Wachtman Lynn M, Miller Andrew D, Xia DongLing, Curran Elizabeth H, Mansfield Keith G
New England Primate Research Center, Harvard Medical School, Southborough, Massachusetts, USA.
Comp Med. 2011 Jun;61(3):278-84.
Mycobacterium tuberculosis infections can result in significant morbidity and mortality in nonhuman primate colonies. Preventative health programs designed to detect infection routinely include tuberculin skin testing (TST). Because Mammalian Old Tuberculin used for TST contains antigens common to a variety of mycobacterial species, false-positive results can occur in animals sensitized to nontuberculous mycobacteria (NTM). Over 11 mo, a large colony of common marmosets (Callithrix jacchus) demonstrated a 3.6% prevalence of equivocal or positive TST reactions (termed 'suspect reactions'). Culture of gastric aspirates, bronchoalveolar lavage fluid, and feces revealed a single animal with a positive fecal culture for Mycobacterium gordonae. PCR amplification of M. gordonae DNA in feces collected from animals with suspect TST reactions (demonstrating a 66.7% colonization rate) and colony controls (demonstrating a 14.3% colonization rate) revealed a significant association between suspect TST reactions and intestinal colonization. Gross and histopathologic evaluation revealed a multifocal lymphadenopathy and granulomatous lymphadenitis in 2 of 4 TST-positive marmosets examined. Counter to expectations, granulomatous lymphoid tissue was culture-positive for M. kansasii rather than M. gordonae. Detection of M. gordonae in the feces of TST-suspect animals likely represents an apathogenic intestinal colonization that may serve as an indicator of NTM exposure, whereas evidence of histopathologic disease is associated with the more pathogenic M. kansasii. Although a high index of suspicion for M. tuberculosis should always be maintained, colonization with NTM organisms represents a cause of suspect TST reactions in common marmosets.
结核分枝杆菌感染可导致非人灵长类动物群体出现严重的发病和死亡情况。旨在常规检测感染情况的预防性健康计划通常包括结核菌素皮肤试验(TST)。由于用于TST的哺乳动物旧结核菌素含有多种分枝杆菌共有的抗原,对非结核分枝杆菌(NTM)致敏的动物可能会出现假阳性结果。在11个多月的时间里,一个普通狨猴(Callithrix jacchus)大群体中,TST反应模棱两可或呈阳性(称为“可疑反应”)的患病率为3.6%。对胃抽吸物、支气管肺泡灌洗液和粪便进行培养,发现有一只动物粪便培养出戈登分枝杆菌呈阳性。对TST反应可疑的动物(定植率为66.7%)和群体对照动物(定植率为14.3%)粪便中戈登分枝杆菌DNA进行PCR扩增,结果显示可疑TST反应与肠道定植之间存在显著关联。大体和组织病理学评估显示,在接受检查的4只TST阳性狨猴中,有2只出现多灶性淋巴结病和肉芽肿性淋巴结炎。与预期相反,肉芽肿性淋巴组织培养出堪萨斯分枝杆菌呈阳性,而非戈登分枝杆菌。在TST可疑动物粪便中检测到戈登分枝杆菌可能代表一种无致病性的肠道定植,这可能是NTM暴露的一个指标,而组织病理学疾病证据与致病性更强的堪萨斯分枝杆菌有关。尽管应始终对结核分枝杆菌保持高度怀疑,但NTM生物的定植是普通狨猴TST反应可疑的一个原因。