On
1st July 2015 in Birmingham, Pharmig and the NHS held a joint
meeting examining the use of sporicides for aseptic transfer in pharmacy units.
The meeting was convened in response to recent MHRA guidance, at the initiative
of Rachel Blount. The object of the meeting was to share best practice and to
outline a strategy for the implementation of sporicidal disinfectants.
The
meeting titled “Sporicides – As Part Of Your Transfer Process”, was chaired by
Tim Sizer (Regional Pharmaceutical Quality Assurance Officer South West).
The
opening presentation was delivered by Tim Sandle (Pharmig committee member) on the
subject of spores. Tim introduced bacterial and fungal spores and explained therisk factors associated with both (bacterial spores having a three layered
structure that confers resistance and limits chemical diffusion; and fungal
spores, which can secrete enzymes). Tim placed a strong emphasis on the need
for a sound biocontamination control strategy to reduce the presence of spores
in the first place.
The
second presentation was delivered by Tim Sizer. Here some of the recent
contamination incidences involving fungal and bacteria spores were outlined.
This included the infamous New England Compounding Centre fungal meningitis
issue, where a number of failures to adhere to Good Manufacturing Practice led
to a mutli-state outbreak of infections. The other topical issue was the
contamination of intravenous bags with Bacillus
cereus, which led to several deaths of babies in NHS hospitals during 2014.
Mark
Oldcorne (All Wales Quality Assurance Specialist Pharmacist) delivered the
third presentation of the day. Here Mark focused on an interpretation of the
MHRA guidelines and the key requirements of effective use of sporicides in
aseptic transfer (including the need to standardise wiping steps).
Rachel
Blount (Pharmig committee member) presented the fourth lecture on disinfectant
efficacy standards. This included the new standard for pre-saturated
disinfectant wipes (ISO 16615). Rachel outlined key aspects such as contact
time, challenge populations, clean and dirty conditions (through simulated
soiling). Rachel emphasised that the surface test provided more meaningful
information than the suspension test.
The
fifth presentation was delivered by Tim Sandle. With this Tim outlined many of
the sporicidal disinfectants available and narrowed the list down to those that
could readily be used in practice. Tim urged delegates to challenge the
information provided by manufacturers and that the only ‘true’ test was how a
product behaved in practice; here data from environmental monitoring is
important.
This
was followed by a second presentation from Mark Oldcorne. Mark outlined the
important criteria for the selection of a sporicidal product. The important
criteria were contact time; residue breakdown products; concerns with
corrosiveness; stability; and quality.
The
day finished with a best practice session presented by Tim Sizer and Mark
Oldcorne, looking a schematics relating to the best practices for implementing
a risk-based sporicidal transfer process. The key steps involved were outlined.
The
event was supported by Pharmig members who supply disinfectant products and
related tests for environmental control. The 130 delegates gave positive
feedback, and found the opportunity to discuss matters with experts throughout
the day very useful.
Posted by Tim Sandle
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