The Stealthy Superbug: the Role of Asymptomatic Enteric Carriage in Maintaining a Long-Term Hospital Outbreak of ST228 Methicillin-Resistant Staphylococcus aureus.

UNLABELLED: Whole-genome sequencing (WGS) of 228 isolates was used to elucidate the origin and dynamics of a long-term outbreak of methicillin-resistant Staphylococcus aureus (MRSA) sequence type 228 (ST228) SCCmec I that involved 1,600 patients in a tertiary care hospital between 2008 and 2012. Combining of the sequence data with detailed metadata on patient admission and movement confirmed that the outbreak was due to the transmission of a single clonal variant of ST228, rather than repeated introductions of this clone into the hospital. We note that this clone is significantly more frequently recovered from groin and rectal swabs than other clones (P < 0.0001) and is also significantly more transmissible between roommates (P < 0.01). Unrecognized MRSA carriers, together with movements of patients within the hospital, also seem to have played a major role. These atypical colonization and transmission dynamics can help explain how the outbreak was maintained over the long term. This "stealthy" asymptomatic colonization of the gut, combined with heightened transmissibility (potentially reflecting a role for environmental reservoirs), means the dynamics of this outbreak share some properties with enteric pathogens such as vancomycin-resistant enterococci or Clostridium difficile. IMPORTANCE: Using whole-genome sequencing, we showed that a large and prolonged outbreak of methicillin-resistant Staphylococcus aureus was due to the clonal spread of a specific strain with genetic elements adapted to the hospital environment. Unrecognized MRSA carriers, the movement of patients within the hospital, and the low detection with clinical specimens were also factors that played a role in this occurrence. The atypical colonization of the gut means the dynamics of this outbreak may share some properties with enteric pathogens.

Echos de jeunesse : les trois âges du pays latin / Antonio Watripon. Le dernier des escholiers / par A. Deberle

Comprend : Le dernier des escholiers / par Alfred Deberle

Compendio di gesti del magnanimo et gloriosissimo Signore Sforza, inc[ipiente] dal tempo de la sua natiuità fine a la morte sua, compiliato in vulgare per Antonio Placentino nel anne MCCCCLVIII in Milano sotto lo Illustrissimo Signore Francesco Sforza Duca Duca quarto. (In fine: " Bartholomeus Gambagnola Cremonensis scripsit mandato Mag[nifi]ci domini Marchisini stanghe ducalis secretarii Die uigesimo septembris MCCCCLXXXX primo ". Membran. Con finissime miniature a f. 1 e 5. Il f. 4 è occupato da una mirabile miniatura rappresentante un guerriero a cavallo; sotto, leggesi: " Sfortia Atendolus italicorum ducum clarissimus ". Il suo ritratto è miniato anche a f. 5: nel margine inferiore della prima pagina è quello di Francesco Sforza. Nel corpo del testo molte lettere iniziali sono miniate).

Visconti. Saisi par Louis XII dans la bibliothèque des ducs de Milan à Pavie . N° 1466 du catalogue de 1544 et cote "Des vulgaires italiens pulpito 1°" de la Librairie royale de Blois ; — n° 2826 du catalogue de la Bibliothèque du roi à Paris à la fin du XVIe s.

[Album de vues et de monuments de Venise et de Rome] / [photogr. par Antonio Perini et Giacomo Caneva]

Ancien possesseur : Rothschild, Adèle de (1843-1922)

La « Regle » de « l'Hospital de Saint Johan de Jerusalem ».

Commençant par : « A tous ceaus qui sont et qui à venir sont, faisons assavoir que la maison de Saint Johan Baptiste et des povres de Jerusalem... » et finissant par : «... fu fet le mol et cloze la marine dou bourc de Rodes » . Le texte, accompagné d'une glose marginale et de notes en langue catalane, se termine par une liste des grands maîtres de l'ordrejusqu'à Daude de Goson. Les dernières lignes sont d'une écriture postérieure. A la fin du volume, des tables et calculs d'astrologie.

Recueil de pièces sur l'origine et l'administration de la « Confrarie et hospital du Sainet-Esperit, fondé en Grève, à Paris, » en 1537.

On y remarque un inventaire de reliques (fol. 209), des copies de requêtes et des recettes médicales (fol. 222).