The Association of Mycobacterium avium subsp. paratuberculosis with Inflammatory Bowel Disease

• Published in: PloS one Vol. 11; no. 2; p. e0148731
• Main Authors: Timms, Verlaine J, Daskalopoulos, George, Mitchell, Hazel M, Neilan, Brett A
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 05-02-2016; Public Library of Science (PLoS)
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Alcoholic beverages; Alcohols; Animals; Antibiotics; Assaying; Biology and Life Sciences; Biopsy; Biotechnology; Cattle; Causes of; Colitis, Ulcerative - genetics; Colitis, Ulcerative - microbiology; Colonoscopy; Crohn Disease - genetics; Crohn Disease - microbiology; Crohns disease; Development and progression; Disease control; Drug Resistance, Bacterial; Endoscopy; Ethambutol; Female; Gastroenterology; Gender; Genomics; Human performance; Humans; Inflammatory bowel disease; Inflammatory bowel diseases; Intestine; IS900 gene; Male; Medicine and Health Sciences; Microorganisms; Middle Aged; Mycobacterium; Mycobacterium avium; Mycobacterium avium subsp. paratuberculosis - genetics; Mycobacterium avium subsp. paratuberculosis - growth & development; Mycobacterium avium subsp. paratuberculosis - isolation & purification; Paratuberculosis; Paratuberculosis - genetics; Paratuberculosis - microbiology; Pasteurization; Patients; Physiological aspects; Research and Analysis Methods; Rifampin; Smoking; Streptomycin; Tissue culture; Ulcerative colitis; Ulcers; Australia; Sydney New South Wales Australia
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0148731

The association of Mycobacterium avium subspecies paratuberculosis (M. paratuberculosis) with Crohn's disease is a controversial issue. M. paratuberculosis is detected by amplifying the IS900 gene, as microbial culture is unreliable from humans. We determined the presence of M. paratuberculosis in patients with Crohn's disease (CD) (n = 22), ulcerative colitis (UC) (n = 20), aphthous ulcers (n = 21) and controls (n = 42) using PCR assays validated on bovine tissue. Culture from human tissue was also performed. M. paratuberculosis prevalence in the CD and UC groups was compared to the prevalence in age and sex matched non-inflammatory bowel disease controls. Patients and controls were determined to be M. paratuberculosis positive if all three PCR assays were positive. A significant association was found between M. paratuberculosis and Crohn's disease (p = 0.02) that was not related to age, gender, place of birth, smoking or alcohol intake. No significant association was detected between M. paratuberculosis and UC or aphthous ulcers; however, one M. paratuberculosis isolate was successfully cultured from a patient with UC. We report the resistance of this isolate to ethambutol, rifampin, clofazamine and streptomycin. Interestingly this isolate could not only survive but could grow slowly at 5°C. We demonstrate a significant association between M. paratuberculosis and CD using multiple pre-validated PCR assays and that M. paratuberculosis can be isolated from patients with UC.