Headlines

Cluster of Mycobacterium chelonae Infections Following TattooingIn late December 2014, the Burgundy Regional Health Agency (ARS) received a report from a dermatologist detailing 18 cases of post-tattoo skin infections among individuals who had visited the same tattoo parlor. An investigation was launched into the epidemiological aspects, the tattoo artist’s practices, the products used by the artist, and the environment. Based on the adverse event reports completed by the dermatologist and the tattoo artist, it was determined that the period of contamination occurred between September 15 and November 15. All patients presented with folliculitis lesions in the tattooed areas where the ink had been diluted. These lesions were difficult to resolve with antibiotics. The bacterium Mycobacterium chelonae was identified in biopsies. Subsequent testing of the salon’s tap water also revealed the presence of this same bacterium, the hypothesis that the tattoo artist used tap water to dilute the inks was corroborated by the fact that during the inspection conducted by the ARS and the DDCSPP, no evidence was found of purchases of sterile injectable water, which is required by regulation for ink dilutions and rinsing of cups. Furthermore, the CNR’s comparison of the mycobacteria from the strains identified in the tap water with those identified in the samples taken from patients did not allow them to be distinguished. No other cases were reported in 2015.Furthermore, physicochemical tests conducted by the French National Agency for Medicines and Health Products Safety on inks collected from the tattoo artist’s studio revealed the presence of banned substances, leading to a national and European alert for the recall of these inks.The literature reports outbreaks of post-tattoo Mycobacterium chelonae, including an outbreak in Normandy, France, in 2010. These outbreaks generally result from the use of tap water, particularly to dilute inks, as this bacterium is normally present in the environment.Thus, although regulated by the Public Health Code since 2008, vigilance on the part of the authorities remains essential regarding tattooing activities, especially since they are currently in vogue.