Bad Ink? Tattoo Infection Outbreak Investigated

Connie K. Ho for — Your Universe Online

A recent study by researchers from the University of Rochester Medical Center examined a local outbreak of infections related to tattoo ink.

The research, published in the New England Journal of Medicine, included documentation of 19 different cases in the Rochester, New York area. This is the highest number of cases ever reported to be associated with tattoo infections caused by a bacteria often found in tap water. The researchers believed that a premixed gray ink that is normally used in portrait or photography tattoos is the reason for the major outbreak.

“I´ve seen people with tattoo-related issues over the years, but never this many: The volume of patients impacted makes this a real public health concern,” commented Dr. Mary Gail Mercurio, a dermatologist at the University of Rochester Medical Center who counseled with 18 of the 19 individuals who had tattoo infections.

The first case of the outbreak was reported by a 20-year-old man who never had any medical issues with receiving multiple tattoos in the past. He reported a persistent, inflamed rash after he received a new tattoo in October 2011. The Monroe County Department of Public Health decided to open an investigation after becoming informed about his case. They later determined that there were 18 other individuals who received tattoos from the same artist and later developed similar rashes.

The scientists at the University of Rochester Medical Center discovered that Mycobacterium chelonae, a particular form of bacteria, was in the patients´ skin. The bacteria caused red, itchy bumps in the tattoos and were later found in a premixed gray ink purchased by tattoo artist from an Arizona manufacturer. The researchers believed that the bacteria found in the ink were transmitted to the skin. The gray ink, called gray wash, is used by tattoo artists in shading and to complete a three-dimensional look. The local tattoo artist told scientists that the manufacturer had diluted the black ink with distilled water to produce a gray shade.

“This organism, M. chelonae, is found in some water supplies,” remarked Dr. Robert F. Betts, infection disease expert at the University of Rochester Medical Center, in the statement. “What probably happened is that the water used to dilute the ink introduced the bacteria into it and the trauma associated with getting the tattoo compromised the circulation to that area of the skin, allowing the organism to enter into the skin and grow.”

The Centers for Disease Control and Prevention (CDC) issued a nationwide warning about the tattoo outbreak after the results of the investigation were publicized. 16 of the 19 patients were treated with azithromycin and doxycycline, standard antibiotics, by Betts. All of the patients improved, but at varying times depending on the individual´s response to the medication.

The scientists recommend that, if a rash appears on a new tattoo, people should seek medical treatment rather than assuming it is an allergic reaction or a routine part of healing after receiving a tattoo.

“Patients and doctors need to have a certain level of suspicion when they see a rash developing in a tattoo. Many of the patients I saw thought their skin was just irritated and the issue would go away during the healing process. In actuality, they had an infection that needed to be treated with an antibiotic; it wasn´t going to go away easily on its own,” explained Mercurio in the statement.

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