Experts claim that
regardless of stringent adherence to cleanliness practices, a tattoo parlor in
Rochester, N.Y. was the source of
outbreak affecting the skin and soft tissues.
Byron Kennedy MD, PhD,
of the Monroe County Department of Public Health in Rochester, and colleagues,
stated that the culprit was 'a sealed batch of supposedly sterile premixed ink,
direct from the manufacturer.'
Kennedy and his
colleagues conducted a study that was published in the
New England Journal of Medicine. Nineteen people were included in
the study who developed a persistent, raised, erythematous rash in the skin
above the tattoo within 3 weeks of the tattoo in the last 4 months of 2011.
"The bacteria were
isolated from 14 of the 19 patients and also from an unopened bottle of
premixed ink, suggesting the source was in the manufacturing chain. The ink's
maker issued a voluntary recall of the product."
The scientists
observed that the condition of 18 patients out of the nineteen improved with
antibiotic treatment.
Researchers, in an
overlapping report in
Morbidity and
Mortality Weekly Report, stated that, 'Additional eight confirmed cases of
tattoo-associated skin infection by nontuberculous mycobacteria picked up by
nationwide surveillance, including:
Three confirmed and 24
possible cases of
Mycobacterium abscessus
infection, and two confirmed and two possible cases of
M. chelonae infection, in separate clusters in Washington state.
Two confirmed
M. chelonae cases in Iowa, and one in
Colorado.'
The CDC report said
that the
M. chelonae were dissimilar
to those found in New York. This shows that different inks were used for
tattooing.
Kennedy and colleagues
noted that the Rochester outbreak was strange for two important reasons:
Firstly, "
M. chelonae, a rapidly growing form of
nontuberculous mycobacteria, is an "uncommon" cause of skin
infections....... The pathogen has also only rarely been associated with
tattoo-related infections."
And secondly, "most
cases of tattoo-related infection arise from unsanitary practices in the tattoo
establishment, rather than premixed packages of ink."
According to the
researchers, the study findings highlighted an important fact that there is a
possibility of underestimation of nontuberculous myobacterial infections with
rising popularity of tattoo practice.
It has been suggested
that tattoo parlors should take adequate safety measures regarding using
sterile instruments, disposable and clean gloves, single-use containers and
personal hygiene. The ink for tattooing should be used in sterile disposable
containers.
Pamela LeBlanc, MPH,
and her colleagues at the FDA's Center for Food Safety and Applied Nutrition in
College Park, Md., mentioned that the case has "raised questions about the
adequacy of prevention efforts implemented at the tattoo-parlor level
alone."
Pamela LeBlanc
et al wrote, "The agency is currently
trying to define what measures should be taken to improve public health in
regard to tattoos."
Reference:
Outbreak of Mycobacterium chelonae Infection
Associated with Tattoo Ink; Byron Kennedy et al; N Engl J Med 2012;
367:1020-1024
Source: Medindia
