Academic Sciences Asian Journal of Pharmaceutical and Clinical Research

Vol 5, Suppl 2, 2012 ISSN - 0974-2441

Research Article

Vol. 4, IssuePRESERVATIVES
ASSESSMENT OF THE HARMONIZED 3, 2011 EFFECACY TEST IN ORAL LIQUID
ISSN - 0974-2441
PHARMACEUTICAL PREPARATIONS USING REFERENCE AND NONE REFERENCE TEST
MICROORGANISMS
QASEM M ABU SHAQRA*1, AND MAISA AL- SHAWAGFEH2
1 Consultant Microbiologist, Jordan Medical Solutions Manufacturing Company and Part Time Lecturer at Al- Balqa Applied University –
Zarqa, Jordan , 2 Al- Balqa Applied University, Zarqa University College, Department of Allied Medical Sciences, Zarqa- Jordan.
Email: [email protected]
Received: 1 February 2012, Revised and Accepted:6 May 2012
ABSTRACT
The microbial challenge test used for the evaluation of preservatives efficacy in none sterile liquid pharmaceutical preparations has been recently
harmonized between the United States, Europeans and Japanese pharmacopoeias. This investigation reports on the assessment of this test using 2
sets of microorganisms. The first was composed of recommended strains derived from the American Type Culture Collection and the second was of
clinical isolates with multi drug resistance. Testing was carried out on a prototype antacid preparation in accordance with documented
methodology. It is shown that although similar results were achieved by using either sets of cultures, many of the clinical isolates persisted in the
challenged product for a longer period of time. In all cases three log reductions were obtained for the challenge organisms within one week of
inoculation and remained with no increase till the end of the experiment which lasted for 28 days. It is concluded that clinical isolates with multi
drug resistance can be used effectively in the test as the recommended strains provided their adaptability and potentials to grow in the unpreserved
product is established. The impact of this investigation on the pharmaceutical industries of the developing countries in regard to registration of new
products is discussed.
Keywords: harmonized challenge test, reference organisms, clinical isolates, liquid pharmaceutical preparations, none sterile dosage form
INTRODUCTION
Preservatives are usually incorporated into none sterile drug repository stock. This point is difficult to achieve by many
products such as oral dosage form to control bacteria and fungi that pharmaceutical manufacturers in certain countries where national
may be inadvertently introduced during manufacture or use by collections of type cultures are not available. This is due to tedious
patients1. Several techniques can be utilized to evaluate preservative regulations imposed recently on the movement of microbial cultures
effectiveness during the formulation stage of the product. These across boarders.
include single challenge test, multi challenge test and in use test 2,3.
The use of different concentrations of challenge inoculums' was also This investigation was undertaken to establish the difference
employed and was suggested as a predictable technique for the between the results of the harmonized challenge test using two sets
microbiological stability of the product over the expected shelf life 4. of test organisms. The first was composed of clinical isolates of
However, for official use, compendial procedures should be Pseudomonas aeruginosa, Staphylococcus aureus and candida albicns
followed. (the bacteria were multi antibiotic resistant). While the second was
composed of organisms derived from the American Type Culture
In recent years challenge test for none sterile liquid pharmaceutical Collection.
preparations has been harmonized between the United States,
Europeans and Japanese pharmacopoeias 5. The harmonization MATERIALS AND METHODS
involved almost all aspects related to the test methodology including A prototype antacid containing 36 gram aluminium hydroxide gel, 7
size of the inoculum, frequency of sampling, recovery media, g mannitol, and 0.05 g saccharin was aseptically prepared in 100 ml
neutralization procedure and the assessment of results 6. It was also sterile purified water. It was preserved with 0.2 % (weight /
pointed out that a single challenge with one level of microbial count volume) methyl and 0.03 % (w/v) propyl parabens. Both
using reference microorganisms should be employed in the preservatives were dissolved in 1 ml alcohol before adding to the
evaluation studies 7. These details are valuable as they eliminate bias preparation. Other two similar prototype products were prepared;
in results that could arise due to the use of different test procedures one was devoid of preservatives and the second contained half the
amount of preservatives employed above. The final pH of all
Sutton8 indicated that work done by the compendia in preparations was 8.1.
harmonization, assumes the equivalence of test strains from the
various culture collections while, in reality this claim of equivalence Products contamination testing
might not be true beyond the culture collection catalogues. The same
author suggested that it would be useful to have current The absence of microbial contamination from the prototype
preparations was established as described in the United States
confirmation that isolates from different collections are in fact, the
Pharmacopoeia 5. In brief, 1 ml aliquot of each product was
same. Friedel 9 questioned the value of using reference organisms in
separately inoculated into a flask containing autoclave sterilized
the challenge test and argued that these organisms have been
Casein Soya Bean Digest (CSBD) broth supplemented with 0.5 %
maintained in cryogenic storage for several decades and therefore,
Polysorbate 80 as preservatives neutralizer, incubated at 35 ºC for
they may have lost the toughness of environmental isolates which 48 hours before a loop full of the flask content was taken and
can resist the action of antimicrobial agents. streaked onto a plate of CSBD agar. These plates were incubated for
Reference strains in use today, were included for the first time in the 48 hours at 35 ºC before the presence or absence of grown colonies
USP 10 of 1970 upon recommendations from the Pharmaceutical was noted. Positive control composed of the prototype product
Manufacturer’s Association 11. Had other organisms been proposed, devoid of preservatives and inoculated with 104 colony forming unit
most probably they would have been adopted instead of those (CFU/ ml) of Pseudomonas aeruginosa ATCC 9027 was processed
employed at present. In order to establish the persistence of the along with the samples.
activity of the challenge organisms, the Phenol Coefficient and the Microbial cultures used
Antimicrobial Resistance tests were then used. The harmonized
requirements abandoned these tests and stipulated that all stock Staphylococcus aereus ATCC 6538 and P. aeruginosa ATCC 9027 in
cultures should be used within five passages from the original addition to Candida albicans ATCC 10231 were employed in the
 Shaqra et al.
Asian J Pharm Clin Res, Vol 5, Suppl 2, 2012, 141-144

challenge test. Another set of similar organisms isolated from clinical was treated as above to serve as a negative control, whereas,
specimens were obtained from the Medical Diagnostic laboratories aliquots of CSBD broth inoculated with test bacteria were included
(Zarqa- Jordan) and were also used. The bacterial isolates were to serve as a positive control. The product was considered as
resistance to various antibiotics and were chosen for this work due adequately preserved when 99.9 % (three log) reduction of the
to the possible linkage between bacterial resistance to preservatives initial inoculums' count was obtained on the 7 th day of incubation
and antibiotics12-14. Each culture was independently inoculated into and remained with no increase up to the 28th day of the experiment.
an aliquot of the prepared prototype antacid (unpreserved) to allow Microbiological culture media used were all derived from Difco –
for adaptation and this process was repeated for three consecutive USA. In separate experiments the same tests were performed using
subcultures. Recovered organisms from the third subculture were antacid prototype with half the amount of preservatives and the use
used to construct the growth curve for each isolate in the prototype of different concentrations of challenge organisms.
preparation over a period of five days.
Neutralization efficacy
Preparation of Inoculums
The prototype antacid suspension used in the test was challenged
Each microbial culture was separately inoculated into CSBD plate, separately with each tested organism (ATCC cultures and the clinical
incubated for 24 hours at 32 ºC before grown colonies were isolates) to give counts of 103 CFU / ml. One ml of the challenged
harvested with sterile saline. This suspension was standardized sample was diluted with 9 ml buffered sodium chloride peptone
using McFarland solution and spectrophotometry to contain 2 x 10 8 solution with preservatives neutralizers as given above. After one
Colony Forming Unit / ml as described by Sutton 15. Candia albicans hour, further 10 fold serial dilution using similar buffer were made.
was grown at 25 ºC fore 48 hours prior to harvesting as for the other All dilutions were kept at room temperature for additional 30
cultures. minutes to allow preservative neutralization to occur. Recovery of at
least 50 % of each test bacteria on SBCD agar or C. albicans on SDA
Challenge test indicated the effectiveness of the neutralization procedure.
The test procedure was similar to that described in the harmonized RESULTS
challenge test and it involved the inoculation of 2 x 10 6 CFU of the
test organism (0.1 ml of the second 10 fold dilution prepared from Contamination testing of the prepared prototype antacid
the original cell suspension) into 20 g of the preserved antacid preparations indicated that all were free from any contaminants.
prototype. Inoculated aliquots were incubated in a shaking water Figure 1 demonstrates the ability of the clinical isolates to grow in
bath at 35 ºC for bacteria and 25 ºC for C. albicans. Samples were the prototype antacid which was free from any preservative.
aseptically removed at day 0, 7, 14, 21 and 28 for viable counting Although it is evident that none of the used cultures lacked the
using buffered sodium chloride peptone solution (supplemented ability to grow in this product, Pseudomonas aeruginosa was the
with 0.5 % polysorbate 80 as preservatives neutralizer) and the most prolific while C. albicans was the least.
pour plate technique. Un-inoculated sample of the test preparation

10
Log number of CFU /ml of

8
preparation

6 Growth of candida albicans

0
0 1 2 3 4 5 6
Incubation time in days

Figure 1: Growth of clinical isolates (P. aeruginosa, S. aereus and C. albicans) in a prototype antacid preparation devoid of any
preservative system.
for the bacterial strains used in the test and these survivors did not
Results of challenge test conducted with all ATCC cultures indicated increase in number through out the period of incubation but in the
that 3 log reductions in the number of the inoculated test organisms contrary they were not detectable after 28 days of inoculation. It is
was obtained on the seventh day of inoculation and remained important to mention that plate counts were considered as valid
without increase till the end of the experiment (Table 1). It is clear only when the number of colonies on the plate exceeded 30 as
from this table that the tested preparation was self sterilizing for C. results of lower counts were not reproducible. When counts below
albicans ATCC 10231, as after 1 week of challenge, no survivors this figure were obtained, they were reported as low to count (LTC).
could be detected while more than three log reduction was obtained
Table 1: Survival of various reference organisms inoculated into adequately preserved prototype antacid preparation in high challenge
level.
Challenge organism Number of survivors (CFU/ ml) over the incubation period
Zero time 7 days 14 days 21 days 28 day
P. aeruginosa ATCC 90279 105 65 LTC* 0 0
S. aureus ATCC 6538 105 LTC* 0 0 0
C. albicans ATCC 10231 105 0 0 0 0
* Low to count in a reproducible manner
Table 2 demonstrates the inhibitory effect of the prototype antacid recorded for S. aereus after 21 days. P. aeruginosa was reduced in
(with preservatives) against all clinical isolates. It is worthy to note number by more than 3 logs and was not detected on the 28th day of
that the tested preparation exhibited sterilizing effect against C. the experiment.
albicans within 7 days of inoculation whereas, the same effect was

142
 Shaqra et al.
Asian J Pharm Clin Res, Vol 5, Suppl 2, 2012, 141-144

Table 2: Survival of various clinical microbial isolates inoculated into adequately preserved prototype antacid preparation in high
challenge level.
Challenge organism Number of survivors (CFU/ ml) over the incubation period
Zero time 7 days 14 days 21 days 28 day
P. aeruginosa 105 80 45 LTC* 0
S. aureus 105 63 LTC* 0 0
C. albicans 105 0 0 0 0
* Low to count in a reproducible manner
The prototype antacid prepared with half the strength of parabens challenge can be extrapolated from both tables. Preservatives
could not withstand the challenge test performed using high neutralization studies demonstrated that the neutralizer employed
microbial inoculums of the clinical isolates (table 3), but the case was effective as it was always possible to recover more than 50 % of
was different when the product was challenged with low numbers of the inoculated organisms.
the same organisms (table 4). The effect of the severity of the
Table 3: Survival and growth of various clinical microbial isolates inoculated into partially preserved prototype antacid preparation at
high challenge level.
Challenge organism Number of survivors (CFU/ ml) over the incubation period
Zero time 7 days 14 days 21 days 28 day
P. aeruginosa 105 7 x 103 2 x 103 1 x 103 4 x 103
S. aureus 105 6 x 102 4 x 102 2 x 102 102
C. albicans 105 2 x 102 LTC* 0 0
* Low to count in a reproducible manner
Table 4: Survival and growth of various clinical microbial isolates inoculated into partially preserved prototype antacid preparation at
low challenge levels.
Challenge organism Number of survivors (CFU/ ml) over the incubation period
Zero time 7 days 14 days 21 days 28 day
P. aeruginosa 103 2 x 102 3 x101 LTC* LTC*
S. aureus 103 7 x101 LTC* LTC* LTC*
C. albicans 103 0 0 0 0
* Low to count in a reproducible manner
DISCUSSION inoculated into the inadequately preserved antacid in high numbers,
they all survived and no 3 log reduction was noted after seven days
The preservation efficacy test agreed upon by the Americans, of challenge. Table 4 demonstrates that when the partially preserved
Europeans and Japanese pharmacopoeias was evaluated using three product was challenged with 103 CFU / ml, C. albicans was killed in 7
recommended test microorganisms and 3 clinical isolates. Findings days whereas the bacteria remained detectable up to the 28th day of
obtained revealed that using either sets of organisms, results were incubation. Abu Shaqra and Husari 4 demonstrated that while a
comparable to each other. This is important as it indicated that product could be bactericidal to a small microbial challenge, it can be
reference cultures and none reference organisms could be used bacteriostatic or even nutritional to a larger challenge level.
effectively in the challenge test. However, these authors used a recommended strain of P. aeruginosa
The preparation which was investigated in this study was an antacid (ATCC 9027); their results are in agreement with those given in the
and this was chosen due to the fact that alkaline liquid above tables, despite the use of none recommended strains in the
pharmaceuticals are amongst the most difficult to preserve 16. Table experiment.
1 demonstrates that when the prototype antacid was separately It has long been suggested that for a meaningful challenge test,
inoculated with the reference ATCC cultures, several survival strains must be chosen for their high level of resistance to
patterns were recorded. C. albicans were not detected after 7 days of antimicrobial agents including preservatives 17. However, antibiotics
inoculation while S. aereus was not isolated after 14 days. The only and preservatives resistance profiles of the contaminants of
organism which lost its viability after 21 days was P. aeruginosa but pharmaceutical products are hardly available in scientific literature;
all organisms exhibited more than three log reduction after 7 days of such a literature is found in relation to cosmetics. Osungunna et al.18
inoculation. The rapid kill of C. albicans in the preparation tested demonstrated that 14 isolates recovered from commercial creams
could be explained on the basis of product alkalinity (pH 8.1) which and lotions were with multi antibiotic resistant whereas, Flores et
is not conducive for the survival of this organism. On the other hand, al.19 showed that microorganisms resistant to preservatives were
the longer survival of P. aeruginosa than S. aereus is anticipated as capable of deteriorating cosmetic products. The bacterial cultures
the latter is more demanding in regard to nutritional requirement as employed in this work were clinical isolates with multidrug
compared to the former one. resistance and as results illustrated they were capable of survival in
Table 2 illustrates that the clinical isolate of C. albicans was the only the tested product 7 days more than the reference strains. This is
challenge organism which exhibited identical death rate to the tangible evidence that these isolates were more resistant to the
reference strain, whereas the absolute absence of S. aereus and P. action of parabens by which the tested preparation was preserved
aeruginosa required additional 1 week as compared to the reference than the reference cultures. This is consistent with observation
strains. Although, slight variation in the kill rate was noted, between reported by Ferrarese et al. 20 who found that environmental and
reference and none reference organisms, the interpretation of the bacterial contaminants of cosmetics showed higher resistance to
test results could lead to the same conclusions. The outcome of the preservatives than ATCC strains.
test is the appropriateness of the preservative system of the antacid Other points which should be considered in choosing the challenge
preparation in coping with challenge organisms regardless of being organisms are their ability to adapt and grow in the product under
reference or otherwise. test. This is critical to ensure that inhibition occurs as a result of the
The severity of the challenge to which a liquid pharmaceutical stress posed by the preservative system and not due to physical and
preparation is exposed, determines the persistence of its chemical factors excreted by the product environment. These factors
preservative activity. Table 3 shows that all clinical isolates when were taken into account and the clinical isolates were allowed to

143
 Shaqra et al.
Asian J Pharm Clin Res, Vol 5, Suppl 2, 2012, 141-144

pass through several subcultures in the product before they were 5. Annon. USP32 - Nf 27 The United States Pharmacopeial
used in the final test. Figure 1 demonstrates that all clinical isolates Convention, 2008; Rockville, MD USA
were capable of proliferating in the prototype antacid in the absence 6. Sutton S. The Harmonization of the Microbial Limits Tests.
of growth restraints and thus, their inability to grow in the same Pharm Technol 2006; 30: 66-73
product when it was supplemented with preservative must have 7. Sutton SVW, Porter, D Development of the Antimicrobial
been due to the efficacy of preservation. Effectiveness Test as USP Chapter <51>. PDA J Pharm Sci
Technol 2002; 56: 300- 311.
It is true that reference strains in the challenge test can decrease 8. Sutton S. Are All Identical Culture Collection Strains the Same?
bias in results obtained by different laboratories but it is obvious PMF Newsletter 2008;14: 6 -13
that this is secondary to the primary goal of indicating the 9. Friedel RR. Drug / consumer product preservation: making
microbiological stability of the product. Therefore, the use of sense of the USP 24 chapter <51> antimicrobial effectiveness
organisms with possible resistance to preservative systems should test, PMF Newsletter 2000; 7: 1- 4.
be used as they might give more meaningful results than the 10. Annon. The United States Pharmacopeial Convention, Inc., The
reference strains. Such organisms can be isolated from the United States Pharmacopeia, 18th Revision, Rockville, MD.
manufacturing environment, raw materials, water used in 1970; p. 845.
formulation in addition to organisms recovered from experimental 11. Leitz M. “Critique of U.S.P. microbiological test” Bull Parenter
batches. This investigation has added clinical isolates with multi Drug Assoc 1972; 26: 212 - 216.
drug resistance as possible candidates in testing the microbiological 12. Gilbert P, McBain AJ. Potential Impact of increased use of
stability of liquid pharmaceutical preparations. biocides in consumer products on prevalence of antibiotic
In countries where own pharmacopoeias are not present, regulatory resistance Clin Microbiol Rev 2003; 16: 189-208.
bodies rely on guidelines derived from international compendia's, 13. Braoudaki M, Hilton AC. Adaptive resistance to biocides in
and since for registration purposes challenge test is required, the Salmonella enterica and Escherichia coli O157 and cross-
use of reference cultures becomes mandatory. Constant update of resistance to antimicrobial agents J Clin Microbiol 2004;42:
reference microbial cultures is a subject of concern to drug 73-78.
producers as the harmonized preservative efficacy test procedure 14. Aiello AE, Marshall B, Levy SB, Della-Latta P, Lin SX, Larson E
demands the use of these organisms within five subcultures. Many Antibacterial cleaning products and drug resistance Emerg
companies may find this stipulation difficult to achieve and probably Infect Dis 2005; 11: 1565-1570.
use reference organisms that have undergone unlimited numbers of 15. Sutton S. Measurement of Cell Concentration in Suspension by
subcultures and in this case, challenge test might be performed using Optical Density P M F Newsletter 2006;12: 3-12
strains thought to be reference, while in fact they are not. It is 16. Hossain M, Ara S, Rahman M.Z Quantitative examination of
therefore proposed that, in developing countries where recent aerobic bacteria and fungi in locally available antacid
update of culture collection is not always feasible, the use of wild suspension and possible contamination by specific bacteria
test strains should be encouraged and if certain about the Pakistan J biol Sci 2004; 7: 2014- 2017.
authenticity of the reference strains, then why not to be included in 17. Cowen RA and Steiger B. Antimicrobial activity – a critical
the test. review of test methods of preservative efficiency J Soc Cosm
Chem 1976; 27: 467-481.
Pharmaceutical companies in America and probably in many 18. Osungunna MO, Oluremi BB, Adetuyi A. Bacteriological and
developed countries are requested to contribute with their ideas Antibiotic Sensitivity Patterns of Bacterial Isolates from
regarding any change in compendial methods or standards 21-23. This Creams and Lotions Hawked in Sagamu, Ogun State Pakistan J.
is typically what happened during the preparatory stage of the Nutr 2010; 9: 773-775.
harmonized microbiological limits which started in the nineties of 19. Flores M, Morillo M, Crespo ML. Deterioration of raw materials
the last century24. The continuous demands of the concerned and cosmetic products by preservative resistant
companies to modify the agreed upon drafts have resulted in the microorganisms Int Biodeter Biodegrad 1997; 40: 157-160.
delay of its implementation25. Even soon after approval of the 20. Ferrarese L, Paglia R, Ghirardini A. Bacterial resistance in
harmonized limits, calls for revisions and further clarifications were cosmetics industrial plant: connected problems and their
requested 26. Because many of the pharmaceutical companies in the solution Annals Microbiol 2003; 53: 477-490
developing countries are negatively affected by the harmonized 21. Sheinin E. B, Schuber' S. "A State of Revision: USP's Guideline
preservative efficacy test, particularly the choice of challenge for the submission of requests for revision" Pham Technol
organisms, it is thought that a statement should be included in future 2003; 2: 772-774.
revisions to allow the use of wild organisms provided that their 22. Cecil T. Public comment and expert oversight the cornerstones
competence for such work is experimentally proven. or USP standards development Pharm Technol 2007; 31: 12-
14.
CONCLUSION
23. Schneipp S. "Have a say in USP standards," Pham Technol
Results presented in this communication provided strong evidence 2009; 33: 88 – 91.
to the suitability of using microbial cultures other than those 24. 24. Opalchenova G. "A Comparison of the microbial limit tests
recommended by the harmonized challenge test procedure. Criteria in the British, European, and US Pharmacopeias and
for the selection of appropriate test organisms include adaptability recommendations for harmonization" Pharm Forum 1994;
and ability to grow in the tested product devoid of preservatives. 20: 7872-7877.
25. Annon. USP. Harmonized microbiology general chapters:
REFERENCES notice of postponement, Pharm Forum 2007; 33: 168-169
26. 26. Sutton S. Does international harmonization of the USP
1. Boukarim C, Abou Jaoude S, Bahnam R, Barada R, Kyriacos S.
microbial limits tests require re-validation of finished product
Preservatives in liquid pharmaceutical preparations. J Appl Res
tests? J Val Technol 2009; 15: (2009) 10- 16.
2009; 9: 14- 17
2. Abu Shaqra QM , Husari N. Preservation efficiency of some
commercially available antacid suspensions against
Pseudomonas aeruginosa (ATCC 9027). Int Biodeter 1987; 23:
47-51
3. Leak RE, leech R. Challenge tests and predictive ability In:
Microbial quality assurance in pharmaceuticals, cosmetics and
toiletries, Bloomfield Et al (eds) chapter 10, 1988; p 129-14 6
4. Abu Shaqra QM, Husari NT. A modified titration technique for
the evaluation of preservative effectiveness in liquid
pharmaceutical preparations. Int Biodeter 1987; 23: 281-286.

144