INFECTIONS BY OTHER MYCOBACTERIA OF THE M. TUBERCULOSIS COMPLEX

DOLORES GAVIER-WIDEN

National Veterinary Institute (SVA), and Swedish University of Agricultural Sciences Uppsala, Sweden

MYCOBACTERIUM TUBERCULOSIS (HUMAN TUBERCULOSIS)

Mycobacterium tuberculosis is the principal cause of human tuberculosis worldwide.

MYCOBACTERIUM MICROTI

The main host of M. microti is the field vole (Microtus agrestis), and the disease is called vole tuberculosis. The infection has been reported to be endemic with high prev­alence in field voles in the UK⁽⁸¹⁾. Mycobacterium microti infection also occurs in wood mice (Apodemus sylvaticus), bank voles (Clethrionomysglareolus), shrews (Sorexaraneus), domestic cats (mostly of extra urban locations) and occa­sionally in badgers (Meles meles), domestic pigs, cattle, llamas, alpacas and zoo animals in Europe.

In a study in the UK the prevalence of vole tuberculosis, based on detection of gross skin lesions, was estimated to vary from zero to up to 50% of voles infected per site studied. The prevalence increased with the age of individu­als and showed apparent seasonality, with higher numbers of cases in the late spring and early summer, which was attributed to a higher proportion of older voles in the spring⁽⁸¹⁾.

The molecular typing of M. microti isolates from cats and other animals in the UK has shown a diversity of genotypes, geographically localized and different from iso­lates obtained from M. microti infection clusters in the Netherlands and Belgium^(82,83), and did not overlap with the distribution of M. bovis⁽⁸²⁾. No host specificity for the different spoligotypes of M. microti were shown⁽⁸²⁾.

It has been suggested that field voles act as maintenance host of M. microti^ix1 and cats are spillover hosts that con­tract the infection from hunting rodents⁽⁸²⁾.

Mycobacterium microti causes lesions in a wide range of mammalian species, in some of which infection is proba­bly acquired via the skin through bite wounds. Voles show characteristic cutaneous lesions, which consist of subcuta­neous granulomas with skin ulcers in the scapular region; these represent late stage of infection and are therefore found in adult voles (mass >17 g)⁽⁸¹⁾. Lesions may be dis­seminated and occur also in the lungs, lymph nodes and other organs. In particular, superficial lymph nodes drain­ing skin wounds show granulomas. Lesions in cats are mostly located in the skin and superficial lymph nodes of the head, suggesting infection via bite injuries contracted during hunting of rodent prey⁽⁸²⁾. In other species, includ­ing alpacas, a llama, a horse and badgers, a range of pathol­ogy has been described, from no visible lesions to generalized disease⁽⁸²⁾. The frequency of generalized disease in any species is unknown. Histologically, in voles accu­mulation of macrophages, with necrosis and calcification, and sometimes abundant AFB are observed in the skin and granulomatous lesions occur also in lungs, lymph nodes and other organs.

In a study in voles in the UK, the recognition of clinical signs of vole tuberculosis (characteristic skin lesions and superficial lymphadenitis) detected a prevalence of 7%, whereas post mortem examination (with demonstration of caseous abscesses in subcutaneous or internal abdominal organs) detected more cases, a prevalence of 21%⁽⁸³⁾.

Mycobacterium microti is a zoonotic agent, and infection has been reported in immunosuppressed and also in immunocompetent humans in several European countries.

MYCOBACTERIUM PINNIPEDII

Mycobacterium pinnipedii infection has been reported in various captive and free-ranging pinnipeds in the southern hemisphere. Terrestrial mammals, including humans, are also susceptible to M. pinnipedii infection. An outbreak of tuberculosis due to M. pinnipedii occurred in southern sea lions (Otaria flavescens) in a zoo in the Netherlands, with granulomatous lesions in bronchial, mediastinal and mesenteric lymph nodes, lungs and other organs. Many zookeepers in close contact with the sea lions contracted the infection⁽⁸⁴⁾. Infection by M. pinnipedii has also been reported in other zoos in Europe, causing mostly pulmo­nary and lymph node lesions in a South American sea lion (Otaria byronia), Bactrian camels (Camelus bactrianus bac- trianus) and Malayan tapirs (Tapirus indicus) in Germany⁽⁸⁵⁾. No cases of M. pinnipedii infection have been reported in free-ranging wild animals in Europe.

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