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Nontuberculous Mycobacterium Skin Infections Associated With One Tattoo Studio-Oregon, January-April 2023

Elizabeth Slocum1,2, Madison G Walton1,3, Siobhan Burns4

  • 1Epidemic Intelligence Service, CDC, Atlanta, Georgia, USA.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|August 21, 2025
PubMed

Insights

Eight individuals contracted Mycobacterium immunogenum infections following tattoos from a single artist. Contaminated tattoo ink, possibly from a self-prepared diluent, was the likely source. Public health surveillance is crucial for identifying such outbreaks.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Public Health

Background:

  • Nontuberculous mycobacteria (NTM) can cause skin and soft tissue infections following various procedures.
  • Cosmetic, surgical, and tattooing procedures are recognized risks for NTM infections.
  • Mycobacterium immunogenum is an emerging pathogen causing localized infections.

Purpose of the Study:

  • To report an outbreak of Mycobacterium immunogenum skin infections linked to tattooing.
  • To identify the source and transmission route of the NTM infections.
  • To emphasize the importance of NTM surveillance and reportability.

Main Methods:

  • Case series investigation of eight infected individuals in Oregon.
  • Epidemiological interviews to determine common exposures.
  • Microbiological analysis of clinical isolates and potential sources (e.g., tattoo ink).

Main Results:

  • Eight cases of Mycobacterium immunogenum infection were identified.
  • All patients reported receiving tattoos from the same artist.
  • Contaminated tattoo ink, likely due to a self-prepared diluent, was implicated as the source.

Conclusions:

  • Tattooing procedures can transmit NTM infections like Mycobacterium immunogenum.
  • Self-prepared tattoo ink diluents pose a significant contamination risk.
  • Enhanced NTM surveillance and reporting are vital for public health interventions and outbreak detection.
Keywords:
infectious diseasesnontuberculous mycobacteriumoutbreak responseskin and soft-tissue infectionstattooing procedures

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