Acupuncture is one of the widely-practiced methods of alternative medicine. Because acupuncture needles are inserted up to several centimeters below the surface of the skin, acupuncture may pose risks the patients, the most important of which is infection.
Healthcare professionals should have a high index of suspicion for acupuncture-related infections.
Acupuncture-related infections occur due to transmission of pathogenic micro-organisms, either from the environment or from one patient to another. Of the 50 cases of acupuncture-related bacterial infection described around the world, most cases were related to inadequate skin disinfection prior to acupuncture. About 70 percent of patients had musculoskeletal or skin infections corresponding to the site of acupuncture needle insertion. Other patients had more serious infections, including meningitis, infective endocarditis, and abdominal abscesses. Staphylococcus aureuswas the most common bacteria implicated. Although most of the acupuncture patients recovered, 5 to 10 percent died and at least another 10 percent had serious consequences.
In addition to bacterial infections, five outbreaks of hepatitis B virus infection have been associated with acupuncture, affecting more than 80 patients. In most outbreaks the source of the hepatitis B infection was an acupuncture patient, but in one outbreak the source of the infection was thought to be the acupuncture practitioner.
More recently, acupuncture has been associated with infections caused by mycobacteria which are thought to be transmitted from the environment to patients through contaminated equipment, such as cotton swabs, towels, hot pack covers, and boiling tanks. The infections usually begin with red bumps that develop into pustules, abscesses, and ulcerative lesions over several weeks to months. Mycobacteria outbreaks related to acupuncture have affected more than 70 patients, many of whom delayed seeking medical advice due to slowly developing and relatively mild symptoms. Thus, acupuncture patients and healthcare professionals should watch out for infections transmitted by acupuncture and they should alert health authorities if infections do occur.