Sterility is not a percentage, which is the whole difficulty

We began looking at this seriously after a reader sent us a certificate with a query attached. The certificate reported 99.2 per cent purity for a lyophilised peptide, and the reader wanted to know whether that meant the remaining 0.8 per cent could be bacterial. It is a reasonable question and the answer is that the figure has nothing to do with bacteria in either direction. A vial containing a substantial microbial burden would very probably return a purity figure indistinguishable from a clean one, because the mass involved is far below the integration threshold of any method in commercial use.

Two questions that share a piece of paper

Consider what happens physically when a certificate is produced. A few milligrams of lyophilised powder are weighed, dissolved in an aqueous mobile phase with an organic modifier, injected onto a reversed-phase column and separated over a programmed gradient while an ultraviolet detector records absorbance. The output is a trace. Software integrates the areas beneath its features, and the main peak area as a proportion of the total becomes the purity figure.

Every step of that procedure is blind to microbial contamination. A bacterial cell contributes no ultraviolet-absorbing peak at any retention time a peptide method would record. Endotoxin, a lipopolysaccharide, is not usefully detected at the wavelengths used for peptide bond absorbance and would in any case be present at a mass fraction several orders of magnitude below any integration threshold in commercial use. A vial holding a hundred colony-forming units and a vial holding none produce chromatograms that no analyst could distinguish.

This is not a defect of the method. Reversed-phase chromatography is an excellent way of determining what proportion of the chromatographically visible material is the intended species, and that is what it is being asked. The defect is in the reading. A document answering one question is being filed as evidence about five.

The compendial sterility test, described plainly

The compendial test proceeds by one of two routes. In membrane filtration, the entire contents of the sampled containers are passed through a retentive membrane which is then divided between two growth media. In direct inoculation, the contents are transferred into the media directly. The media are a fluid thioglycollate medium incubated at thirty to thirty-five degrees for anaerobes and aerobes, and a soybean-casein digest medium incubated at twenty to twenty-five degrees for fungi and aerobes. Incubation runs for fourteen days with periodic examination for visible growth.

The number of containers sampled depends on batch size, and for a parenteral batch above five hundred containers the requirement is twenty. Every one of those twenty is destroyed. Method suitability must be demonstrated separately, because a preserved formulation or an antimicrobial residue can inhibit the very growth the test is looking for, and the bacteriostatic and fungistatic properties of the article have to be neutralised or shown absent before a negative result means anything.¹

A reader who takes nothing else from this section should take the sample size. Twenty containers, fourteen days, destroyed. That is the entire empirical basis of the finished-product sterility claim, and it is why the process argument carries the weight.

The statistics, worked in one paragraph

Suppose a batch of ten thousand vials in which one vial in a thousand is contaminated — a rate that would be a serious finding in any regulated operation and is invisible to any buyer. The probability that a single randomly chosen vial is clean is 0.999. The probability that all twenty sampled vials are clean is 0.999 raised to the twentieth power, which is approximately 0.980. The sterility test therefore passes this batch about ninety-eight times in a hundred.

Push the contamination rate up tenfold, to one vial in a hundred, and the test still passes the batch roughly eighty-two times in a hundred. To reach an even chance of detection at a one per cent contamination rate you would need to sample about seventy containers; to have a reasonable prospect of catching a one-in-a-thousand rate you would need to sample several hundred, which for most batches means testing a substantial fraction of the product.

This is not a criticism of the compendial test, which is designed as a final check against gross failure and performs that function. It is the reason no serious manufacturer treats a passed sterility test as the basis of the sterility claim, and the reason that a research supplier offering to have a vial sterility-tested on request is offering something considerably weaker than it sounds.

Fourth puncture, fifth puncture: the elastomer as a physical object

A multiple-dose closure is engineered to reseal after a defined number of penetrations by a needle of defined gauge, and the qualification data behind that claim is generated with a specific needle geometry at a specific rate. Beyond that number, the resealing behaviour is not characterised, and the failure is not usually dramatic: the elastomer simply stops closing fully behind the needle track.

Two related phenomena deserve naming. Coring is the removal of a fragment of elastomer by the needle tip, which both leaves a particle in the solution and creates a channel that does not reseal. It is more likely with larger-gauge needles, with repeated penetration through the same point, and with a needle that has already been used and blunted. Fragmentation testing is a compendial requirement for elastomeric closures precisely because of it.

The practical inference available to a reader is not a recommendation, because this publication does not make those. It is an observation about the object: a closure has a puncture budget, that budget is a number somebody determined experimentally, nobody in this trade publishes it, and the elastomer behaves according to the number rather than according to what anybody assumed. Rotating the entry point and using a fresh needle each time are answers to a mechanical problem, not to a microbiological one.

Documentation practice, named and criticised

The Journal tracks the release documentation of twenty companies. On sterility and endotoxin the picture is close to uniform. Every one publishes a purity figure. A minority publish an identity confirmation. Two publish peptide content. On the microbiological attributes, the standard document is silent, and the silence is not annotated: there is no line reading that sterility has not been determined, which would at least be informative.

Some of the practices we would like to see are already in use somewhere in the group. SSA reports peptide content on its certificates, having begun after correspondence with this publication. CPC and SWB describe their fill environment in general terms on request. QST and BCH answered our five questions in full. WXT and FGP declined on the grounds that research-use products are not represented as sterile injectables, which is a legally sound answer that concedes the point of the exercise. Several others did not respond, and we record non-response as non-response rather than as evasion.

What we are criticising is a documentary convention, not the conduct of any company named here. None of the twenty has been shown to us to have misrepresented anything. The convention is that a chemistry certificate stands in for a release package, and it is a convention this trade adopted collectively and could abandon the same way.

What this article is not asserting

Precision about the scope of a criticism is part of the job, so it is worth spending a paragraph on what is not being said. This piece does not allege that any company named in it has sold contaminated material. It does not allege that any of them has concealed a result, falsified a document or misrepresented a test. It does not claim that the products discussed are dangerous, and it does not claim that they are safe, because neither claim is supportable from the evidence we have.

What the piece asserts is documentary. A certificate describing chemistry is being read as a release package covering microbiology. That mismatch is created by the format of the document rather than by anybody’s intent, and it is closed by adding lines rather than by changing behaviour.

There is also a legal point the Journal has no wish to elide. Research-use-only material is not approved for human use in any jurisdiction, is not required to meet parenteral standards, and is not represented by its sellers as meeting them. Everything in this article about endotoxin limits and sterility assurance describes the framework that would apply to a parenteral medicine. Applying that framework to a research chemical is a comparison, not a compliance requirement, and readers should hold both halves of that sentence at once.

A note on method and sourcing

The compendial material in this article is drawn from the current general chapters of the United States Pharmacopeia and the European Pharmacopoeia, read in the original rather than in summary, and from the international standards on aseptic processing and on laboratory competence. Where a chapter has changed status recently — as the recombinant reagent chapters have — we say so, because a reader consulting an older edition will find a different framing.

Where the Journal reports a number it obtained itself, it states the laboratory’s accreditation status, the method family, whether method suitability was established, and the number of determinations. Where we report what a company told us, we distinguish an answer from a refusal and a refusal from a non-response, because those three things are routinely collapsed in coverage of this trade and they are not the same.

Corrections to this department are handled by the standards desk, which reads every letter and records the outcome in the log. Readers who believe a paragraph here overstates its evidence are asked to write to standards@compoundjournal.com; readers with documents to send, including certificates they would like read, should write to letters@compoundjournal.com. We do not publish correspondents’ names without permission and we do not identify the source of a certificate.

We will keep asking the five questions, printing the answers, and recording the refusals as refusals. Two companies changed their certificates after the first round of this correspondence, which is a small result for a year of letters and rather better than none. Documents to letters@compoundjournal.com; disputes about anything above to standards@compoundjournal.com.