NOV 26, 2018 5:27 PM PST

Nontuberculous Mycobacterial Infections in Tattoos

WRITTEN BY: Dena Aruta

Contracting an infection when getting a tattoo is always a major concern. Consumers should be aware of the risk of developing infections with bloodborne pathogens (HIV, hepatitis B, hepatitis C) as well as bacteria found in contaminated tattoo ink and instruments. Florida experienced a recent outbreak of non-tuberculous mycobacterial (NTM) skin infections from tattoo ink diluted with tap water. The CDC recommends that ink manufacturers ensure they sterilize their products as well as tattoo parlors and artists dilute the ink with sterile water instead of tap water.

The Florida Department of Health in Miami-Dade County was informed by a local dermatologist regarding three patients with possible NTM skin infections in tattoos they received at the same tattoo parlor. The health department began their investigation, which was published in Clinical Infectious Diseases in November 2018.

NTM are acid-fast, beaded gram-positive rods that are rapid growers, usually within 2-4 days on Lowenstein-Jensen media. As a comparison, Mycobacterium tuberculosis takes several weeks to a month to grow in culture. NTM are pervasive in soil, rivers, and lakes, and in tap water. They have a propensity for forming biofilms in drinking water systems. When there is cutaneous exposure to NTM through skin abrasions and punctures, a rash may develop possibly requiring treatment with a mixture of antibiotics for several months.

NTM outbreaks are associated with a lack of infection control practices at tattoo parlors as well as contamination of greywash ink by the manufacturer. In this study, the organisms that were isolated through culture and polymerase chain reaction (PCR) included: M. abscessus, M. fortuitum, and M. abscessus-chelonae complex. As the researchers looked more in-depth into the sources of infection, they realized that manufacturer contamination was not a significant source. Cultures of patient specimens, tap water, and open greywash ink grew the species of NTM. Tap water was considered to be the source of infection in the three patients. The authors recommended that future safeguards and guidelines regarding ink manufacture and ink dilution need to be put in place.

In 2012, the Florida Department of Health (FDOH) set forth statues that require licensure of tattoo artists and parlors, educational requirements, and standards of practice for both conventional and cosmetic tattooing. All artists and tattoo establishments have to be licensed by 2013 or administrative penalties will be applied. Educational resources that meet the FDOHs requirements can be found on their website and include both classroom and online courses.  

Before deciding on a specific tattoo artist or parlor, thorough research about the establishment is encouraged. Check whether it is licensed as required by the state and if the licenses are current and up-to-date. Discuss with the artist and other employees about their sterilization procedures. Visit the establishment to check on cleanliness. If there are customers waiting, talk with them about their experiences. If not, ask for a list of references. Choosing a reputable artist and parlor is a critical decision because bloodborne diseases, including HIV and hepatitis B, are incurable. There is no going back once that bridge is crossed.

About the Author
  • After earning my Bachelor of Science degree in biology/chemistry from Virginia Polytechnic Institute and State University (aka Va. Tech), I went on to complete clinical rotations in laboratory medicine at Roanoke Memorial Hospital. I spent the next 21 years working in healthcare as a clinical microbiologist. In 2015, I combined my fascination with medicine and passion for writing into a freelance career, and I haven't looked back. Even though my expertise is in microbiology and infectious diseases, I'm adept at writing about any medical topic. Being a freelance writer allows me to pursue a career where I can work at home with my two feline assistants, Luke and Grace. I'm a firm supporter of animal rights and volunteer for a local rescue during my free time. 
You May Also Like
APR 21, 2020
Clinical & Molecular DX
APR 21, 2020
Skin Deep: Handheld Device Sees the Earliest Signs of Cancer
Researchers have developed a handheld device that can image structures under the skin at resolutions 100 times greater t ...
APR 22, 2020
Drug Discovery & Development
APR 22, 2020
Only 3% of COVID-19 Antibody Tests Approved by FDA
So far, only 3% of at least 90 COVID-19 antibody tests in the US have been approved by the Food and Drug Administration ...
APR 21, 2020
Health & Medicine
APR 21, 2020
How to Read COVID-19 News (Without Going Crazy)
  It can feel like COVID-19 news is consuming the country, and taking all the toilet paper and N95-masks with it. N ...
MAY 01, 2020
Microbiology
MAY 01, 2020
Once Thought to Make COVID-19 Worse, ACE Inhibitors Now Tested as Therapeutic
Researchers were once concerned that blood pressure medications may increase the risk of infection, or make an infection ...
MAY 11, 2020
Cardiology
MAY 11, 2020
Urbanization and Cardiometabolic Risk
A recent study by the Barcelona Institute for Global Health (ISGlobal) was first to analyze the possible connection betw ...
MAY 21, 2020
Cancer
MAY 21, 2020
A New Player in the Regulation of Cancer's Microenvironment
Breast cancer is one of the most common cancers in the world.  Triple-negative breast cancer (TNBC) is a sub-type o ...
Loading Comments...