Am J Health Syst Pharm. 2012 Jul 15;69(14):1218-24. doi: 10.2146/ajhp110295.
Aseptic technique of pharmacy operators was assessed using simulated media-fill tests challenged with microorganisms.
Simulation of the process was done in accordance with multiple transfer steps using tryptone soya broth. All stoppers of broth medium vials were deliberately contaminated with a challenge micro-organism (Enterococcus faecalis). Each final preparation (vials, syringes, and minibags), including the culture medium, was incubated for 14 days at 32 °C. Vials, syringes, and bags were held in front of light daily for 14 days to detect any visual turbidity. At the end of the 14-day period, all clear culture media were filtered via a 0.45-μm sterile filter, which was then incubated at 32 °C on a tryptone soya agar plate. Bags and vials not subjected to manipulation were incubated simultaneously and served as controls. Visual observation by a pharmacist was conducted during the media-fill test, and finger dabs were taken at the end of the media-fill test to test for contamination.
Ten operators previously trained in aseptic technique were assessed. The overall operator failure rate was 40%, and 2.3% of the 300 preparations were contaminated. Similarly, 10 of 60 finger dabs were found to be contaminated with E. faecalis, the challenge microorganism. There was no association between operators' years of experience and media-fill test results.
Optimized media-fill tests allowed for the detection of minor deviances from standard protocol and helped to provide evidence of improper aseptic technique used by pharmacy operators.
采用模拟介质填充试验,用微生物挑战对药剂操作人员的无菌技术进行评估。
根据使用胰蛋白胨大豆肉汤的多次转移步骤对模拟过程进行操作。故意将肉汤介质小瓶的所有瓶塞污染有挑战微生物(粪肠球菌)。每个最终制剂(小瓶、注射器和小袋),包括培养基,在 32°C 下孵育 14 天。每天将小瓶、注射器和袋子放在光下 14 天,以检测任何可见的混浊。在 14 天期末,所有澄清的培养基均通过 0.45-μm 无菌过滤器过滤,然后在胰蛋白胨大豆琼脂板上于 32°C 孵育。同时孵育未经过操作的袋子和小瓶作为对照。在介质填充测试期间由药剂师进行视觉观察,并在介质填充测试结束时进行手指擦拭以测试污染情况。
评估了 10 名先前接受过无菌技术培训的操作人员。操作人员的总体失败率为 40%,300 个制剂中有 2.3%受到污染。同样,在 10 个 60 个手指擦拭物中发现粪肠球菌(挑战微生物)受到污染。操作人员的工作年限与介质填充测试结果之间没有关联。
优化的介质填充测试能够检测到标准方案中的微小偏差,并有助于提供药剂操作人员使用不当无菌技术的证据。