solvent when particle-free water is not suitable.
The number of test specimens must be adequate to provide a statistically
sound assessment.
For large volume parenterals or for small volume parenterals having a volume
of 25 ml or more, fewer than 10 units may be tested, using an appropriate
sampling plan.
Wet the inside of the filter holder fitted with the membrane filter with several
ml of particle-free water. Transfer to the filtration funnel the total volume of a
solution pool or of a single unit, and apply a vacuum. If needed, add stepwise
a portion of the solution until the entire volume is filtered. After the last
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addition of solution, begin rinsing the inner walls of the filter holder by using a
jet of particle-free water. Maintain the vacuum until the surface of the
membrane filter is free from liquid. Place the membrane filter in a Petri dish,
and allow the membrane filter to air-dry with the cover slightly ajar. After the
membrane filter has been dried, place the Petri dish on the stage of the
microscope, scan the entire membrane filter under the reflected light form the
illumination device, and count the number of particles that are equal to or
greater than 10um and the number of particles that are equal to or greater
than 25um. Alternatively, partial membrane filter count and determination of
the total filter count by calculation is allowed. Calculate the mean number of
particles for the preparation to be examined.
The particle sizing process with the use of the circular diameter graticule is
carried out by estimating the equivalent diameter of the particle in comparison
with the 10um and 25 um reference circles on the graticule. Thereby the
particles are not moved from their initial locations within the graticule field of
view and are not superimposed on the reference circles for comparison. The
inner diameter of the transparent graticule reference circles is used to size
white and transparent particles, while dark particles are sized by using the
outer diameter of the black opaque graticule reference circles.
In performing the Microscopic Particle Count Test, do no attempt to size or
enumerate amorphous, semiliquid, or otherwise morphologically indistinct
materials that have the appearance of a s stain or discoloration on the
membrane filter. These materials show little or no surface relief and present a
gelatinous or film-like appearance. In such cases, the interpretation of
enumeration may be aided by testing a sample of the solution by the Light
Obscuration Particle Count Test.
6. Evaluation:
For preparations supplied in container with a nominal volume of more than
100 ml, apply the criteria for Test 2.A.
For preparations supplied in containers with a nominal volume of less than
100 ml, apply the criteria for Test 2.B
For preparations supplied in containers with a nominal volume of 100 ml,
apply the criteria for Test 2.B (Note: Test 2.A is used in the Japanese
Pharmacopeia).
Test 2.A: (Solutions for parenteral infusion or solutions for injection supplied
in containers with a nominal content of more than 100 ml)-The preparation
complies with the test if the average number of particles present in the units
tested does not exceed 12 per/ml equal to or greater than 10 um and does
not exceed 2 per/ml equal to or greater than 25 um.
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Test 2.B (Solutions for parenteral infusion or solutions for injection supplied in
containers with a nominal content of less than 100 ml)-The preparation
complies with the test if the average number of particles present in the units
does not exceed 3000 per container equal to or greater than 10 um and does
not exceed 300 per container equal to or greater than 25 um.
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A.
Materials/Equipment
1. Sampling Materials
a. Sterile Dacron or cotton swab with a sterile transport media solution.
b. Alternative sampling system:
c. Sterile sponge with detachable handle
d. *Hycheck surface samplers
e. *RODAC plates (with locking lid)
*Use media containing lecithin and tween neutralizers
f. Sterile Whirl-pak bags.
g. Sterile water for irrigation or sterile saline held in screw cap containers.
h. Dey/Engley (D/E) neutralizing broth
i. Sterile 70% alcohol spray bottle or wipes
j. Black magic marker (permanent, fine point).
k. Digital Camera
2. Testing Equipment and Materials
a. Biological Safety Cabinet (BSC) with HEPA filtration
b. Laminar Flow Hood (LFH) with HEPA filtration
c. 10% Bleach or appropriate disinfectant/sporicide
d. Sterile 70% ethanol (ETOH) or Isopropyl Alcohol (IPA)
e. Sterile Sleeves
f. Sterile Gloves
g. Hair Net
h. Lab Coat
i. Beard Cover and/or Mask
j. Incubator set at 32.5C 2.5C
k. Incubator set at 22.5C 2.5C
l. Modified Letheen Broth (MLB)
m. Modified Letheen Agar (MLA)
n. Sabouraud Dextrose Broth
o. Sabouraud Dextrose Agar
p. Malt Extract Agar w/chlorotetracycline
q. TSA w/5% Sheep Blood Agar
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r.
s.
t.
u.
v.
w.
B.
MacConkey Agar
RODAC plates
Hycheck slides
Soybean Casein Digest Agar (TSA)
Soybean Casein Digest Broth (with neutralizers)
Neutralizers (i.e. lecithin, tween, etc...)
Sampling Preparation
C.
EM Sampling Procedure
It is recommended that the investigative team bring equipment for both qualitative and
quantitative EM methods. Qualitative methods utilizing sponges/ swabs are used for
hard to reach areas. RODACs or Hychecks are employed for the quantitative method to
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enumerate microbes on open flat work surfaces. See suggested sampling locations
listed in section E of this procedure.
1. Disinfect gloved hand with a suitable sanitizing agent (i.e. sterile 70% alcohol).
a. Repeat this step between each EM sample.
b. Allow gloves to air dry so no alcohol is dripping from gloves.
c. Some swab/sponge sampling packages include a secondary set of sterile
gloves. In these instances, the secondary glove can be aseptically used on
top of the primary gloves to expedite the sampling process. The secondary
pair of gloves will need to be disposed of aseptically after use. If the primary
gloves touch the secondary gloves outer surface, then a suitable sanitizing
agent must be used on the primary gloves. Allow primary gloves to air dry
after sanitizing.
d. When sampling a Class 100 scenario. For example,
i. Verify current certification of LFH/BSC
ii. Allow LFH/BSC to run approximately 10 minutes before initiating
sampling
iii. Wipe down all outer sampling containers with a suitable sanitizing
agent before placement in the LFH/BSC
iv. Do not open sampling materials outside the LFH/BSC
2. Qualitative Swabbing
a. Open a sterile swab (or sponge). Dampen with wetting agent (sterile water,
saline, or D/E neutralizing broth) and squeeze off excess by pressing against
the inside of the container holding the wetting agent.
b. Apply swab (or sponge with handle) to surface (or equipment) being
monitored with firm application pressure. Be sure to emphasize that the swab
contact should be firmly pressed against the surfaces being sampled.
c. When sampling (monitoring) flat surfaces allow the swab (or sponge with
handle) to firmly rub an area of approximately 24 to 30 cm2.
d. Apply the swab (or sponge) within this contact area in both a horizontal and
vertical direction for approximately 10 seconds (count it out).
e. Replace the swab (or sponge) back into the carrier container (if it came with
one) and place into the sterile Whirl-pak bag. (Be sure to break off the
handle portion of the sponge applicator stick.)
3. Quantitative RODAC/Hycheck Sampling
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a. Carefully remove the lid of RODAC plate or loosen the cap on the Hycheck
slide tube. Take care not to touch the agar surface.
Note: Examine agar for contamination and or dehydration
b. Gently but firmly touch the RODAC agar surface against the area being
sampled, exert moderate, even, vertical pressure and then carefully replace
lid. Avoid using rubbing motions with the plate at the sample site as this may
break the agar.
c. When using Hycheck press down on the spike to bend the paddle at the
hinge line gently lowering the slide and press the agar to the surface with firm
and even pressure. Repeat this step using the 2nd agar surface on an area
adjacent to the initial test site. Replace slide in container and close tightly.
4. Place the EM sample into a sterile Whirl-pak bag and identify the bag immediately
after.
5. Assign a consecutive number to the sample (i.e.1, 2, 3, etc.), in addition include the
date, location of sample site (be specific) and your initials. Record in your
inspectional record book the swab number and the location of the swab site.
6. Later, place all the Whirl-pak bags in an officially sealed plastic or brown paper bag.
Do not freeze or refrigerate. Freezing can kill the microbes and the cold can induce
a shock to vegetative cells. These microbes were surviving at room temperature
(ambient). Therefore, an ambient temperature should be maintained during
transportation.
7. Place into a suitable mailing container to prevent crushing or physical damage to the
swabs. The container should have some insulation capacity to prevent extreme
temperature (freezing or excessive heat).
8. Ensure contact with the receiving laboratory in advance regarding pending samples
in order for them to have appropriate personnel and materials for sample set up
within 48 hours.
D.
When on an inspection, do not allow the firm to disinfect the work area prior to sampling.
The presence of disinfectant on the swab may reduce the microbial bioburden or
increase inhibition during broth incubation. When collecting EM samples start in
locations that are under the greatest control (ISO 5- HEPA filtered LFH/BSC or Isolator)
and sample to lesser controlled areas (areas outside the work station but still within the
room).
1. Swab the frequently utilized surfaces within the controlled work station such as:
a. Center of work surface
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b.
c.
d.
e.
f.
E.
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F.
Analytical Procedure
1. Approximately 100 ml of sterile media (i.e., SDB, MLB, etc.) should be aseptically
added to each plastic bag containing a square sponge swab. Mix or swirl
thoroughly.
2. Approximately 10 ml of sterile media (i.e., SDB, MLB, etc.) should be aseptically
added to each tube containing a swab. Mix or swirl thoroughly.
3. All swabs are incubated at 25C- 30C for at least 14 days to allow for the
resuscitation of potentially stressed microbes.
4. Hycheck slides and RODAC plates should be directly incubated at 20C- 35C for
at least 5-7 days. Longer incubation times may be required when contaminants
are suspected to be slow growing. Check plates daily for colony formation to
minimize obscuring visualization of smaller colonies by over growth.
a. Count and record the number of colony forming units for RODAC plates.
All colony types should be picked and re-streaked for purity and
subsequently identified.
b. Count the number of colonies on both sides of the paddle for the Hycheck
slide. Report the colony counts for each side of the paddle and all colony
types should be picked and re-streaked for purity and subsequently
identified.
5. Check all swabs daily for turbidity and subculture for isolation as turbidity is
observed. All sub culturing must be performed under LFH or BSC.
6. Subculture all turbid swabs onto a combination of non-selective media (i.e. MLA,
etc.) and selective/differential media (i.e. MacConkey agar, MEA, etc.). It is
recommended to include TSA w/5% Sheep Blood Agar as one of the differential
media for subculturing.
a. Fungal media should be incubated at 20 to 25 for 5 to 7 days. Possibly
longer but no more than 14 days
b. All other cultural media should be incubated at 30 to 35 for 2 to 3 days.
7. Re-incubate all cultured swabs until the full incubation (14 days) timeframes are
met.
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8. Culture all submitted negative controls & diluents in order to confirm that the
equipment or any aseptic techniques were not compromised.
9. Once isolation of the organism is achieved, perform microbial characterization
and identification following USP <1113> Microbial characterization, Identification
and Strain Typing, as guidance. Typically, rapid identification systems (i.e.
VITEK) are employed after primary screening and characterization are
performed. Other identification platforms may be beneficial if acceptable
identification is not obtained through biochemical testing.
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1. Purpose
To standardize and implement a protocol that can rapidly identify microbial
presence in drugs intended to be sterile through direct microscopic staining.
2. Scope/Policy
Any sample received with visible, potentially microbiological matter in a sterile
drug must be given the highest priority for testing, due to the importance of
quickly ascertaining whether the product poses an infection risk to patients. This
procedure requires all ORA laboratories involved in microbiological testing of
sterile pharmaceutical products to conduct microscopic screening of samples that
appear to have visible contamination.
3. Responsibilities
ORA Microbiology Laboratories that routinely test pharmaceutical products using
the USP compendia methods must adopt a rapid screening practice to visually
examine sterile pharmaceutical products that appear to have macroscopic
contamination by using a direct microscopic staining protocol to determine if
microbial contamination is present. It is the responsibility of the analyst to note
any modifications to this procedure in the worksheet.
4. Background
FDA analysis of marketed drugs purporting to be sterile and containing visible
foreign matter has revealed microbial contamination, which has been linked in
some cases to outbreaks of patient infections and fatal outcomes. Because
microbiologically contaminated products pose a grave health hazard to patients
and the consequences of exposure to contaminated product can be mitigated
once healthcare providers and their patients are alerted, it is important for FDA to
obtain analytical information as early as possible when microbial contamination is
suspected.
This requires the FDA laboratory to undertake special measures upon receipt of
a sample with visible, potentially microbiological contamination. Accordingly,
CDER and ORA have met and agreed on recommendations for the immediate
conduct of a microscopic screening test, under specified circumstances, to
rapidly identify microbiological contamination in products purporting to be sterile.
The objective of this protocol is institute rapid microscopic screening in ORA
laboratories to expedite provision of the analytical findings to ORS and CDER.
5. Procedure
a. Before Sample is transferred to Class 100 Clean room or Sterility
Test Isolator
i. Remove and count the number of product units from the sample
collection package bag and examine each unit to confirm the
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Medical Product
C:\Documents and
Settings\marilyn.khanAdverse Event Trackin
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14. Request a list of the entire laboratorys Microbiological Data Deviations (OOS/OOL
results) and Corrective Action Preventative Actions (CAPA) ( since last FDA on-site
inspection)
15. Stability Testing sample storage conditions, missed sampling dates, etc.
B.
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port sanitization or sterilization problems; problem with skip lot testing on raw
material.
9. Maintenance records- determine dates, and location of equipment failure or out-ofservice that may have an impact on microbial ingress; looks for signs of roof leaks
and water stains on ceiling panels, the degree of dirt and dust accumulation on
supply and exhaust vents; Ask about new construction, plumbing or air handling
system and the reason for change.
10. Compressed Air Systemssterile process air, microbial particulate filtration (0.2 m,
hydrophobic), condensate causing blockage & microbial growth, routine point-of-use
sampling, maintenance, filter integrity test
C.
What to review when all the firms Sterility and/or Microbial Limits test results indicate no
microbial growth and you need to know whether this is true:
1. Medium- Growth Promotion; pH; Low agar or broth volume in container, Incubator
temp not set correctly; improper medium storage after QC (crystals from freezing,
inadequate mixing prior to dispensing, agar plates dried out during incubation, etc.)
2. Method Suitability testing- Validation for Sterility; Preparatory testing (BET). May
need added neutralizers, product dilution, filtration; water chemical contaminant with
toxin effects in buffers, Not following method (excess of product added to broth
during test but not during suitability testing, etc)
3. Improper tube or agar plate examination- check filter surface on submerged filter
membrane (mold budding); surface film, light hazy growth in Thio broth, microbes
settle to bottom of tube, pinpoint colonies (microaerophilic); medium not inoculated.
Disinfection process adds antimicrobial residue onto/into product during sample
preparation; Gas used for Isolator sterilization with medium inside chamber may
penetrate into liquid broth and/or test product packaging
4. Fastidious microorganisms found in the product bioburden may require special
additives to the medium- Halophilic contaminants in bicarbonate, or high salt
products need medium supplements with essential salts for survival
5. Water test method- membrane filter with a 0.45 micron pore size may miss quantities
of water-borne organisms. Suitability testing necessary. Note: USP <71> only
requires pore size not greater than 0.45m.
6. Inadequate incubation time (14 days)/temp (USP required temps)
7. Possible falsification or incorrect entry onto worksheets or Laboratory LIM system.
Compare LIMs database entries to the analysts laboratory notebook; Phrase the
question When you get a positive test result. not If you get a positive test
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result... Inspect the laboratory refrigerator or freezer for evidence of stored sample
isolates. If they lyophilize sample isolates ask to review the spread sheet data
storage directly from the computer screen; hard copies could be obtained later.
Review the Vitek or Micro Id isolate log book for all microorganisms identified and
work backwards to the product lot number, filling rooms, equipment used,
components or raw material used for that lot. This may allow you to find other lots
associated with the contaminated lot.
8. Personnel- review training records and personnel qualifications and experience
Observe analysts during sample collection, preparation, etc., to look for errors which
may inhibit microbial recovery.
9. Visit the microbiology laboratory and look into the refrigerators, incubators, discarded
plates from that days work or request speciation log book and determine if microbial
recovery has occurred, but not recorded on official worksheets or entered into LIMs.
D.
When you encounter inspectional evidence that the firm has manufactured
microbiologically contaminated product, the few suggestions listed below should help
you evaluate and proceed with this information.
1. Documentation- Review and obtain copies of all records for lots indicating
contamination; determine if there are other lots manufactured either before or after
the bad lot(s); Review all associated activity and equipment related to the
contaminated lot. There may be common water, mixing tanks. Piping, raw material,
sterilizers, filters, etc that may have been cross contaminated and transferring
microbes to subsequent lots of products.
2. Review current established validation studies for product/component sterilization
(disinfection for non-sterile products); has there been any equipment changed or
modified; has there been a change of personnel or training; any new source material
for equipment (vent filters, gaskets, filter manufacturer, etc.); any processing
changes or room modifications, construction elsewhere in the facilities, etc.
3. Review of Environmental monitoring (EM) procedures and results for manufacturing
and laboratory area- Would the product contaminant grow on the EM medium; was
the product contamination found in the manufacturing area; Growth promotion
potential of contaminant in other medium (i.e., TSB and Thio)
4. Speciation- Record and copy the method of identification (i.e. API, Vitek, etc);
Determine if there were possible secondary contaminants that were not identified or
recorded (check original plates, or isolates); verify accuracy into the LIM system.
5. Determine potential source- Staphylococcus (skin, insect, etc); Pseudomonas (water,
plants, etc) ; yeast and mold (spores) (environmental)
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E.
1. When a firm has an end product test result that indicates a failure (USP test failure,
OOS, etc) the inevitable question is Were the results laboratory error or a true
process contamination? Below are a few starter questions to help in your FDA review
of the firms investigative report.
2. During the subsequent investigation, there are two areas for the review to focus: the
manufacturing site and the laboratory that determined the OOS result. The following
review questions suggest possible variables that may impact the final conclusions.
The investigations may run concurrently between manufacturing and the laboratory.
For ease of review I listed my questions first with manufacturing and secondly with
laboratory data. I divided the manufacturing review into aseptic manufacturing (High
risk) and terminally sterilized products (low risk). Part two covers those questions
that I would ask for a critical review of the microbiological data accumulated for the
Sterility failures, Microbial limits failures, etc.
F.
1. Review QC records for proper/validated sterilization of all equipment and media used
during the sterility test method: manifold/ steritest; rinse fluid, culture media, canister
kits, etc.
2. Review the EM data acquired during sterility testing (i.e., settling plates, RODAC),
simulation system controls, etc. What are the microbial species and its determined
normal habitat (i.e., water, plants, people, etc?)
3. Review training records and qualification of analysts performing the test; interview
and/or observe analysts
4. Review the qualification of the bio-clean room facilities or isolator chamber used
during testing. Are there any leaks in the gloves, improper sanitization of product
container before placement into work station or isolator? Has the isolator been
evaluated for leaks?
5. Review cleaning and sterilization requirements for reusable glassware and
equipment. Poorly cleaned glassware will make sterilization of equipment more
difficult and possibly shelter trapped microbes from the killing effect of the sterilant.
6. Review laboratory areas used for sub-culturing the sterility test medium onto
enrichment plates. Cluttered work space or un-sanitized surfaces may cause plate
contamination.
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7. Check the original plates used for isolation for possible pre-existing contamination
(i.e. growth in non-streaked locations on the agar surface, subsurface growth)
8. Check to see if the medium had been recalled or has had past problems with
contamination during manufacturing.
9. It may be necessary to perform a genotype identification on the two isolates (product
source and manufacturing area isolate) if they are the same species.
G.
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Has there been a change or breach in the personnel barrier system to protect the
product? Were there any interventions by maintenance or other staff personal during the
manufacturing of the contaminated lots? Review glove/uniform monitoring results.
Review the Antimicrobial Effectiveness challenge studies for the product. Where there
any changes to the container/closure component source or requirements?
Were there any changes to the disinfection procedure, reagents use, new personnel,
application, equipment (mops, aerosols, etc.) etc.?
2. Terminally sterilized drug product
Check autoclave validation studies for sterilization process- cold spot, heat penetration
(challenged inside dry tubing, connectors/caps/stoppers, largest liquid volume, etc.),
changes in chamber load configuration, etc.)
Check maintenance records for house steam, records for autoclave repair, new
plumbing
Check Biological Indicator (BI) information- improper storage of BIs; changes in the
culture (inoculum level and/or BI organism species) and incubation parameters
Evaluate the heat resistance characteristics of the microbial isolate found in the product
during Sterility testing and determine if it can survive during the process condition ,
review product container/closure integrity data and possible recent supply source
changes to vials or rubber stoppers; Check possible post sterilization package integrity
problem- mostly medical device issue.
H.
Using the Inspectional criteria described in the FDA Compliance Program Guidance
Manual Program 7356.002, I selected only key coverage elements listed in five of the six
(6) Inspectional Systems that relate to microbiological issues and in some cases I
included an example for clarification.(Labeling system not included)
1. QUALITY SYSTEM
-Discrepancy and failure investigations related to manufacturing and testing:
documented; evaluated; investigated in a timely manner; includes corrective action
where appropriate.
- Validation: status of required validation/revalidation (e.g., computer, manufacturing
process, laboratory methods).
- Training/qualification of employees in quality control unit functions.
2. FACILITIES AND EQUIPMENT SYSTEM
a. Facilities
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4. PRODUCTION SYSTEM
Training/qualification of personnel
- Validation and verification of cleaning/sterilization/ depryrogenation of containers and
closures
- Established time limits for completion of phases of production (i.e. microbial growth
potential of product)
- Implementation and documentation of in-process controls, tests, and examinations
(e.g., bioburden determination pH, adequacy of mix,)
- Justification and consistency of in-process specifications and drug product final
specifications
- Prevention of objectionable microorganisms in non-sterile drug products
- Equipment cleaning and use logs
- Process validation, including validation and security of computerized or automated
processes (i.e. simulation studies)
- documented investigation into any unexpected discrepancy
5. LABORATORY CONTROL SYSTEM
Training/qualification of personnel
- Adequacy of staffing for laboratory operations
- Adequacy of equipment and facility for intended use
- Calibration and maintenance programs for analytical instruments and equipment
- Validation and security of computerized or automated processes
- Reference standards; source, purity and assay, and tests to establish equivalency to
current official reference standards as appropriate
- System suitability checks on chromatographic systems (e.g., GC or HPLC)
- Specifications, standards, and representative sampling plans
- Adherence to the written methods of analysis
- Validation/verification of analytical methods
- Control system for implementing changes in laboratory operations
- Required testing is performed on the correct samples
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SAMPLING
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I. Legal requirements and regulationsCFR 210 & 211 cGMPs for finished Pharmaceuticals
(http://www.fda.gov/cder/dmpq/cgmpregs.htm)
CFR 210 & 211 amended effective Dec, 2008 (several changes that include microbiological
requirements of aseptically filled products)
(http://frwebgate6.access.gpo.gov/cgibin/TEXTgate.cgi?WAISdocID=336828190639+0+1+0&WAISaction=retrieve)
CFR 610 General Biological Product standards (Not covered during this review)
(http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?CFRPart=610)
CFR 820 Quality Systems Regulation (Devices, not covered)
(http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?CFRPart=820)
CFR 314.81(b)(3)(ii)- Applications for FDA approval to market a new drug (revised April 1, 2008)
For submission of an alternate microbiological method with a comparability study
(http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm)
CFR 1271 Human cells, tissues, and cellular and tissue-based products
(http://www.fda.gov/BiologicsBloodVaccines/TissueTissueProducts/default.htm)
II. FDA Compliance program Guidance Manual for FDA Staff: Drug
Manufacturing Inspections program 7356.002
(http://www.fda.gov/cder/dmpq/compliance_guide.htm)
(http://www.fda.gov/ora/cpgm/default.htm)
During an inspection this program designated six (6) critical systems for review. They include:
Quality System (always covered during an FDA inspection); Facilities &Equipment; Material;
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For each of the following, the firm should have written and approved procedures and
documentation. The firm's adherence to written procedures should be verified through
observation whenever possible. These areas are not limited only to finished products, but may
also incorporate components and in-process materials. These areas may indicate deficiencies
not only in this system but also in other systems that would warrant expansion of coverage.
When this system is selected for coverage in addition to the Quality System, all areas listed
below should be covered; however, the depth of coverage may vary depending upon
inspectional findings.
- Training/qualification of personnel
- Adequacy of staffing for laboratory operations
- Adequacy of equipment and facility for intended use
- Calibration and maintenance programs for analytical instruments and equipment
- Validation and security of computerized or automated processes
- Reference standards; source, purity and assay, and tests to establish equivalency to current
official reference standards as appropriate
- System suitability checks on USP compendial tests and/or Microbial Id. system
- Specifications, standards, and representative sampling plans
- Adherence to the written methods of analysis
- Validation/verification of analytical methods
- Control system for implementing changes in laboratory operations
- Required testing is performed on the correct samples
- Documented investigation into any unexpected discrepancy
- Complete analytical records from all tests and summaries of results
- Quality and retention of raw data (e.g., microbial identification printout)
- Correlation of result summaries to raw data; presence of unused data
- Adherence to an adequate Out of Specification (OOS) procedure which includes timely
completion of the investigation
- Adequate reserve samples; documentation of reserve sample examination
- Stability testing program, including demonstration of stability indicating capability of the test
methods
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<63> Mycoplasma
<71> Sterility Tests
<81> Antibiotics-Microbial Assays
<85> Bacterial Endotoxins Test
<151> Pyrogen Test
<161> Transfusion and Infusion Assemblies and Similar Medical Devices
<171> Vitamin B12 Activities Assay
<797> Pharmaceutical Compounding-Sterile Preparations
Dietary Supplements General Chapters Information<2021> Microbial Enumeration Test-Nutritional and Dietary Supplements
<2022> Microbiological Procedures for Absence of Specified Microorganisms- Nutritional and
Dietary Supplements
<2023> Microbiological Attributes of Non-sterile Nutritional and Dietary Supplements
USP Informational chapters (<1000>through <1999> are not generally enforced by FDA but
found to be extremely informative. These Informational chapters will help explain or expand on
scientific principles established in the regulatory chapter.
<1035> Biological Indicators for Sterilization
<1072> Disinfectants and antiseptics
<1111> Microbiological Examination of Nonsterile Products: Acceptable Criteria for
Pharmaceutical Preparations and Substances for Pharmaceutical Use
<1112> Application of water activity Determination to Non-sterile pharmaceutical products.
<1113> Microbial Characterization, Identification, and Strain Typing
<1116> Microbiological evaluation of clean rooms and other controlled environments
<1117> Microbiological Best Laboratory Practices
<1207> Sterile Product PackagingIntegrity Evaluation
<1208> Sterility Testing Validation of Isolator Systems
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V. AOAC internationalIncludes chapters on disinfectants evaluation (i.e., Phenol coefficient Methods; Hard surface
carrier test methods; Use-Dilution Method) Online access is available through
(http://inside.fda.gov/Library/ElectronicResourcesWebLERN/Alphabeticallist/index.htm)
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July
2007
1981
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1983
1984
Depyrogenation
1985
11
1988
13
1990
(Revised
2001)
15
1992
20
1990
21
1990
22
2011
23
1996
26
2008
28
2006
(revised)
29
2012
30
1999
33
2000
34
2001
35
2001
36
2002
40
2005
41
Virus Filtration
2005
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45
2008
57
61
Steam in place
2013
XI. Industry Technical referencesParenteral Drug Association (PDA) Technical Reports- Although the scientific
recommendations in these technical reports are not enforceable by FDA they do contain
industry current manufacturing practices and scientifically sound principles that support
regulatory concerns. This is prime reading material for novice and experts interested in
understand microbiological principles and applications.
(http://eroom.fda.gov/eRoom/CDER7/CDERPDATechnicalReports/0_227d)
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