‘Latently adapted’ organisms can persist for years or decades until reactivation occurs due to a variety of factors including waning of immuno-surveillance.

“These results demonstrate that MAP is capable of adaptation to NRP [non replicating persistence] similar to that observed for MTB with differential susceptibility to antibiotics under aerobic versus anaerobic conditions. Such findings have significant implications for our understanding of the pathogenesis of MAP in vivo and the treatment of CD should this organism be established as the causative agent.”