Fungal and Bacterial Spore Excursions in Cleanrooms: Case ... · •Bacillus subtilis •Bacillus...

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Fungal and Bacterial Spore Excursions in

Cleanrooms: Case Studies

Jim Polarine

Sr. Technical

Service Manager

Pharmig

November 29, 2018

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Copyright © 2017 STERIS Corporations. All Rights Reserved.

Outline

Fungal and Bacterial Spore Excursions: Case

Studies

• Bacillus cereus Contamination Case Study

• Fungal Spore Contamination Case Studies

• Contamination Sources

• Proactively prevent recontamination

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Review - Microflora in Cleanrooms (U.K.)

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Review - Microflora in Cleanrooms (U.K.)

Genus A/B

(6729) C/D

(2500)

Micrococci (and related) 38% 40%

Staphylococci 21% 11%

Bacillus (and related) 13% 10%

Pseudomonas (and related) <1% 8%

Corynebacterium (and related) 3% 5%

Rhodococci <1% N/A

Fungi N/A 3%

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Risk Assessments

• Pathogenic or Toxic Molds

• Does it affect product contact surfaces

• Where is it picked up onsite

• Create a risk map or diagram

• What are the possible assignable causes

• Proactively prevent the mold from reoccuring

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Where does the Investigation team begin?

Cause & Effect Diagram example:

Machine Method Materials

Aspergillus Contamination

Mother Nature

Man Measurement

HVAC Differential Pressures

Preventive Maintenance

Equipment Repair

Instrument Calibration

Change Controls

SOP Changes

Cleaning procedures

Raw materials

Cleaning products

Equipment Flow

Leak in Ceiling

Power Outage

Tornado

Frequency of Cleaning

Limits too high

Limits too low

Construction

Training

Personnel Monitoring

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Investigation Strategies:

Critical Zones

Trend history of organisms in the area versus the contaminant.

Sample Type Sample Frequency Minimum Data Review Period

Water

Daily ≥ 3 weeks prior to the excursion

Weekly ≥ 3 months prior to the excursion

Pure Steam Weekly

Monthly Quarterly

≥ 3 months prior to the excursion ≥ 3 months prior to the excursion ≥ 6 months prior to the excursion

Compressed Air/Gas Quarterly ≥ 1 year prior to the excursion

Environmental Monitoring Daily ≥ 2 months prior to the excursion

Environmental Monitoring Bi-Weekly or Monthly ≥ 6 months prior to the excursion

Personnel Applicable Facility SOP ≥ 3 months prior to the excursion

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Common Sources of Spores

• Items brought into the Cleanroom – Bags, Boxes, Intervention Equipment, Pallets, Pallet

Jacks, Scrubbers, Cart Wheels, Carts, Shoes, Shoe

Covers, Markers, Pens, Cellphones

– Raw Materials and components

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Bacillus cereus Contamination

Case Study

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Microorganism Resistance

Hierarchy

From McDonnell, “Antisepsis, Disinfection, and Sterilization: Types, Action, and Resistance” 2007, ASM Press

Bacillus cereus / sphaericus

Bacillus subtilis / G. stearothermophilus

Clostridium spp.

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Bacterial Spores in

Operations

•Bacillus subtilis

•Bacillus cereus

•Bacillus pumilus

•Bacillus licheniformis

•Bacillus sphaericus

•Bacillus thuringiensis

•Paenibacillus polymyxa

•Geobacillus spp.

•Clostridium difficile

B. cereus Group:

B. cereus, B. anthracis, B.

mycoides, B. thuringiensis,

B. pseudomycoides,

B. weihenstephanensis,

B. manliponensis

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Bacterial Endospore

Courtesy Dan Klein

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Bacterial Endospore Bacterial Spore Structure

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Bacillus cereus Case

Study

• ISO-7 and ISO-8 cleanrooms

• Spores tracked throughout the facility

• Process Vessels

–Source Locations

•Cleanroom Shoe Cover

•Fermenter

•Process Vessels

The Source was a Raw Material

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Exosporium – B. anthracis

Cote CK et al. 2011. Microbes and Infection 13(14-15):1146-55.

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Exosporium – B. anthracis

https://www.llnl.gov/str/Sep06/Velsko.html

Hydrophobicity helps adhere to fibers

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A schematic diagram illustrating a possible model for the exosporium of the B. cereus family.

Kailas L et al. PNAS 2011;108:16014-16019

©2011 by National Academy of Sciences

Model of B. cereus exosporium

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Bacillus Testing

Wyeth Spore Isolate T.K. Wyeth Spore Isolate B.cereus, 5.81, n=2

10-16-08

0.001.00

2.003.00

4.005.00

6.007.00

SK R

TU

1:4

Bleac

h

1:10

Ble

ach

CIP

100

CIP

200

Wes

cody

ne

Pro

klen

z 1

Sk Con

c. 1

:18

Formulation

Av

era

ge

Lo

g R

ed

uc

tio

n

20 min.

40 min

60 min

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Fungal Spore Contamination

Case Study

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Molds common to cleanrooms

and cold rooms •Aspergillus spp.

•Penicillium spp.

•Stachybotrys spp.

•Cladosporium spp.

•Mucor spp.

•Scopulariopsis spp.

•Trychophyton spp.

•Chaetomium spp.

•Acremonium

•Candida albicans (yeast)

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Aspergillus

• ISO-5 Cleanroom

– Source

• High Impingement Spraying Device

• Broken Pipes

• HVAC Shut Down

• Exceeding Limits in ISO-7 areas

– Dock Doors proximal to ISO-7

cleanroom

– Storage room with limited control

– No limits for mold spores (Establish

Limits)

– Limited control for incoming and

outgoing items

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High Pressure

Impingement Sprayers

Holes

in Walls

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Sources of Aspergillus

Behind Cleanroom Door Kickplate

Black Sharpie

Marker Tip

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Courtesy Dan Klein

Aspergillus brasiliensis

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Aspergillus Investigation

• Sporicidal usage in pass-through

• Clean and dirty area on the dock

• Better control of gowning area

• Cart Wheel control methods

• Better gowning control

Photo: Terra Universal

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NECC Fungal

Contamination

There was no investigation by the firm when levels exceeded the action

limits and no identification of isolates. No documented corrective

actions were taken to remove microbial contamination (bacterial and

fungal) from the facility. (FDA WL October 2, 2012)

83 out of 321 vials of methylprednisolone acetate contaminated (fungal

contamination found)

64 deaths and 750 Illnesses

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Aspergillus brasiliensis

Courtesy Bruce Ritts

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Aspergillus spores Aspergillus brasiliensis

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Spiny Spores

Courtesy Dave Shields

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Courtesy Dan Klein

Cleanroom Fungi

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Penicillium

• Two ISO-7 Cleanrooms

• Action Levels of 10 and picking up >100 Fungal Spores

– Engineering Investigating

– HVAC

– Duct Work

– HEPA Filters

– Cooling Coils (two hits)

– Wall Coverings

– Airflow Vents

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Penicillium Investigation

• Entry and Exit Procedures

• Gowning Procedures (Triple Gowning)

• Cart Wheels

• Construction (Current Maintenance Log)

– Further Investigation

– Use of Sporicides and Frequency

– Plastic Containers in the Cleanroom

– Coldroom Cleaning Procedures (0-

5°Celsius)

– Documentation of Cleaning Process

– Designate Assignable Causes

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Penicillium Investigation

Cleanroom Cooling Coils

Plywood from a

Wooden Pallet from

Construction

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Penicillium

Courtesy Ann Larson

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Penicillium Spores


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Glass Evaluation

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Stainless Steel Evaluation

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Flooring Evaluation

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Cladosporium Spores


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Paecilomyces Spores


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Leptosphaerulina Spores


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Testing Bacterial Spore

Formers

• Bacterial spores are significantly more

challenging to inactivate than

vegetative cells (worst case for a

strain)

• Bacterial spores generally require

sporicidal agent to inactivate

• Spore form is most likely form of

Bacillus, Paenibacillus, etc. to be

encountered in classified area

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Formers

Can you consistently test

against “vegetative” Bacillus?

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Formers in DET

• Bacterial spore formation is a stochastic event

• Sporulation occurs within sub-populations (i.e. the entire suspension does not sporulate at the same time)

• Sporulation kinetics is complicated, depending on a multitude of environmental factors-NOT just nutrient scarcity

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Paenibacillus 24 Hour Culture

Courtesy of Jamie Knutson, STERIS Laboratories

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Paenibacillus 18 Hour Culture


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18 Hour Paenibacillus Culture


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Contamination Sources

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Contamination Sources

Facility • Poor design

• Aging facility

• Maintenance

• Cleaning and

disinfection

People • Gowning rooms

• Attire (clothing, shoe covers,

hoods, face masks, goggles, etc)

• Conduct

• Standard Operating Procedures

Materials • Pass through sterilizers

(autoclaves, dry heat ovens,

depyrogenation tunnels, etc.)

• Decontamination chambers (EO,

VHP, UV, etc.)

• Material handling airlocks

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Industry References

• USP 41 <1072> Disinfectants and Antiseptics

• Annex 1 (2008) and MHRA Orange Guide (2015)

• FDA Aseptic Processing Guide (2004)

• FDA, MHRA, HPRA, CFDA, ANSM, ANVISA, & EMA Expectations

• Industry Articles (Ex. Scott Sutton, Jose Martinez, Tim Sandle, Richard Prince,

Rebecca Smith, Jeanne Moldenhauer), Crsytal Booth

• PDA Cleaning and Disinfection TR No. 70 (October, 2015)

• PDA TR No. 69 on Biofilms (2015)

• The CDC Handbook - A Guide to Cleaning & Disinfecting Cleanrooms (Tim Sandle

2016)

• A Guide to Disinfectants and their use in the Pharmaceutical Industry (Pharmig 2006)

• USP 41 <1116> Microbiological Control and Monitoring of Aseptic Processing

Environments

• USP 41 <1115> Bioburden Control of Non-Sterile Drug Substances and Products

• PIC/S Guide to Good Practices for the Preparation of Medicinal Products in

Healthcare Establishments (2014)

• WHO Annex 6

• PHSS Technical Monograph #20 “Bio-contamination characterization, control,

monitoring and deviation management in controlled/GMP classified areas

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Acknowledgements

Thank you audience!

STERIS Life Sciences

• Dan Klein – Sr. Manager, Research and Development

Microbiology and Clinical Affairs

• Bruce Ritts and Stacey Gish– STERIS R&D, Scanning

Electron Microscopy

• Dave Shields – Manager, STERIS Laboratories

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Introduction

Jim Polarine

• Senior Technical Service Manager

• STERIS Corporation | Life Sciences

• Mobile: 314-616-9931

• E-Mail: [email protected]

• Web: www.sterislifesciences.com

STERIS Technical Services

mailto:[email protected]

http://www.sterislifesciences.com/

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Thank you for your attention!

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Fungal and Bacterial Spore Excursions:

Case Studies

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