Pedicure-Associated Rapidly Growing Mycobacterial Infection: An Endemic Disease

Abstract

Pedicure-associated mycobacterial furunculosis was endemic in these 2 North Carolina counties during 2005-2008. Suboptimal footbath cleaning may have contributed to these infections, which suggests straightforward means of potential prevention. The relative rarity of this type of infection in the setting of nearly ubiquitous exposure to these pathogens suggests that as yet undefined host-specific or procedure-related factors may be involved in susceptibility to these infections.

Nontuberculous Mycobacteria

“…74 Shaving the legs before the procedure appears to be one of the main risk factor for infection. [73][74][75][76][77] Of note, other subspecies, such as M chelonae, Mycobacterium massiliense, and Mycobacterium bolletii, also should be considered when pedicure-related mycobacterial infection is suspected, especially because these often require different diagnostic techniques, such as gene sequencing. 77 In general, M fortuitum affects younger, immunocompetent patients who tend to experience limited infections associated with low mortality.…”

“…[73][74][75][76][77] Of note, other subspecies, such as M chelonae, Mycobacterium massiliense, and Mycobacterium bolletii, also should be considered when pedicure-related mycobacterial infection is suspected, especially because these often require different diagnostic techniques, such as gene sequencing. 77 In general, M fortuitum affects younger, immunocompetent patients who tend to experience limited infections associated with low mortality. However, M fortuitum is increasingly known as an opportunistic pathogen causing disseminated infection, mainly in patients with impaired cellular immunity or receiving glucocorticoid therapy.…”

“…Recent reports showed M chelonae to be endemic in 2 North Carolina counties where suboptimal footbath cleaning during pedicures led to numerous cases of furunculosis. 77 M chelonae also can colonize skin wounds, such as hidradenitis suppurativa lesions. 107 …”

Evaluation of bacterial and fungal contamination in hairdressing and beauty salons

“…These health risks vary depending on the nature of the service, the tools and equipment that are used, the health status of the clients and service providers as well as the infection control procedures implemented. While it is known that invasive procedures, such as piercing and tattooing are clearly associated with bacterial, viral and fungal infection risks, even non-invasive procedures such as pedicures can result in infection (Stout et al, 2011). It is believed that any service with the potential to break the skin's surface can be associated with infections and infections can then be transmitted to and between clients if proper infection control procedures are not implemented.…”

Detection of Autofluorescent Mycobacterium Chelonae in Living Zebrafish

“…Interestingly, a recent systematic survey for pedicure-associated nontuberculous mycobacterial outbreaks in humans determined that 91% of infections were caused by M. chelonae. 31 Biofilms from footbaths were processed and precise isolation and speciation was successful in 50% of the samples. Cultured isolates were resistant to multiple antibiotics.…”