Sterility testing is an essential part of in-process and release testing for cellular therapy products. The FDA specifically recommends that sterility testing be performed as outlined in 21 CFR 610.12. Furthermore, because they are concerned that antibiotics may interfere with the accurate assessment of sterility testing, the FDA requires preliminary bacteriostasis and fungistasis testing according to the USP """"""""<71> Sterility Test"""""""" on all samples containing antibiotics, including cells grown in antibiotic-containing media. The methods for sterility testing described in the CFR and USP standards were developed more than 25 years ago, and are labor-intensive and require incubation for 14 days. Since the time these methods were published, more sensitive and rapid methods have been developed for detection of microbial growth in various body fluids. These modern methods include automated systems for the detection of microbial growth in blood and other normally sterile fluids. Despite the fact many laboratories use these automated systems to assess sterility of cellular therapy products, the FDA has not sanctioned this application because there are no published data from any formal comparison of these newer methods with the CFR and USP methods (CFR/USP). For these reasons, we have developed a validation protocol comparing the CFR/USP method with two automated culture methods: the bioMerieux BacT/Alert (BTA) system and the Becton Dickinson (Bactec) system. Six different cell products from the Department of Transfusion Medicine (DTM) were seeded with selected bacteria (8 strains) and fungi (2 strains) (10 colony forming units and 50 CFUs) and then tested in triplicate with each method. The test sensitivity and time to detect a positive culture were assessed. With each bacterium and fungus, the automated systems were found to be more rapid and sensitive for detection of contaminated cell products. Growth of strict aerobic and anaerobic organisms grew preferentially in aerobic and anaerobic blood culture broths, respectively; therefore, each cell product would have to be cultured in the two broth formulations. Results: Positive cultures were detected in a mean (range) of 72% (7-100%) of the cultures for CFR/USP, 82% (0-100%) for BTA, and 93% (57-100%) for Bactec. For nine of the 10 organisms tested, overall detection rates for BTA and Bactec were equivalent to or higher than CFR/USP. Of the six product media tested, detection of organisms was impaired only by the medium containing multiple antibiotics: this occurred in all three systems. Both BTA and Bactec had shorter times to detection than the CFR/USP method, with overall means (ranges) of 87 (24-264 ) hours for CFR/USP, 24 (12-54) hours for BTA, and 33 (12-80) hours for Bactec. Detection occurred coonsistently within 7 days for both BTA and Bactec, but not for CFR/USP.
|Khuu, H M; Stock, F; McGann, M et al. (2004) Comparison of automated culture systems with a CFR/USP-compliant method for sterility testing of cell-therapy products. Cytotherapy 6:183-95|