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Updated: Jul 17, 2025
A Delayed Inoculation Model of Chronic Pseudomonas aeruginosa Wound Infection
Published on: February 20, 2020
Community Outbreak of Pseudomonas aeruginosa Infections Associated with Contaminated Piercing Aftercare Solution,
Abstract:
In April 2021, the South Eastern Sydney Local Health District Public Health Unit (Sydney, New South Wales, Australia) was notified of 3 patients with Pseudomonas aeruginosa infections secondary to skin piercings performed at the same salon. Active case finding through laboratories, clinician alerts, and monitoring hospital visits for piercing-related infections identified additional cases across New South Wales, and consumers were alerted. We identified 13 confirmed and 40 probable case-patients and linked clinical isolates by genomic sequencing. Ten confirmed case-patients had used the same brand and batch of aftercare solution. We isolated P. aeruginosa from opened and unopened bottles of this solution batch that matched the outbreak strain identified by genomic sequencing. Piercing-related infections returned to baseline levels after this solution batch was recalled. Early outbreak detection and source attribution via genomic sequencing are crucial for controlling outbreaks linked to contaminated products. Manufacturing standards for nonsterile cosmetic products and guidance for piercing aftercare warrant review.
Insights
A contaminated aftercare solution caused Pseudomonas aeruginosa infections in 53 patients following skin piercings. Recalling the product resolved the outbreak, highlighting the need for better manufacturing standards and genomic surveillance.
Area of Science:
- Public Health
- Infectious Diseases
- Genomic Epidemiology
Background:
- An outbreak of Pseudomonas aeruginosa infections linked to skin piercings occurred in New South Wales, Australia.
- The infections were associated with a specific salon and a particular brand of aftercare solution.
Purpose of the Study:
- To identify the source and extent of the Pseudomonas aeruginosa outbreak.
- To evaluate the role of genomic sequencing in outbreak detection and control.
Main Methods:
- Active case finding through laboratories, clinician alerts, and hospital visit monitoring.
- Genomic sequencing of clinical isolates and the suspected aftercare solution.
- Case-patient interviews and product testing.
Main Results:
- 13 confirmed and 40 probable cases of Pseudomonas aeruginosa infection were identified.
- Genomic sequencing linked clinical isolates to P. aeruginosa found in the aftercare solution batch.
- Infections decreased after the implicated aftercare solution batch was recalled.
Conclusions:
- Genomic sequencing is crucial for early outbreak detection and source attribution of contaminated products.
- Manufacturing standards for nonsterile cosmetic products require review.
- Aftercare guidance for skin piercings needs reevaluation to prevent future infections.
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