title: The Risk of Bacterial Infection After Tattooing.
abstract: BACKGROUND
  Tattooing is a globally growing trend. Overall prevalence among adults in industrialized countries is around 10-20%. Given the high and increasing numbers of tattooed people worldwide, medical and public health implications emerging from tattooing trends require greater attention not only by the public, but also by medical professionals and health policy makers.
  
  
  METHODS
  We performed a systematic review of the literature on tattooassociated bacterial infections and bacterial contamination of tattoo inks. Furthermore, we surveyed tattoo inks sampled during an international tattoo convention in Germany to study their microbial status.
  
  
  RESULTS
  Our systematic review identified 67 cases published between 1984 and 2015, mainly documenting serious bacterial infectious complications after intradermal deposition of tattoo inks. Both local skin infections (e.g. abscesses, necrotizing fasciitis) and systemic infections (e.g. endocarditis, septic shock) were reported. Published bacteriological surveys showed that opened as well as unopened tattoo ink bottles frequently contained clinically relevant levels of bacteria indicating that the manufactured tattoo product itself may be a source of infection. In our bacteriological survey, two of 39 colorants were contaminated with aerobic mesophilic bacteria.
  
  
  CONCLUSIONS
  Inappropriate hygiene measures in tattoo parlors and non-medical wound care are major risk factors for tattoo-related infections. In addition, facultative pathogenic bacterial species can be isolated from tattoo inks in use, which may pose a serious health risk.
authors: German Federal Institute for Risk Assessment (BfR), Department of Biological Safety, Berlin, Regional Public Health Office, Department for Infection Control, Reutlingen, University Hospital Würzburg, Department of Dermatology, Venereology and Allergology, Würzburg, German Federal Institute for Risk Assessment (BfR), Department of Chemical and Product Safety, Berlin, RWTH Aachen University Hospital, Clinic for Gastroenterology, Metabolic Disorders and Internal Intensive Medicine (Medical Clinic III), Aachen.
authors: Ralf
authors: R
authors: Dieckmann
authors: Ides
authors: I
authors: Boone
authors: Stefan O
authors: SO
authors: Brockmann
authors: Jens A
authors: JA
authors: Hammerl
authors: Annette
authors: A
authors: Kolb-Mäurer
authors: Matthias
authors: M
authors: Goebeler
authors: Andreas
authors: A
authors: Luch
authors: Sascha
authors: S
authors: Al Dahouk
mesh_terms: D001424:Bacterial Infections / Q000209:etiology*; D005858:Germany; D006801:Humans; D007281:Ink; D012307:Risk Factors; D013653:Tattooing / Q000009:adverse effects*