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20-05-2012 | Immunology | Article

‘Fish pedicure’ risks infection for vulnerable patients

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MedWire News: UK researchers highlight the potential for the spread of harmful bacteria from fish to man through the use of "pedicure fish," especially in diabetes patients and other individuals with an increased risk for infection due to long-term disease.

In a letter to Emerging Infectious Disease, the team, from the Centre for Environment, Fisheries and Aquaculture Science Weymouth Laboratory in Dorset, reports widespread bacterial infection among Garra rufa freshwater fish imported into the UK from Indonesia.

The fish are traditionally used to nibble away dead skin cells for cosmetic reasons or to treat skin conditions such as psoriasis, explain David Verner-Jeffreys and co-authors.

The researchers investigated disease in the fish following fatal infections in 6000 fish imported for pedicure spas to the UK in April 2012. The fish, showing exophthalmia and hemorrhage, were found to be infected with Streptoccocus agalactiae, a pathogen associated with skin and soft tissue infections in older adults and those with chronic diseases, such as diabetes.

When fish in five further G. ruffa deliveries from Indonesia were examined, the team identified a raft of bacteria associated with soft tissue infection in vulnerable individuals, including Vibrio vulnificus, V. cholera, Mycobacteria, S. agalactiae, and Aeromonas spp. Of concern, these bacteria were resistant to a variety of antimicrobial agents including tetracyclines and fluoroquinolones, Verner-Jeffreys et al write.

While the S. agalactiae isolate identified did not carry a genotype strongly associated with invasive disease, the researchers warn that "a fish-adapted strain could eventually take advantage of the opportunity afforded by repeated exposure and thereby also affect humans."

The team therefore concludes: "Our study raises some concerns over the extent that these fish, or their transport water, might harbor potential zoonotic disease pathogens of clinical relevance.

"In particular, patients with underlying conditions (such as diabetes mellitus or immunosuppression) should be discouraged from undertaking such treatments, especially if they have obvious breaks in the skin or abrasions."

They add: "This risk can probably be reduced by use of certified disease-free fish reared in controlled facilities under high standards of husbandry and welfare."

By Lynda Williams

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