ABSTRACT
BACKGROUND: Investigation and case-control study to identify risk factors in a large outbreak in 2003 of auricular chondritis associated with piercing. METHODS: Epidemiologic, environmental, and laboratory (pulsed-field gel electrophoresis) investigation, and case-control study. Telephone interviews were conducted for 15 cases and 61 controls. Odds ratios were determined for risks of infection. RESULTS: Of 15 confirmed cases, nine (60%) were hospitalized (median duration 4.4 days) and treated with intravenous/oral antibiotics. Cases required surgical treatment and multiple antibiotics. Risk factors for infection included piercing location and the use of a contaminated aftercare solution. Pseudomonas aeruginosa isolates, nine from patients and four from the aftercare solution, were indistinguishable by pulsed-field gel electrophoresis; one from the sink at the facility differed by two bands. CONCLUSIONS: This study demonstrates the serious consequences of cartilage piercing, identifies specific risk factors for infection, and suggests the importance of implementation and assurance of safe procedures.
