Mycobacterium chelonae Abscesses Associated with Biomesotherapy, Australia, 2008

Mihaela Ivan

, Craig Dancer, Ann P. Koehler, Michaela Hobby, and Chris Lease

Author affiliations: South Australia Department of Health, Adelaide, South Australia, Australia (M. Ivan, A. P. Koehler, M. Hobby, C. Lease); SA Pathology, Adelaide (C. Dancer)

Abstract

An outbreak of skin abscesses occurred in Adelaide, Australia, in association with biomesotherapy, an alternative therapy practice. Mycobacterium chelonae was identified in 8 patient and 3 environmental samples. Our findings show M. chelonae infection can be associated with alternative therapies when infection-control breaches occur. Tighter regulations of alternative therapy practices are needed.

Biomesotherapy is marketed in Australia as a new therapy that combines homotoxicology, mesotherapy, and acupuncture. Saline solution and homeopathic formulations are injected subcutaneously at specific acupuncture or trigger points, and homeopathic formulations are administered orally during treatment sessions. Biomesotherapy is used for pain management and general well-being.
Mycobacterium chelonae is a rapid-growing mycobacterium that occurs naturally in water sources and produces rare infections in humans. The bacterium can cause pneumonia and skin and ocular lesions, mostly following tissue trauma (1). M. chelonae is commonly present in tap water; however, it is not reliably removed by filtration or by boiling for short periods. Outbreaks and isolated cases of cutaneous infections caused by M. chelonae and other rapid-growing mycobacteria have been described in association with alternative therapies, hospital settings, and spas (2–8).
Mycobacterial infections are notifiable in South Australia, a state in the southern central part of Australia. On average, 2 cases of nonpulmonary M. chelonae infection are reported in South Australia each year.