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细胞治疗的无菌检测:临床微生物学实验室的作用是什么?

Sterility Testing for Cellular Therapies: What Is the Role of the Clinical Microbiology Laboratory?

机构信息

Sterility Testing Service, Department of Laboratory Medicine, Clinical Center, National Institutes of Health, Bethesda, Maryland, USA.

Sterility Testing Service, Department of Laboratory Medicine, Clinical Center, National Institutes of Health, Bethesda, Maryland, USA

出版信息

J Clin Microbiol. 2020 Jun 24;58(7). doi: 10.1128/JCM.01492-19.

Abstract

Sterility testing of cellular therapy products along with the associated environmental monitoring requirements for aseptic facilities, including compounding pharmacies, continues to impact clinical microbiology laboratories, as evidenced by the numerous discussions recurring on American Society for Microbiology Division C and ClinMicroNet listservs. This minireview provides an overview of this complex field of current good manufacturing practices (cGMP) based on biopharmaceutical industry standards and summarizes the compendial and alternative rapid microbial test methods available for product sterility and testing. In addition, this minireview highlights major overarching regulatory requirements governing any laboratory performing product testing as regulated by the United States Food and Drug Administration (FDA). These requirements are different from the more familiar clinical requirements of the Clinical Laboratory Improvement Act of 1988 (CLIA '88), the College of American Pathologists (CAP), and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), all of which have no jurisdiction in this area. As the cellular therapy field continues to advance and an increasing number of medical centers participate in clinical trials of these novel therapies, it is critical that laboratories have a sound understanding of the major regulations and cGMP practices governing microbiological testing in the biopharmaceutical industry.

摘要

细胞治疗产品的无菌检测以及包括制剂室在内的无菌设施的相关环境监测要求,持续影响着临床微生物学实验室,这一点在美国微生物学会 C 分会和 ClinMicroNet 邮件列表上反复出现的众多讨论中得到了证实。本综述基于生物制药行业标准,概述了当前良好生产规范 (cGMP) 的这一复杂领域,并总结了产品无菌检测和替代快速微生物检测方法的药典和其他方法。此外,本综述还重点介绍了美国食品和药物管理局 (FDA) 监管的任何进行产品检测的实验室必须遵守的主要监管要求。这些要求与更熟悉的临床要求不同,如 1988 年临床实验室改进法案 (CLIA '88)、美国病理学家学院 (CAP) 和医疗机构联合评审委员会 (JCAHO),这些机构在这一领域都没有管辖权。随着细胞治疗领域的不断发展,越来越多的医疗中心参与这些新型疗法的临床试验,实验室必须充分了解生物制药行业微生物检测的主要法规和 cGMP 实践。

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