Culture of Mycobacterium avium subspecies paratuberculosis (MAP) from blood and extra-intestinal tissues in experimentally infected sheep

Mycobacterium avium subspecies paratuberculosis (MAP) is the causative agent of Johne's disease or paratuberculosis, a chronic enteritis of ruminants, and has been suggested to play a role in Crohn's disease in humans. While Johne's disease is primarily expressed in the gastrointestinal tract, isolation of MAP from extra-intestinal tissues indicates that microbial dissemination via the haematogenous route may occur during the infection. Consequently, the occurrence of mycobacteraemia and dissemination to the liver and hepatic lymph node was investigated in 111 sheep. Disseminated infection was detected in 18 of the 53 sheep that were confirmed to be infected following oral exposure to MAP while the bacterium was isolated from the blood of only 4 of these animals. Disseminated infection was detected more frequently from animals with a positive compared to a negative faecal culture result, multibacillary compared to paucibacillary lesions, and clinical compared to subclinical disease. Detection of MAP in blood by culture was significantly associated with increased time post-exposure and clinical disease, with trends for increased detection in animals with multibacillary lesions and positive faecal culture results. Isolation of MAP from blood was difficult in the early stages of the disease and in paucibacillary animals as the bacteraemia may be intermittent, below the limit of detection or MAP may be present in a dormant non-culturable form. Prolonged incubation periods prior to growth in BACTEC were consistent with inhibition of growth or dormancy in some blood cultures.