Culture of Mycobacterium avium subspecies paratuberculosis from the blood of patients with Crohn's disease

Lancet. 2004 Sep 18-24;364(9439):1039-44. doi: 10.1016/S0140-6736(04)17058-X.


Background: Crohn's disease, a form of inflammatory bowel disease, resembles some aspects of tuberculosis, leprosy, and paratuberculosis. The role of Mycobacterium avium subspecies paratuberculosis (MAP) in Crohn's disease is controversial.

Methods: We tested for MAP by PCR and culture in buffy coat preparations from 28 individuals with Crohn's disease, nine with ulcerative colitis, and 15 without inflammatory bowel disease.

Findings: MAP DNA in uncultured buffy coats was identified by PCR in 13 (46%) individuals with Crohn's disease, four (45%) with ulcerative colitis, and three (20%) without inflammatory bowel disease. Viable MAP was cultured from the blood of 14 (50%) patients with Crohn's disease, two (22%) with ulcerative colitis, and none of the individuals without inflammatory bowel disease. Current use of immunosuppressive medication did not correlate with a positive MAP culture. Sequencing of PCR products from MAP cultures confirmed the presence of the MAP-specific IS900 fragment. Among 11 MAP isolates assessed, we identified nine strains that were not identical.

Interpretation: We detected viable MAP in peripheral blood in a higher proportion of individuals with Crohn's disease than in controls. These data contribute to the evidence that MAP might be a cause of Crohn's disease.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Bacteremia / complications
  • Bacteremia / microbiology
  • Colitis, Ulcerative / microbiology
  • Crohn Disease / microbiology*
  • DNA, Bacterial / analysis
  • Female
  • Humans
  • Inflammatory Bowel Diseases / microbiology
  • Male
  • Middle Aged
  • Milk, Human / microbiology
  • Mycobacterium avium subsp. paratuberculosis / genetics
  • Mycobacterium avium subsp. paratuberculosis / isolation & purification*
  • Paratuberculosis / complications
  • Polymerase Chain Reaction


  • DNA, Bacterial