title: Outbreak of acupuncture-associated cutaneous Mycobacterium abscessus infections.
abstract: BACKGROUND
  Cutaneous atypical mycobacterial infections have been increasingly described in association with cosmetic and alternative procedures.
  
  
  OBJECTIVE
  We report an outbreak of acupuncture-associated mycobacteriosis. Between April and December 2002, 32 patients developed cutaneous mycobacteriosis after visiting an acupuncture practice in Toronto, Canada.
  
  
  RESULTS
  Of 23 patients whose lesions were biopsied, 6 (26.1%) had culture-confirmed infection with Mycobacterium abscessus. These isolates were genetically indistinguishable by amplified fragment length polymorphism. The median incubation period was 1 month. Of 24 patients for whom clinical information was available, 23 (95.8%) had resolution of their infection. All patients developed residual scarring or hyperpigmentation.
  
  
  CONCLUSIONS
  Nontuberculous mycobacteria should be recognized as an emerging, but preventable, cause of acupuncture-associated infections.
authors.affiliation: Department of Laboratory Medicine, Toronto, ON, Canada.
authors.forename: Patrick
authors.initials: P
authors.lastname: Tang
authors.forename: Scott
authors.initials: S
authors.lastname: Walsh
authors.forename: Christian
authors.initials: C
authors.lastname: Murray
authors.forename: Cecilia
authors.initials: C
authors.lastname: Alterman
authors.forename: Monali
authors.initials: M
authors.lastname: Varia
authors.forename: George
authors.initials: G
authors.lastname: Broukhanski
authors.forename: Pamela
authors.initials: P
authors.lastname: Chedore
authors.forename: Joel
authors.initials: J
authors.lastname: DeKoven
authors.forename: Dalal
authors.initials: D
authors.lastname: Assaad
authors.forename: Wayne L
authors.initials: WL
authors.lastname: Gold
authors.forename: Danny
authors.initials: D
authors.lastname: Ghazarian
authors.forename: Michael
authors.initials: M
authors.lastname: Finkelstein
authors.forename: Marjolyn
authors.initials: M
authors.lastname: Pritchard
authors.forename: Barbara
authors.initials: B
authors.lastname: Yaffe
authors.forename: Frances
authors.initials: F
authors.lastname: Jamieson
authors.forename: Bonnie
authors.initials: B
authors.lastname: Henry
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Phillips
mesh_terms: D015670:Acupuncture Therapy / Q000009:adverse effects*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D017053:Infection Control / Q000592:standards; D008297:Male; D008875:Middle Aged; D009165:Mycobacterium Infections, Nontuberculous / Q000453:epidemiology* / Q000209:etiology*; D009339:Needles; D009864:Ontario / Q000453:epidemiology; D012189:Retrospective Studies; D017192:Skin Diseases, Bacterial / Q000453:epidemiology* / Q000209:etiology*