A worrisome superbug seen in prisoners and athletes is also showing up in people who get illegal tattoos, federal health officials said Thursday.
Forty-four tattoo customers in Ohio, Kentucky and Vermont developed skin infections caused by methicillin-resistant Staphylococcus aureus (MRSA), according to the U.S. Centers for Disease Control and Prevention.
The infections occurred in 2004 and 2005, and were traced to 13 unlicensed tattoo artists, according to an article in the CDC's Morbidity and Mortality Weekly Report.
These are the first documented cases if tattoo-related MRSA infections, said Dr. Mysheika LeMaile-Williams, a CDC infectious disease investigator who co-authored the report.
MRSA is an antibiotic-resistant bacteria that fights off the body's immune system and destroys tissues. The community-associated variety, seen in the tattoo infections, has been diagnosed in otherwise healthy athletes, military recruits and prison inmates.
The skin infections can be transmitted from person to person by contact with draining sores, or through contact with contaminated items or surfaces. MRSA generally causes mild skin infections, but in some cases has led to pneumonia, bloodstream infections, and a painful, flesh-destroying condition called necrotizing fasciitis.
Clusters of MRSA cases were seen in Ohio in June 2004, November 2004 and April 2005, involving 33 people. A four-person cluster was reported in Kentucky in May 2005 and a seven-person cluster was in Vermont in August.
Four of the patients were hospitalized, but all recovered, LeMaile-Williams said.
Ohio, Kentucky and Vermont require licensing for tattoo artists, but all the affected customers went to unlicensed artists. Instead of doing the work in tattoo parlors, the body art was done in the homes of the tattooists or the recipients, or even in public places such as a park.
The tattooists sometimes did not use masks or gloves, did not properly disinfect skin and did not properly clean the equipment. One Ohio tattooist used a homemade tattoo gun made from a computer ink-jet cartridge and guitar strings, LeMaile-Williams said.
Three of the Ohio tattooists had recently been jailed, she said.
Customers sometimes seek out unlicensed tattooists because their services are less expensive, or because they are younger than 18 and cannot go to a licensed tattooist without parental consent, she said.
Several of the infected patients were under 18, she added.
The tattoo cases are not surprising, said Dr. Kate Heilpern, an Atlanta emergency room physician and Emory University researcher who has studied MRSA.
The superbug is appearing in locker rooms, homes and many other unsterile places where people are in skin-to-skin contact.