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P
art I of this article was published in the September issue
of Pharmaceutical Technology and provided an update
of the validation of moist heat sterilization, reviewing the
the sterility concept, sterilization principles, development
of sterilization cycles, and the measurement of sterilization effi-
This article illustrates a ciency. Part II discusses the qualification–validation procedure
and the probability of nonsterility of a load during the valida-
qualification–validation strategy
tion of the steam sterilization process.
for moist heat sterilization and
briefly discusses the sterility The qualification–validation procedure
concept and common sterilization As recommended by the American National Standards Insti-
principles. In Part II, the authors tute (1), the qualification–validation of a moist heat steriliza-
discuss the qualification– tion process involves
● qualification of the autoclave by checking its performance
validation procedure, including
against the design specifications
the installation, operational, and ● validation of the process by establishing the actual effective-
performance qualification phases, ness and reproducibility of the cycle in relation to the prod-
when requalification–revalidation uct and the loading configurations
is required, and a system for ● assessment of possible changes in the product that could have
One thermocouple must always be located next to the auto- the chamber’s coolest spot and the mean chamber temperature
clave temperature probe, which is usually placed in the cham- is acceptable (8).
ber drain. The reason for this practice is that, theoretically, the Performance qualification (PQ) phase. PQ represents the con-
“cold spot” of a chamber is in the drain. Depending on various firmatory phase of the validation program and consists of tests
chambers’ geometry, sometimes the location of the cold spot performed with the autoclave chamber under loaded condi-
in the chamber drain is not confirmed in practice. tions. During the PQ phase, which is sometimes referred to as
The OQ phase consists of a verification of the equipment process validation, the following objectives must be attained (1):
functionality. A series of checks and tests should be performed ● demonstration of the uniformity and effectiveness of the
after the unit is installed. The proper operation of alarms and process in inactivating or removing microorganisms to the
safety devices also must be tested. For a prevacuum cycle in- required safety level
volving an air-removal phase, the attainability, effectiveness, ● demonstration of the reproducibility of the process—through
and consistency in time of vacuum conditions must be tested. the use of sufficient cycles
Chamber mapping consists of heat distribution studies ● demonstration of the compatibility of the process with the
throughout the chamber for each sterilizing temperature used. items to be sterilized—through the assessment of the influ-
Heat distribution studies determine during processing whether ence of the sterilization process on the products.
the temperature is uniform and reproducible throughout the The PQ phase consists of studies that use thermocouples in-
empty chamber and localize the cold spots within the cham- serted into the articles being sterilized and studies that use BIs
ber. These studies also confirm that the system works within in operationally fully loaded autoclave conditions (2).
the specified limits throughout the entire range of operational Heat penetration studies are considered the most critical
parameters. component of the entire validation program. These studies are
The sterilizing temperatures are programmed into the auto- intended to find areas in the loads that are difficult to penetrate
clave controls. For each sterilizing temperature being validated, or heat. When selecting the monitoring sites, one must take into
the empty chamber should be monitored three times during a account the cold spots previously found during the monitor-
period of one hour, and the reproducibility of the results ob- ing of the empty chamber.
tained must be compared. The comparative readings of the ref- Heat penetration studies must demonstrate the repro-
erence temperature sensor, the thermocouple near the tempera- ducibility of a cycle in relation to the loads and the effective-
ture sensor, and the temperature displayed by the autoclave ness of the killing effect throughout the chamber and load.
recorder should be 1 C. During the exposure phase, a dif- Selecting loading configurations must be performed very care-
ference no greater than 2.5 C between the temperature of fully and should be based on worst-case situations. The maxi-
100 Pharmaceutical Technology OCTOBER 2002 www.phar mtech.com
Table II: Temperature data interpretation for a heat penetration study during exposure phase.
Values within the Run Values
Run Thermocouple Numbers for Heat Penetration across
Function Number T10 T11 T12 T13 T14 T15 T16 T17 T18 T19 the Run
Minimum 1 120.26 120.91 121.05 120.76 120.69 120.86 120.57 120.67 120.91 121.15 120.26
temperature 2 120.84 121.35 121.04 120.80 121.08 120.73 120.80 120.87 121.07 121.14 120.73
3 120.62 120.95 121.18 120.96 120.86 120.92 120.45 121.15 120.22 120.87 120.21
4 120.81 121.48 121.31 121.33 121.19 121.38 121.27 121.20 121.14 121.23 120.81
Maximum 1 123.10 122.33 122.20 122.31 122.66 122.34 122.49 122.52 122.28 121.92 123.10
temperature 2 122.35 121.92 122.11 122.31 121.99 122.40 122.10 122.17 122.04 121.98 122.40
3 122.83 122.27 122.01 122.04 121.91 122.09 121.85 121.71 122.40 121.84 122.83
4 122.91 122.14 122.26 122.19 122.32 122.20 122.37 122.27 122.30 122.25 122.90
Mean 1 121.67 121.68 121.69 121.61 121.64 121.60 121.53 121.55 121.54 121.56 121.61
temperature 2 121.53 121.63 121.55 121.53 121.56 121.57 121.56 121.63 121.64 121.63 121.58
3 121.63 121.62 121.54 121.53 121.45 121.54 121.33 121.52 121.33 121.39 121.49
4 121.58 121.77 121.81 121.81 121.84 121.83 121.82 121.84 121.81 121.82 121.79
Mean of the 121.60 121.67 121.64 121.62 121.62 121.63 121.56 121.63 121.58 121.60
four runs
Standard 1 0.06 0.06 0.12 0.13 1.66 0.13 0.2 0.14 0.19 0.17 1.04
deviation for 2 0.04
the means 3 0.10
4 0.07
t value 1 — 0.17 0.57 0.83 0.4 0.69 0.71 0.69 0.83 0.98 —
2 0.35
3 0.007
4 0.00002
mum number of bottles in the loads for the most-critical or For statistical significance, tests with BIs that are performed
used products should be decided. Ideally, three consecutive vali- during the PQ phase should be conducted at least three times
dation runs should be performed per loading configuration. per loading configuration. After sterilization, the BIs should be
During testing, if some configurations cannot be successfully incubated for seven days and checked daily for growth. As a part
sterilized because they are too big, the worst case in regard to of the documentation, information provided by the manufac-
the size of the loading configuration should be redesigned. If turer concerning the spore lot number (i.e., D and z values for
the results are still unsatisfactory, then the cycle should be re- the current lot) must be available.
designed, which usually can be achieved by modifying the ex- Demonstrating the integrity of the product after sterilization
posure time. represents another aspect of process validation. The product
Heat penetration results must show the slowest heating points must be tested for possible physical and chemical changes that
in the load and must ensure that the minimum time and tem- may have occurred during sterilization. In this regard, the pH
perature requirements are met. The success of a qualified cycle of solutions and the physical condition and appearance of goods
depends on the determination of the F0 value measured inside before and after sterilization must be verified. For culture media,
the item located at the coldest spot. It should be confirmed that tests for growth promotion that are recommended by USP
a minimum prescribed F0 value is delivered consistently through- should prove whether the culture media show growth follow-
out the autoclave chamber. ing the sterilization process.
Microbiological validation, which consists of tests involving Qualification–validation report. The final stage of the validation
BIs, should be performed concomitant with heat penetration program requires the documentation of all acquired data. The
studies to verify independent of the temperature data results qualification–validation report summarizes the overall results
that the minimum F0 value is met at the coldest spot of the load. of validation. It includes the calibration certificates for cali-
For terminal moist heat sterilization, heat penetration studies brating instrumentation, calibration records, and methods for
must demonstrate an SAL of 106 or higher. The BIs should be calibrating the measuring instruments, gauges, and recorders
placed in operational, maximum loads at the locations pre- as well as the accuracy verification data of thermocouples (4).
sumed to be the least accessible to the sterilizing agent. One Test data such as high–low temperature ranges, average tem-
should place the BIs next to the thermocouples and inside the peratures during exposure time, minimum and maximum F0
item being tested. They must not be placed directly on surfaces values achieved for every load configuration, run date and time,
or outside the loads because the heating process is rapid in those and autoclave records must be included.
areas and the BIs may get killed faster. The number of BIs used The qualification–validation report is not complete unless it
per load depends on the size and the complexity of the load. contains evidence checks for the availability of an instrument
102 Pharmaceutical Technology OCTOBER 2002 www.phar mtech.com
Table III: Accumulated F0 value interpretation for a heat penetration study.
Std.
Mean Std. Error
F0 Dev. of 95% t Values
Run Thermocouple Number per per the Confidence across
Function No. T10 T11 T12 T13 T14 T15 T16 T17 T18 T19 Run Run Mean Interval the Run
F0 1 25.82 25.04 24.92 23.86 24.50 24.35 23.76 24.42 24.42 24.51 24.56 0.59 0.18 24.14* 24.98* —
2 23.95 24.81 24.01 23.50 24.20 23.91 24.25 24.80 24.90 25.12 24.35 0.53 0.16 23.97* 24.73* 0.4
3 23.85 24.55 24.26 23.96 23.03 24.42 22.02 24.08 22.03 22.69 23.49 0.96 0.31 22.80* 24.17* 0.009
4 24.68 26.05 26.13 26.14 26.05 26.43 25.65 26.32 25.15 26.06 25.87 0.55 0.17 25.47* 26.26* 0.00008
Mean 24.58 25.11 24.83 24.36 24.45 24.78 23.92 24.91 24.13 24.60 24.57 1.08 24.23** 24.90**
of the
four
runs
Standard 0.90 0.66 0.95 1.20 1.24 1.12 1.50 0.99 1.43 1.42
deviation
for the
means
t value — 0.38 0.71 0.78 0.87 0.79 0.49 0.64 0.62 0.98
* The confidence interval per run was calculated considering t for 0.05 (95%) confidence level 2.262 (N-1 9 degrees of freedom).
** The confidence interval across runs was calculated considering the critical value for 95% level of confidence 1.96.
logbook, the standard operating procedures (SOPs) used with ● user, calibration, and maintenance SOPs.
the autoclave, procedures for preventive and unscheduled main- When requalification–revalidation activities are required. Once
tenance, and recalibration programs. The validation report also a unit has been installed and qualified, it does not need re-
should include the user’s training records. Training should beginqualification, unless the unit is reinstalled in another
only after the validation has been accomplished to ensure that location or has undergone major modifications. Only revali-
users will implement already-validated loading configurations. dation is performed periodically. Generally, the extent of
The qualification–validation report must include the draw- requalification–revalidation depends on the nature of the
ings of all loads tested. The location of the thermocouples and changes that occur and how they affect the already-validated
BIs must be specified in each drawing. Any specification devi- sterilization cycles. The responsibility for deciding which vali-
ations that were encountered during validation activities and dation activities should be reperformed must be assigned. Vali-
the procedures that followed their discovery should be reviewed. dation frequency must be stipulated in the validation docu-
After the validation activities are completed, all data and docu-ments. The need for possible revalidation should be assessed
ments that were accumulated must be revised, approved, and every 12–24 months, and revalidation should occur whenever
certified by both the owner of the autoclave and the contractor major repairs have been performed. Any modifications to con-
in cases when the validation was performed with third parties trol systems should be evaluated to confirm that process con-
or by the manufacturer. ditions delivered to the load are comparable with those origi-
Once the autoclave is qualified and the loading configura- nally validated. However, the validation should be repeated
tions are validated, the following documents must be present whenever new sterilization cycles, loading configurations, or
in the laboratory at all times: major changes in the sterilization procedure are introduced.
● diagrams of various loading configurations stamped with Change control. A system for change control should be im-
their effective dates plemented that establishes when the qualification–validation
● a list of the determined lag times for each loading configuration
process should be repeated (1). The nature of the change must
● temperature–pressure recorder printouts be assessed to determine the potential effects on the cycles and
load. Changes that could affect sterilization conditions
are not allowed to be introduced without documen-
Table IV: Sterility assurance levels (SALs) attained for each run. tation. The change-control procedure must follow a
F0 Values Representing change-control SOP.
the Calculated Lower Changes in any of the following items can invali-
Limit of the 95% date an autoclave validation: pressure gauge, tempera-
Run Confidence Interval SAL ture gauge, control panel programming, temperature-
1 24.14 10–10.09 control valve, steam trap, and steam source. Changes
2 23.97 10–9.98 introduced by preventive or unplanned maintenance
3 22.80 10–9.2 procedures must be evaluated and documented in re-
4 25.47 10–10.98 gard to a decision for revalidation.
104 Pharmaceutical Technology OCTOBER 2002 www.phar mtech.com
tory referred to in this article uses the sterilized broth for
microbiological testing of nonsterile products and stab cultures.
Materials and methods. As recommended by pharmaco-
poeias (2,9,10), the reference sterilization conditions for liquid
media (121 C for an exposure of 15 min) were tested. A pre-
liminary experiment was performed to determine the lag-time
characteristic for this loading configuration. A simulation load
comprising 50 bottles filled with 200 mL of tap water was used
first.
To monitor the temperatures attained in the chamber under
loaded conditions, 9 thermocouples were placed in various lo-
cations within the chamber, and another 10 were placed in the
middle of the liquid contained in the bottles. The placement of
the thermocouples in the chamber and the loading configu-
ration are presented in Figure 1, which shows the overhead view
of the autoclave chamber.
Timing the lag time began when the thermocouple placed in
the drain next to the sterilizer temperature probe reached the
sterilizing temperature. Timing stopped when the last thermo-
couple placed in the load reached the sterilizing temperature.
The heat penetration studies were conducted concomitant
with the BI studies. An ampul containing a population of 106
spores of Bacillus stearothermophilus was placed next to each
thermocouple inserted into the load. In the loading diagram
(see Figure 1) the positioning of the thermocouples and BIs is
indicated by the letters T and B. For the ampuls, the number
marked on each of the 50 bottles was assigned. After insertion
into the thermocouples, the sterilized ampuls were incubated
with the positive controls (nonsterilized ampuls) for seven days
at 55–60 C and were checked daily for growth. As a means to
Figure 1: Representation of the autoclave chamber (overhead view). B verify the sterilization efficiency, 5 of the 50 bottles containing
is the number of the bioindicator ampul, and T is the thermocouple TSB were incubated after sterilization for five days at 32 C. The
number. Heat-distribution thermocouples are marked with a number broth was checked daily for growth.
and letter indicating their position in the chamber: u upper position, To check the effectiveness of the culture medium after its steri-
m middle position, b bottom position, r under the rail, lization, the TSB was tested in accordance with the USP Growth
d in the chamber drain. T8 was placed in the piping heading to the Promotion Test (11). The broth was tested for growth in the
pressure gauge. The dotted rectangles represent the two rails of the presence of Bacillus subtillus, ATCC 6633, spores and incubated
autoclave chamber. The circles represent the 50 bottles, some of them at 37 C for 48 h.
containing thermocouples and bioindicator ampuls. Another means for verifying the integrity of the physical
properties of the broths and buffers is to measure their pH val-
ues before and after sterilization. For TSB a pH of 7.3 0.2
During routine use, personnel should ensure that the process should be obtained after its preparation.
specifications established during qualification testing are fol- Results. For the simulation load, a lag time of 13 min was
lowed and remain valid. The critical parameters governing the measured. The TSB has a slightly higher viscosity than tap water.
process must be monitored routinely to confirm that previously A lag time of 15 min was considered sufficient to be added to
determined conditions are achieved. the required exposure time of 15 min.
Temperature profiles recorded by using thermocouples in-
Estimation of probability of nonsterility of a load during serted into a simulation load have indicated that during the ex-
validation of the steam sterilization process posure phase the temperature of the load is slightly below the
Qualification–validation activities were performed for a steam set temperature of 121 C. To achieve the prescribed steriliza-
sterilizer, model 2020, from Amsco AHSC-South Africa (Pty) tion temperature of 121 C inside the load, the set temperature
Ltd. The following example demonstrates the validation of a of the PLC was raised to 122 C. Therefore the experiments for
saturated steam–vented cycle used with a load containing 50 the validation loads were performed with the new set parame-
250-mL bottles filled with 200-mL trypticase soy broth (TSB). ters of 122 C and 30 min. As an example, Figure 2 shows the
TSB is a heat-sensitive medium that is prone to alteration dur- middle portion of the temperature profiles achieved within the
ing the sterilization process. Therefore, the parameters for steri- autoclave chamber, in the chamber drain, and inside the load
lization had to be carefully chosen. The microbiology labora- during the second run.
106 Pharmaceutical Technology OCTOBER 2002 www.phar mtech.com
The SAL achieved was determined for each of the four runs.
The calculated lower limit of the 95% confidence interval was
introduced in Equation 4 of Part I of this article indicated by
EP (9) for the calculation of the F0 value. In rearranging that
equation, one can define a probabilistic term P as the absolute
value of Nt expressed as
[2]
Circle/eINFO 81
110 Pharmaceutical Technology OCTOBER 2002 www.phar mtech.com
7. British Standard 2646, “Autoclaves for Sterilization in Laboratories.
Part 5: Methods of Test for Function and Performance,” (British Stan-
dard Institution, 1993), pp. 1–11.
8. M.J. Akers and N.R. Anderson, “Sterilization Validation of Sterile Prod-
ucts,” in Fundamentals in Pharmaceutical Process Validation, I.R. Berry
and R.A. Nash, Eds. (Marcel Dekker, New York, NY, 2d ed., 1993), pp.
25–87.
9. European Pharmacopoeia (Council of Europe, Strasbourg, 3d ed., 1997),
pp. 283–285.
10. British Pharmacopoeia, Volume II (The Stationary Office, London,
2001), pp. A332–A335.
11. P. Hoet, “Validation and Parametric Release for a Sterile Product,”
S.T.P. Pharma Practiques 7 (5), 372–374 (1997). PT
Pharmaceutical
Technology
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NORTH AMERICA
MARY CLARK
ADVANSTAR MARKETING SERVICES
800-822-6678 ext. 226
541-984-5226 Fax: 541-686-5731
Email: mclark@advanstar.com
Circle/eINFO 83
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