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Prevalence of Mycobacterium avium subsp. paratuberculosis and Escherichia coli in blood samples from patients with inflammatory bowel disease

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Abstract

Mycobacterium avium subsp. paratuberculosis (MAP) and adherent-invasive Escherichia coli (AIEC) have been implicated as primary triggers in Crohn’s disease (CD). In this study, we evaluated the prevalence of MAP and E. coli (EC) DNA in peripheral blood from 202 inflammatory bowel disease (IBD) patients at various disease periods and compared against 24 cirrhotic patients with ascites (CIR) (non-IBD controls) and 29 healthy controls (HC). MAP DNA was detected by IS900-specific nested PCR, EC DNA by malB-specific nested PCR and AIEC identity, in selected samples, by sequencing of fimH gene. CD patients with active disease showed the highest MAP DNA prevalence among IBD patients (68 %). Infliximab treatment resulted in decreased MAP detection. CIR patients had high individual and coinfection rates (75 % MAP, 88 % EC and 67 % MAP and EC), whilst HC controls had lower MAP prevalence (38 %) and EC was undetectable in this control group. EC DNA prevalence in IBD patients was highly associated with CD, and 80 % of EC from the selected samples of CD patients analyzed carried the fimH30 allele, with a mutation strongly associated with AIEC. Our results show that coinfection with MAP and AIEC is common and persistent in CD, although the high MAP and EC detection in CIR patients suggested that colonization is, at least, partially dependent on increased gut permeability. Nevertheless, facilitative mechanisms between a susceptible host and these two potential human pathogens may allow their implication in CD pathogenesis.

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Acknowledgments

This work received financial support from the European Union (FEDER funds), through Programa Operacional Factores de Competitividade—COMPETE, and from National Funds (FCT, Fundação para a Ciência e a Tecnologia), through grant number PIC/IC/82802/2007. The authors wish to thank all patients and controls for their participation in this study.

Conflict of interest

The authors declare that they have no competing interests.

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    Authors and Affiliations

    1. FP-ENAS (UFP Energy, Environment and Health Research Unit), CEBIMED (Biomedical Research Centre), University Fernando Pessoa, Rua Carlos da Maia, 296, 4200-150, Porto, Portugal

      Nair Nazareth, Elisabete Machado, Teresa Gonçalves Ribeiro, António Martinho, Pedro Rodrigues, Rita Alves, Gonçalo Nuno Macedo & Amélia Sarmento

    2. Institute of Pharmacology and Therapeutics, Faculdade de Medicina, Universidade do Porto, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal

      Fernando Magro & Daniela Gracio

    3. Gastroenterology Department, Centro Hospitalar São João, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal

      Fernando Magro, Rosa Coelho & Guilherme Macedo

    4. MedInUP -Center for Drug Discovery and Innovative Medicines, Universidade do Porto, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal

      Fernando Magro & Daniela Gracio

    5. REQUIMTE, Laboratory of Microbiology, Faculdade de Farmácia, Universidade do Porto, Rua de Jorge Viterbo Ferreira, 228, 4050-313, Porto, Portugal

      Elisabete Machado & Teresa Gonçalves Ribeiro

    6. Infection and Immunity Unit, IBMC – Instituto de Biologia Molecular e Celular, Universidade do Porto, Rua do Campo Alegre, 823, 4150-180, Porto, Portugal

      Pedro Rodrigues, Rui Appelberg & Amélia Sarmento

    7. Department of Infectious Diseases, Centro Hospitalar S. João, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal

      Candida Abreu

    8. Nephrology Research and Development Unit, Faculdade de Medicina da Universidade do Porto, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal

      Candida Abreu

    9. Department of Biostatistics and Medical Informatics, Faculdade de Medicina, Universidade do Porto, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal

      Camila Dias

    10. Institute for Infection and Immunity, St George’s University of London, Cranmer Terrace, London, SW17 0RE, UK

      Tim Bull

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    1. Nair Nazareth
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    Corresponding author

    Correspondence to Amélia Sarmento.

    Additional information

    Nair Nazareth and the Fernando Magro have contributed equally to this work.

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    Nazareth, N., Magro, F., Machado, E. et al. Prevalence of Mycobacterium avium subsp. paratuberculosis and Escherichia coli in blood samples from patients with inflammatory bowel disease. Med Microbiol Immunol 204, 681–692 (2015). https://doi.org/10.1007/s00430-015-0420-3

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    • DOI: https://doi.org/10.1007/s00430-015-0420-3

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