When Water Kills Art: NTM Outbreaks Re-Emphasize Sterile Practices in Tattooing — US & International (historic outbreaks and lessons)

Public-health case investigations (including a high-profile cluster published in NEJM) traced clusters of nontuberculous mycobacterial (NTM) skin infections to contaminated inks or dilution with non-sterile water at the point of tattooing. These outbreaks show how a single contaminated bottle or poor studio practice can produce dozens of serious skin infections that require prolonged antibiotics or surgical care. The public-health lesson is blunt: use factory-sterile inks, never dilute with tap water, log ink lots, and report suspected infections immediately to local health authorities.