Swisher Samantha D, Taetzsch Sara J, Laughlin Mark E, Walker William L, Lehman Kimberly A, Carroll Anne, Bravo Doris M, Langer Adam J, Pieracci Emily G
1Division of Global Migration Health, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia.
2Epidemic Intelligence Service, CDC, Atlanta, Georgia.
J Am Assoc Lab Anim Sci. 2025 Jul 1:1-6. doi: 10.30802/AALAS-JAALAS-25-057.
Screening nonhuman primates (NHPs) for tuberculosis (TB) is important to protect the health of NHP colonies and people who interact with them. Screening is especially important for imported NHPs from countries where TB is prevalent and biosecurity practices may be lax. There are a variety of testing methods available for TB screening and diagnosis in NHPs; all have limitations, and their performance in different settings is incompletely characterized. The US Centers for Disease Control and Prevention (CDC) collects TB testing results as part of its regulatory oversight of NHP importation. We collated the results of tuberculin skin tests (TSTs), interferon-γ release assays (IGRAs), multiplexed fluorometric immunoassay (MFIA), Mycobacterium tuberculosis complex PCR, staining for acid-fast bacilli (AFB), and culture of bacteria from tissues for imported NHPs in CDC-mandated quarantine during fiscal years 2021 to 2024. We used these data to assess test performance and intertest agreement for the different tests used. Among 107 imported NHPs tested, TST and IGRA were the most common antemortem tests performed, but they agreed poorly with each other and with culture. AFB staining and PCR exhibited moderate agreement and high positive predictive values using culture as the gold standard. The most commonly affected tissues were lungs and tracheobronchial lymph nodes, regardless of the Mycobacterium sp. identified. Further research is needed to identify and validate additional methods for TB testing in NHPs, particularly for antemortem screening. Tissue acid-fast staining and PCR exhibited high positive predictive values and could be useful to inform policies and clinical decisions about colony management and occupational health while awaiting culture results.
对非人灵长类动物（NHPs）进行结核病（TB）筛查对于保护非人灵长类动物群体以及与它们接触的人员的健康至关重要。对于从结核病流行且生物安全措施可能松懈的国家进口的非人灵长类动物，筛查尤为重要。有多种检测方法可用于非人灵长类动物的结核病筛查和诊断；所有这些方法都有局限性，并且它们在不同环境中的性能尚未完全明确。美国疾病控制与预防中心（CDC）收集结核病检测结果，作为其对非人灵长类动物进口监管的一部分。我们整理了2021财年至2024财年期间在CDC规定的隔离期内对进口非人灵长类动物进行的结核菌素皮肤试验（TST）、干扰素-γ释放试验（IGRA）、多重荧光免疫测定（MFIA）、结核分枝杆菌复合群PCR、抗酸杆菌（AFB）染色以及组织细菌培养的结果。我们利用这些数据评估了所使用的不同检测方法的性能以及检测间的一致性。在接受检测的107只进口非人灵长类动物中，TST和IGRA是最常用的生前检测方法，但它们彼此之间以及与培养结果的一致性较差。以培养作为金标准，AFB染色和PCR表现出中等一致性和较高的阳性预测值。无论鉴定出的分枝杆菌种类如何，最常受影响的组织是肺和气管支气管淋巴结。需要进一步研究以确定和验证用于非人灵长类动物结核病检测的其他方法，特别是用于生前筛查的方法。组织抗酸染色和PCR表现出较高的阳性预测值，在等待培养结果期间，可有助于为有关群体管理和职业健康的政策及临床决策提供参考。
