Skip to main content

Skin Infections Linked to Tattoo Ink

 |  By cclark@healthleadersmedia.com  
   August 11, 2011

Doctors and hospitals that treat difficult chronic skin infections should be aware of tattoos on patients, Seattle researchers suggest.

In a report published in this month's issue of the Journal of Emerging Infectious Diseases by the Centers for Disease Control and Prevention, Jeffrey S. Duchin, and colleagues at the University of Washington say they found two cases of Mycobacterium haemophilum infection, a type of bacteria that usually affects only patients with damaged immune systems.

The infections showed up as chronic blotches and weeping ulcers on the skin and were unresponsive to routine antibiotics such as ceftriaxone and trimethoprim sulfamethoxazole, Duchin explained in a telephone interview.

He is unaware of other cases so far, but said that such infections may be hard to identify when they turn up in otherwise healthy adults. Infection with this type of bacteria, which is commonly found in the environment, had not previously been found in patients' tattoos.

Duchin said these cases were caught because the two patients, who did not know each other, went to the same tattoo parlor and by coincidence sought care from the same physician who reported it to public health officials. The infection ran along the lines of the tattoos, so Duchin says "it definitely went in with the ink."

Tara R. Perti, MD, the physician who treated the patients and grew the bacteria in culture.  noted that the ink used probably wasn't a commercial product, because other cases would have shown up by now.

After investigation and research, Duchin explained, public health officials narrowed the source down to contaminated tap water, which was used to dilute the inks.

One of the lessons from this finding, Duchin says, is that currently "there are no industry-wide standards for optimal tattoo procedures, although there are some guidelines from different groups. But there's nothing required, and no real guideline about whether tap water should or shouldn't be used."

On the basis of this, he said, "we recommend tap water should not be used to dilute inks used for tattoos."

Duchin said that many more cases may be occurring, but they may go unrecognized because in some people "[the infections] get better on their own."

Labs don't normally run tests for this type of bacteria, in part because doing so is difficult and takes a long time. But Duchin says doctors who see patients with otherwise unexplained infections should consider Mycobacterium haemophilum as a source.

Another concern is the growing popularity of body art, which may be designed and applied by artists who are less than diligent at adhering to safe practices.

"For healthcare providers, the key is to think about these organisms in patients who develop tattoo- associated infections, especially those that don't respond to initial treatment."

Tagged Under:


Get the latest on healthcare leadership in your inbox.