{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T14:59:51Z","timestamp":1776524391172,"version":"3.51.2"},"reference-count":16,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2025,1,10]],"date-time":"2025-01-10T00:00:00Z","timestamp":1736467200000},"content-version":"unspecified","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2025]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:p>In September 2023, the UK Health Security Agency\u2019s (UKHSA) South West Health Protection Team received notification of patients with <jats:italic>Pseudomonas aeruginosa<\/jats:italic> perichondritis. All five cases had attended the same cosmetic piercing studio and a multi-disciplinary outbreak control investigation was subsequently initiated. An additional five cases attending the same studio were found. Seven of the ten cases had isolates available for Variable Number Tandem Repeat (VNTR) typing at the UKHSA national reference laboratory. Clinical and environmental <jats:italic>P. aeruginosa<\/jats:italic> isolates from the patients, handwash sink, tap water and throughout the wall-mounted point-of-use water heater (including outlet water) were indistinguishable by VNTR typing (11,6,2,2,1,3,6,3,11). No additional cases were identified after control measures were implemented, which included replacing the sink and point-of-use heater.<\/jats:p>\n\t  <jats:p>The lack of specific recommendations to control for <jats:italic>P. aeruginosa<\/jats:italic> within Council-adopted ear-piercing byelaws or national guidance means that a cosmetic piercing artist could inadvertently overlook the risks from this bacterial pathogen despite every intention to comply with the law and follow industry best practice advice. Clinicians, Environmental Health Officers and public health professionals should remain alert for single cases of <jats:italic>Pseudomonas<\/jats:italic> perichondritis infections associated with piercings and have a low threshold for notification to local health protection teams.<\/jats:p>","DOI":"10.1017\/s0950268824001572","type":"journal-article","created":{"date-parts":[[2025,1,10]],"date-time":"2025-01-10T10:37:26Z","timestamp":1736505446000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":1,"title":["Outbreak of <i>Pseudomonas aeruginosa<\/i> perichondritis associated with ear piercings and a contaminated water system"],"prefix":"10.1017","volume":"153","author":[{"given":"Claire E.","family":"Brown","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4894-3641","authenticated-orcid":false,"given":"Derren","family":"Ready","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline","family":"Willis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ben","family":"Sims","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nick","family":"Young","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Sheridan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helen","family":"Osbourne","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louise","family":"Jones","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yvette","family":"Landy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naomi","family":"Long","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy","family":"Walkden","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jane F.","family":"Turton","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karren","family":"Staniforth","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ginny","family":"Moore","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Parks","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricia","family":"Barkoci","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Bird","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2025,1,10]]},"reference":[{"key":"S0950268824001572_r4","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES.2018.23.37.1700795"},{"key":"S0950268824001572_r15","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.001698"},{"key":"S0950268824001572_r14","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2022.08.007"},{"key":"S0950268824001572_r7","doi-asserted-by":"publisher","DOI":"10.5070\/M562052915"},{"key":"S0950268824001572_r11","unstructured":"[11] Public Health England, Chartered Institute of Environmental Health, Health and Safety Laboratory, and Tattoo & Piercing Industry Union, Tattooing and body piercing guidance: toolkit, 2013."},{"key":"S0950268824001572_r16","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2007.01.077"},{"key":"S0950268824001572_r10","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2009.03049.x"},{"key":"S0950268824001572_r3","doi-asserted-by":"publisher","DOI":"10.1016\/S1808-8694(15)30156-7"},{"key":"S0950268824001572_r9","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.054841-0"},{"key":"S0950268824001572_r12","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25238"},{"key":"S0950268824001572_r13","doi-asserted-by":"publisher","DOI":"10.3201\/eid2910.230560"},{"key":"S0950268824001572_r8","unstructured":"[8] The Health Protection (Notification) Regulations (2010) Available at https:\/\/www.legislation.gov.uk\/uksi\/2010\/659\/contents\/made."},{"key":"S0950268824001572_r6","doi-asserted-by":"publisher","DOI":"10.2147\/IDR.S434522"},{"key":"S0950268824001572_r1","article-title":"An outbreak of Pseudomonas Aeruginosa infection linked to a \u201cBlack Friday\u201d piercing event","volume":"9","author":"MacPherson","year":"2017","journal-title":"PLoS Currents"},{"key":"S0950268824001572_r2","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-021-01635-6"},{"key":"S0950268824001572_r5","volume-title":"Pinna Perichondritis","author":"Khan","year":"2023"}],"container-title":["Epidemiology and Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0950268824001572","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,10]],"date-time":"2025-01-10T10:37:33Z","timestamp":1736505453000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0950268824001572\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025]]},"references-count":16,"alternative-id":["S0950268824001572"],"URL":"https:\/\/doi.org\/10.1017\/s0950268824001572","relation":{},"ISSN":["0950-2688","1469-4409"],"issn-type":[{"value":"0950-2688","type":"print"},{"value":"1469-4409","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025]]},"assertion":[{"value":"\u00a9 The Author(s), 2025. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e8"}}