FDA认证咨询，质检化验室的检查指南重点强调了有关化学分析方面的内容

GUIDE TO INSPECTIONS OF MICROBIOLOGICAL PHARMACEUTICAL QUALITY CONTROL LABORATORIES
微生物实验室检查指南
Note: This document is reference material for investigators and other FDA personnel. The document does not bind FDA, and does not confer any rights, privileges, benefits, or immunities for or on any person(s).
I. INTRODUCTION介绍
The Guide to the Inspection of Pharmaceutical Quality Control Laboratories provided very limited guidance on the matter of inspection of microbiological laboratories. While that guide addresses many of the issues associated with the chemical aspect of laboratory analysis of pharmaceuticals, this document will serve as a guide to the inspection of the microbiology analytical process. As with any laboratory inspection, it is recommended that an analyst (microbiologist) who is familiar with the tests being inspected participate in these inspections.
质检化验室的检查指南重点强调了有关化学分析方面的内容，对于微生物检查的内容涉及比较少，本文将作为化验室检查中对微生物检查方面的指南。对于任何一次质检室的检查，我们都建议需要有熟悉这方面知识的分析学家或者微生物学家参与检查。
II. MICROBIOLOGICAL TESTING OF NON-STERILE PRODUCTS非无菌产品的微生物测试
For a variety of reasons, we have seen a number of problems associated with the microbiological contamination of topical drug products, nasal solutions and inhalation products. The USP Microbiological Attributes Chapter <1111> provides little specific guidance other than "The significance of microorganisms in non-sterile pharmaceutical products should be evaluated in terms of the use of the product, the nature of the product, and the potential hazard to the user." The USP recommends that certain categories be routinely tested for total counts and specified indicator microbial contaminants. For example natural plant, animal and some mineral products for Salmonella, oral liquids for E. Coli, topicals for P. aeruginosa and S. Aureus, and articles intended for rectal, urethral, or vaginal administration for yeasts and molds. A number of specific monographs also include definitive microbial limits.
由于种种理由，我们发现一些外用制剂、滴鼻剂和吸入剂会产生微生物污染的问题。但USP中有关微生物检测的章节<1111>对此方面只提到了“对于非无菌药品的微生物特性，应根据产品用途、产品特性以及对使用者产生的潜在危害进行评价”。USP建议对某些种类的药品应进行微生物污染总数及微生物鉴定方面的检测。例如，对植物药、动物药和某些矿物药应进行沙门氏菌的检测，对口服液应进行大肠杆菌的检测，对外用制剂应进行绿脓杆菌和金黄色葡萄球菌的检测，对供直肠、尿道或阴道用的制剂应进行酵母菌和霉菌的检测。在药典的一些各论中也包括了特定的微生物限度要求。
As a general guide for acceptable levels and types of microbiological contamination in products, Dr. Dunnigan of the Bureau of Medicine of the FDA commented on the health hazard. In 1970, he said that topical preparations contaminated with gram negative organisms are a probable moderate to serious health hazard. Through the literature and through our investigations, it has been shown that a variety of infections have been traced to the gram negative contamination of topical products. The classical example being the Pseudomonas cepacia contamination of Povidone Iodine products reported by a hospital in Massachusetts several years ago.
作为药品微生物污染可接受水平和类型的总指南，FDA药物局的Dunnigan博士对微生物所产生的健康危害作了评论。在1970年，他指出使用被革兰氏阴性菌污染的外用制剂会产生中度到重度的健康为害。通过文献的报道及我们的调查发现，多种感染都与外用制剂的革兰氏阴性菌污染有关。最典型的例子就是几年前在麻萨诸塞州的一家医院发生的洋葱假单胞菌污染聚维酮碘事件。
Therefore, each company is expected to develop microbial specifications for their non-sterile products. Likewise, the USP Microbial Limits Chapter <61> provides methodology for selected indicator organisms, but not all objectionable organisms. For example, it is widely recognized that Pseudomonas cepacia is objectionable if found in a topical product or nasal solution in high numbers; yet, there are no test methods provided in the USP that will enable the identification of the presence of this microorganism.
因此，每家公司都应该为他们的非无菌药品制定微生物限度标准。USP微生物限度章节<61>也提供了检测一些微生物的方法，但并不包括所有的致病菌。例如，在外用制剂或者滴鼻剂中如存在大量的洋葱假单胞菌会对人体产生危害，但是，在USP中却未能提供鉴别该微生物的方法。
A relevant example of this problem is the recall of Metaproterenol Sulfate Inhalation Solution. The USP XXII monograph requires no microbial testing for this product. The agency classified this as a Class I recall because the product was contaminated with Pseudomonas gladioli/cepacia. The health hazard evaluation commented that the risk of pulmonary infection is especially serious and potentially life-threatening to patients with chronic obstructive airway disease, cystic fibrosis, and immuno-compromised patients. Additionally, these organisms would not have been identified by testing procedures delineated in the general Microbial Limits section of the Compendia.
有关这个问题的相应例子还有对间羟异丙肾上腺素吸入剂的召回事件。USPXXII专论中规定对这种产品不需要进行微生物检测。但FDA将被唐菖蒲假单胞菌污染的间羟异丙肾上腺素吸入剂作为I类召回。不良反应评估指出这些污染菌对肺部感染的风险非常大，并且对患有慢性阻塞性呼吸道疾病、囊肿性纤维化和免疫功能低下的病人具有潜在的生命威胁。然而，药典中有关微生物限度检测章节中介绍的方法并不能检测出这种细菌。
The USP currently provides for retests in the Microbial Limits section <61> however there is a current proposal to remove the retest provision. As with any other test, the results of initial test should be reviewed and inve