Risk Factors for Cartilage Infections of the Ear Original Research Article

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.