Letters Mycobacteria introduced by tattoos

Contaminated ink might be responsible for Mycobacterium chelonae infection after tattooing

BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f122 (Published 30 January 2013) Cite this as: BMJ 2013;346:f122
  1. Ossie Ferdinand Uzoigwe, medical writer1
  1. 1Sheffield S10 1DG, UK
  1. chikauzoigwe{at}yahoo.co.uk

During one week in December 2012, both the BMJ and the New England Journal of Medicine reported a case of Mycobacterium chelonae infection after tattooing.1 2 These reports followed an outbreak in a New York tattoo parlour, reported in September 2012,3 where M chelonae was isolated from unopened ink vials from an Arizona distributor. This prompted the US Food and Drug Administration Agency to attempt to raise awareness among healthcare providers, public health officials, consumers, and the tattoo industry. The Centers for Disease Control and Prevention (CDC) started a nationwide investigation, which identified similar outbreaks in other American states. The CDC also issued a nationwide alert.

The authors of the BMJ article suggested that non-sterile water mixed with the ink might have been the source of infection, but the ink vials may have been precontaminated. The FDA warns clinicians to be alert to the possibility of ink contamination before distribution.3 Høgsberg et al found that 11% (6/58) of unopened tattoo inks vials were contaminated with infectious pathogens and concluded that the Europe Council resolution that tattoo ink should be sterile was not respected in Europe.4 They also noted that tattoo ink in Europe is often imported from the US and UK.

M chelonae is not a notifiable disease in the UK or US.5 Given the synchronous occurrence of tattoo related infections on both sides of the Atlantic, transatlantic collaboration might help determine any international common origin. Reporters of the US outbreak advocate greater oversight of tattooing and the ink manufacturing process, which may be pertinent for both the UK and US.3


Cite this as: BMJ 2013;346:f122


  • Competing interests: None declared.