Gebo James E T, Feehely Kayla M, Lattimore Chase E, Mogavero Dylan P, Lau Anna F
Sterility Testing Service, Department of Laboratory Medicine, Clinical Center, National Institutes of Health, Bethesda, Maryland, USA.
J Clin Microbiol. 2025 Sep 10;63(9):e0147724. doi: 10.1128/jcm.01477-24. Epub 2025 Aug 11.
Product sterility testing requests are becoming increasingly common in clinical microbiology laboratories due to the rapid development of advanced therapies. Most laboratory directors are hesitant to bring on such tests because they fall under current Good Manufacturing Practices (cGMP) regulated by the United States Food and Drug Administration (FDA), where expectations differ from clinical requirements (regulated by the Centers for Medicare and Medicaid Services). When considerations are made for cGMP testing in the clinical lab, most focus is placed on analytical test validation. In this mini-review, we provide an overview of one critical element within the cGMP quality system-validation of equipment, software, and systems through installation, operational, and performance qualification (IQ, OQ, and PQ or IOPQ). This terminology is not common in clinical laboratories, and the IQ and OQ portions are often overlooked, not performed, and/or not documented, although phase II CAP requirements exist (COM.30550 and COM.30575). This mini-review will provide an overview of the IOPQ framework, what is included and how it differs from CAP requirements, important considerations for an IOPQ, and a summary of FDA citations relating to equipment validation. We provide examples using blood culture systems, controlled temperature units (CTUs; e.g., incubator), and the laboratory information management system, given their likelihood for use in cGMP activities in the clinical lab. Importantly, the IOPQ requirements summarized here would have also been relevant to laboratory-developed tests (LDTs) classified as "devices" prior to the March 31, 2025, annulment of the ruling.
由于先进疗法的迅速发展,产品无菌检测请求在临床微生物实验室中越来越普遍。大多数实验室主任对开展此类检测持犹豫态度,因为它们属于美国食品药品监督管理局(FDA)监管的现行良好生产规范(cGMP)范畴,而其要求与临床需求(由医疗保险和医疗补助服务中心监管)不同。在考虑临床实验室的cGMP检测时,大多数关注点都放在分析测试验证上。在本小型综述中,我们概述了cGMP质量体系中的一个关键要素——通过安装确认、运行确认和性能确认(IQ、OQ和PQ或IOPQ)对设备、软件和系统进行验证。这个术语在临床实验室并不常见,尽管有CAP第二阶段要求(COM.30550和COM.30575),但IQ和OQ部分经常被忽视、未执行和/或未记录。本小型综述将概述IOPQ框架、其包含的内容以及与CAP要求的不同之处、IOPQ的重要考虑因素,以及与设备验证相关的FDA引用摘要。我们以血培养系统、控温单元(CTU;如培养箱)和实验室信息管理系统为例,因为它们在临床实验室的cGMP活动中很可能会被使用。重要的是,这里总结的IOPQ要求在2025年3月31日该裁决废止之前,也适用于被归类为“设备”的实验室自行开发的检测(LDT)。