Watch out where you get that tattoo!
From the ever insightful CDC’s Morbidity and Mortality Weekly Report, a news alert about an outbreak of Mycobacterium infections following receiving a tattoo. In January 2012, the New York Department of Health received reports of 14 cases of Mycobacterium chelonae skin infection among residents at the site of a recent tattoo. M. chelonae is a member of a group of non-tuberculosis mycobacteria (NTM), and has traditionally been associated with relatively non life threatening, superficial infections, typically acquired nosocomially. Disseminated disease can occur and is typically fatal, but generally only occurs in extenuating circumstances where the patient is otherwise immunocompromised as with AIDS. Because the disease is typically not serious, and no human to human cases of transmission have been documented, cases are not generally reported to the CDC and the actual levels of infection are not precisely known. Voluntary reporting indicates level of disease around 3 cases per million population, however underreporting of disease is likely the case.
With the current outbreak, patients were identified by an address list provided by a tattoo artist in New York, after one patient reported a persistent rash 1 week following receiving a tattoo. Culturing of the isolate identified it as M. chelonae. From the address list, 14 additional individuals were identified, and M. chelonae was again isolated. No lapses in infection control were found to be done by the tattoo artist, and the organism was not found in water and environmental samples at the tattoo parlor. The artist reported using prediluted ink provided by a commercial vendor; analysis of one opened and one unopened bottle of prediluted grey ink indicated contamination with the organism. Pulsed field DNA gel electrophoresis (PFGE) analysis indicated greater than 95% genetic identity among all of the recovered isolates, strongly supporting the ink as the source of the outbreak. The CDC then identified other tattoo parlors in other states and found additional instances of infection in Washington, Iowa, and Colorado.
In light of this outbreak, the CDC makes the following “best practices” recommendations for tattoo artists:
- avoid using products not intended for tattooing (e.g. non-sterile water)
- avoid ink dilution, and if dilution is necessary, only use sterile water
- follow aseptic technique practices at all points in the procedure\
and has several recommendations for consumers:
- use only licensed tattoo parlors
- request ink specifically manufactured for tattoos
- ensure that artists use good hygiene
- be aware of the potential for infection, and follow up with a health practitioner if an adverse reaction occurs.
Posted on August 27, 2012, in Microbes in the News, The more you know, Wash your hands! and tagged Centers for Disease Control and Prevention, Mycobacterium chelonae, Tattoo. Bookmark the permalink. 2 Comments.