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Removing lampenflora, phototrophic organisms developing on rock surfaces in tourist cavities due to the artificial lighting, is a challenge for sustainable and appropriate long-term management of caves. Photosynthetic-based biofilms usually cause rock biodeterioration and an ecological imbalance in cave ecosystems. In this work, a detailed investigation of the effects of the 3 most commonly used lampenflora cleaning operations (NaClO, H2O2 and UVC) was carried out in Pertosa-Auletta Cave (Italy). The application of NaClO showed good disinfection capability over extended periods of time without causing any appreciable rock deterioration. The H2O2 treatment showed to be corrosive for the rock surfaces covered with vermiculation deposits. The chemical alteration of organic and inorganic compounds by H2O2 did not remove biomass, favoring biofilm recovery after three months of treatment. Both NaClO and H2O2 treatments were effective at removing photoautotrophs, although the bacterial phyla Proteobacteria and Bacteroidetes as well as Apicomplexa and Cercozoa among the Eukaryotes, were found to be resistant to these treatments. The UVC treatments did not show any noticeable effect on the biofilms.

Nearly half a century ago, two papers postulated the likelihood of lunar lava tube caves using mathematical models. Today, armed with an array of orbiting and fly-by satellites and survey instrumentation, we have now acquired cave data across our solar system-including the identification of potential cave entrances on the Moon, Mars, and at least nine other planetary bodies. These discoveries gave rise to the study of planetary caves. To help advance this field, we leveraged the expertise of an interdisciplinary group to identify a strategy to explore caves beyond Earth. Focusing primarily on astrobiology, the cave environment, geology, robotics, instrumentation, and human exploration, our goal was to produce a framework to guide this subdiscipline through at least the next decade. To do this, we first assembled a list of 198 science and engineering questions. Then, through a series of social surveys, 114 scientists and engineers winnowed down the list to the top 53 highest priority questions. This exercise resulted in identifying emerging and crucial research areas that require robust development to ultimately support a robotic mission to a planetary cave-principally the Moon and/or Mars. With the necessary financial investment and institutional support, the research and technological development required to achieve these necessary advancements over the next decade are attainable. Subsequently, we will be positioned to robotically examine lunar caves and search for evidence of life within Martian caves; in turn, this will set the stage for human exploration and potential habitation of both the lunar and Martian subsurface.

To the Editor — 2021 is the International Year of Caves and Karst. To honour this occasion, we wish to emphasize the vast potential embodied in planetary subsurfaces. While researchers have pondered the possibility of extraterrestrial caves for more than 50 years, we have now entered the incipient phase of planetary caves exploration....

The microbiota associated with vermiculations from karst caves is largely unknown. Vermiculations are enigmatic deposits forming worm-like patterns on cave walls all over the world. They represent a precious focus for geomicrobiological studies aimed at exploring both the microbial life of these ecosystems and the vermiculation genesis. This study comprises the first approach on the microbial communities thriving in Pertosa-Auletta Cave (southern Italy) vermiculations by next-generation sequencing. The most abundant phylum in vermiculations was Proteobacteria, followed by Acidobacteria > Actinobacteria > Nitrospirae > Firmicutes > Planctomycetes > Chloroflexi > Gemmatimonadetes > Bacteroidetes > Latescibacteria. Numerous less-represented taxonomic groups (< 1%), as well as unclassified ones, were also detected. From an ecological point of view, all the groups co-participate in the biogeochemical cycles in these underground environments, mediating oxidation-reduction reactions, promoting host rock dissolution and secondary mineral precipitation, and enriching the matrix in organic matter. Confocal laser scanning microscopy and field emission scanning electron microscopy brought evidence of a strong interaction between the biotic community and the abiotic matrix, supporting the role of microbial communities in the formation process of vermiculations.

Morgana Cave is located in Val di Scerscen, Central Italian Alps. The cave opens at an altitude of 2,600 m a.s.l. close to the retreating glacier Vedretto di Scerscen, and its entrance was discovered 30 years ago hidden underneath the glacier. A characteristic of this cave is the occurrence of vermiculation deposits on the walls and ceiling. In general, the composition of the microbial communities in cave vermiculations is relatively unknown and rarely investigated. Here we present the data of a geomicrobiological study of vermiculations from an Alpine cave subjected to extreme climate conditions. The microbial communities were dominated by 13 main phyla of Bacteria, and contained a negligible percentage (<1%) of Archaea. The two major bacterial classes were Gammaproteobacteria and Betaproteobacteria, whose metabolic traits were mainly associated with the nitrogen cycle. In addition, psychrophilic and methanotrophic bacterial groups were identified. The occurrence of a large number of uncultured members, at the lowest taxonomic ranks, indicated the presence of still unexplored microbial taxa in the vermiculations.

The authors regret the presence of incomplete information in the author affiliations (reported correctly above) and in the acknowledgments of the original article (provided in the amended version below). The authors are obliged to Mr. Vincenzo Manisera, speleologist of the MIdA Foundation, for sharing his experiences and for his invaluable help in all the field activities, to Dr. Sacha A. Berardo (University of Salerno, Italy) for the language editing, and to the two anonymous reviewers, who provided helpful comments and suggestions. Funding was provided by the Spanish project MINECO CGL2016-75590-P with ERDF funds, by the MIdA Foundation, which generously supported the whole project, and by the University of Salerno, which provided facilities for carrying out the research. The authors would like to apologise for any inconvenience caused.

San Salvador (Bahamas) is a carbonate island with dozens of flank margin caves formed in the phreatic zone by fresh seawater mixing within the freshwater lens. These caves have no direct connection with the sea, and form at or close to the tidally influenced fluctuating water table. After sea-level fall, in their subaerial parts caves are enlarged mainly by rock dissolution and by erosion close to the water level, condensation-corrosion and breakdown processes. For understanding the geomorphological features observed in these caves and how they are related to light attenuation, we investigated three sampling sites in the tidally influenced zone of Lighthouse Cave, which has been re-invaded by seawater during the Holocene sea-level highstand. A freshwater lens no longer exists within or adjacent to the cave. Rock samples were collected above and below the internal lake shores close to the entrance, and in the twilight and dark zones of this cave. Light and electron microscopy examinations were conducted for detecting microbial cells, as well as bioconstruction and bioweathering features. In addition, a high precision laser scanner was used for characterising sample microtopography. Our data showed that the microtopography and geomorphology of the lake shore samples (cave entrance) are dominated by bioweathering, whereas the samples of the twilight and dark zones are controlled by a combination of both bioweathering and bioconstructive processes depending on light availability. Bioconstructive structures, such as semi-planar lamination, at the fluctuating water level of the Lighthouse Cave show that dissolution due to water mixing of sea and freshwater in the Holocene is no longer the most important speleogenetic process. We propose that the geomorphological evolution is strongly influenced by the degree of rock diagenesis more than the initial mechanism of speleogenesis.

Contains fulltext : 282954.pdf (Publisher’s version ) (Open Access), BACKGROUND: The COVID-19 pandemic presented major challenges for critical care facilities worldwide. Infections which develop alongside or subsequent to viral pneumonitis are a challenge under sporadic and pandemic conditions; however, data have suggested that patterns of these differ between COVID-19 and other viral pneumonitides. This secondary analysis aimed to explore patterns of co-infection and intensive care unit-acquired infections (ICU-AI) and the relationship to use of corticosteroids in a large, international cohort of critically ill COVID-19 patients. METHODS: This is a multicenter, international, observational study, including adult patients with PCR-confirmed COVID-19 diagnosis admitted to ICUs at the peak of wave one of COVID-19 (February 15th to May 15th, 2020). Data collected included investigator-assessed co-infection at ICU admission, infection acquired in ICU, infection with multi-drug resistant organisms (MDRO) and antibiotic use. Frequencies were compared by Pearson's Chi-squared and continuous variables by Mann-Whitney U test. Propensity score matching for variables associated with ICU-acquired infection was undertaken using R library MatchIT using the "full" matching method. RESULTS: Data were available from 4994 patients. Bacterial co-infection at admission was detected in 716 patients (14%), whilst 85% of patients received antibiotics at that stage. ICU-AI developed in 2715 (54%). The most common ICU-AI was bacterial pneumonia (44% of infections), whilst 9% of patients developed fungal pneumonia; 25% of infections involved MDRO. Patients developing infections in ICU had greater antimicrobial exposure than those without such infections. Incident density (ICU-AI per 1000 ICU days) was in considerable excess of reports from pre-pandemic surveillance. Corticosteroid use was heterogenous between ICUs. In univariate analysis, 58% of patients receiving corticosteroids and 43% of those not receiving steroids developed ICU-AI. Adjusting for potentia

Fetida Cave is an active sulfuric acid cave influenced by seawater, showing abundant microbial communities that organize themselves under three main different morphologies: water filaments, vermiculations and moonmilk deposits. These biofilms/deposits have different cave distribution, pH, macro- and microelement and mineralogical composition, carbon and nitrogen content. In particular, water filaments and vermiculations had circumneutral and slightly acidic pH, respectively, both had abundant organic carbon and high microbial diversity. They were rich in macro- and microelements, deriving from mineral dissolution, and, in the case of water filaments, from seawater composition. Vermiculations had different color, partly associated with their mineralogy, and unusual minerals probably due to trapping capacities. Moonmilk was composed of gypsum, poor in organic matter, had an extremely low pH (0–1) and low microbial diversity. Based on 16S rRNA gene analysis, the microbial composition of the biofilms/deposits included autotrophic taxa associated with sulfur and nitrogen cycles and biomineralization processes. In particular, water filaments communities were characterized by bacterial taxa involved in sulfur oxidation and reduction in aquatic, aphotic, microaerophilic/anoxic environments (Campylobacterales, Thiotrichales, Arenicellales, Desulfobacterales, Desulforomonadales) and in chemolithotrophy in marine habitats (Oceanospirillales, Chromatiales). Their biodiversity was linked to the morphology of the water filaments and their collection site. Microbial communities within vermiculations were partly related to their color and showed high abundance of unclassified Betaproteobacteria and sulfur-oxidizing Hydrogenophilales (including Sulfuriferula), and Acidiferrobacterales (including Sulfurifustis), sulfur-reducing Desulfurellales, and ammonia-oxidizing Planctomycetes and Nitrospirae. The microbial community associated with gypsum moonmilk showed the strong dominance (>6

Item does not contain fulltext, Since the start of the COVID-19 pandemic, there has been concern about the concomitant rise of antimicrobial resistance. While bacterial co-infections seem rare in COVID-19 patients admitted to hospital wards and intensive care units (ICUs), an increase in empirical antibiotic use has been described. In the ICU setting, where antibiotics are already abundantly-and often inappropriately-prescribed, the need for an ICU-specific antimicrobial stewardship programme is widely advocated. Apart from essentially warning against the use of antibacterial drugs for the treatment of a viral infection, other aspects of ICU antimicrobial stewardship need to be considered in view of the clinical course and characteristics of COVID-19. First, the distinction between infectious and non-infectious (inflammatory) causes of respiratory deterioration during an ICU stay is difficult, and the much-debated relevance of fungal and viral co-infections adds to the complexity of empirical antimicrobial prescribing. Biomarkers such as procalcitonin for the decision to start antibacterial therapy for ICU nosocomial infections seem to be more promising in COVID-19 than non-COVID-19 patients. In COVID-19 patients, cytomegalovirus reactivation is an important factor to consider when assessing patients infected with SARS-CoV-2 as it may have a role in modulating the patient immune response. The diagnosis of COVID-19-associated invasive aspergillosis is challenging because of the lack of sensitivity and specificity of the available tests. Furthermore, altered pharmacokinetic/pharmacodynamic properties need to be taken into account when prescribing antimicrobial therapy. Future research should now further explore the 'known unknowns', ideally with robust prospective study designs.

Contains fulltext : 218616.pdf (Publisher’s version ) (Closed access), BACKGROUND: Antimicrobial de-escalation (ADE) is a strategy of antimicrobial stewardship, aiming at preventing the emergence of antimicrobial resistance (AMR) by decreasing the exposure to broad-spectrum antimicrobials. There is no high-quality research on ADE and its effects on AMR. Its definition varies and there is little evidence-based guidance for clinicians to use ADE in the intensive care unit (ICU). METHODS: A task force of 16 international experts was formed in November 2016 to provide with guidelines for clinical practice to develop questions targeted at defining ADE, its effects on the ICU population and to provide clinical guidance. Groups of 2 experts were assigned 1-2 questions each within their field of expertise to provide draft statements and rationale. A Delphi method, with 3 rounds and an agreement threshold of 70% was required to reach consensus. RESULTS: We present a comprehensive document with 13 statements, reviewing the evidence on the definition of ADE, its effects in the ICU population and providing guidance for clinicians in subsets of clinical scenarios where ADE may be considered. CONCLUSION: ADE remains a topic of controversy due to the complexity of clinical scenarios where it may be applied and the absence of evidence to the effects it may have on antimicrobial resistance.

Contains fulltext : 206783.pdf (publisher's version ) (Closed access), BACKGROUND: Isavuconazole was compared to caspofungin followed by oral voriconazole in a Phase 3, randomized, double-blind, multinational clinical trial for the primary treatment of patients with candidemia or invasive candidiasis. METHODS: Adult patients were randomized 1:1 to isavuconazole (200 mg intravenous [IV] three-times-daily [TID] for 2 days, followed by 200 mg IV once-daily [OD]) or caspofungin (70 mg IV OD on day 1, followed by 50 mg IV OD [70 mg in patients > 80 kg]) for a maximum of 56 days. After day 10, patients could switch to oral isavuconazole (isavuconazole arm) or voriconazole (caspofungin arm). Primary efficacy endpoint was successful overall response at the end of IV therapy (EOIVT) in patients with proven infections who received >/=1 dose of study drug (modified-intent-to-treat [mITT] population). The pre-specified noninferiority margin was 15%. Secondary outcomes in the mITT population were successful overall response at 2 weeks after the end of treatment, all-cause mortality at days 14 and 56, and safety. RESULTS: Of 450 patients randomized, 400 comprised the mITT population. Baseline characteristics were balanced between groups. Successful overall response at EOIVT was observed in 60.3% of patients in the isavuconazole arm and 71.1% in the caspofungin arm (adjusted difference -10.8, 95% confidence interval -19.9--1.8). The secondary endpoints, all-cause mortality, and safety were similar between arms. Median time to clearance of the bloodstream was comparable between groups. CONCLUSIONS: This study did not demonstrate non-inferiority of isavuconazole to caspofungin for primary treatment of invasive candidiasis. Secondary endpoints were similar between both groups. CLINICAL TRIALS REGISTRATION: NCT00413218.

Sulfuric acid cave systems host abundant microbial communities that can colonize several environments displaying a variety of morphologies, i.e. white flamentous mats foating on the water surface, white creamy moonmilk deposits on the walls, and biovermiculations. Up to date, only few reports have described the microbiological aspects behind biovermiculation geomicrobiology of Italian sulfuric acid caves despite their overall abundance. Here, we present the frst characterization of biovermiculation microbial populations from the Santa Cesarea Terme (Apulia, Italy) using next-generation sequencing and feld emission scanning electron microscopy (FESEM) approaches. We focused our analysis on biovermiculations from Fetida Cave located along the Adriatic Sea coastline. Tis cave is at sea level, and moving from the entrance to its inner part, it is possible to observe a decrease of marine infuence accompanied by a corresponding increase in the acidic efect of the upwelling waters. Biovermiculations are copiously observed covering the ceiling and walls mainly in the inner and middle environments of the cave, while they are absent near the entrance. Biovermiculations have a widespread range of colors going from grey to dark brown with an overall slimy appearance; dendritic morphologies alternate to very dense wall-covering sheets. Total DNA was extracted from each sample and 16S rDNA sequences were analyzed through Ilumina MiSeq platform. Te main lineages found in all the samples included Gammaproteobacteria, Betaproteobacteria, Alphaproteobacteria, Bacteroidetes, Planctomycetes, Actinobacteria and Acidobacteria. In particular, the samples from the inner part of the cave had the highest abundance of Acidobacteria and showed the presence of Epsilonproteobacteria that can be related to bacterial sulfuroxidizing activity. FESEM images revealed microbial mats composed of flamentous cells including Actinobacteria and reticulated flaments of unknown origin, as well as prosthecate

Contains fulltext : 138263.pdf (publisher's version ) (Open Access), BACKGROUND: Abdominal infections are frequent causes of sepsis and septic shock in the intensive care unit (ICU) and are associated with adverse outcomes. We analyzed the characteristics, treatments and outcome of ICU patients with abdominal infections using data extracted from a one-day point prevalence study, the Extended Prevalence of Infection in the ICU (EPIC) II. METHODS: EPIC II included 13,796 adult patients from 1,265 ICUs in 75 countries. Infection was defined using the International Sepsis Forum criteria. Microbiological analyses were performed locally. Participating ICUs provided patient follow-up until hospital discharge or for 60 days. RESULTS: Of the 7,087 infected patients, 1,392 (19.6%) had an abdominal infection on the study day (60% male, mean age 62 +/- 16 years, SAPS II score 39 +/- 16, SOFA score 7.6 +/- 4.6). Microbiological cultures were positive in 931 (67%) patients, most commonly Gram-negative bacteria (48.0%). Antibiotics were administered to 1366 (98.1%) patients. Patients who had been in the ICU for

[ES]El reciente descubrimiento de minerales hidratados sobre la superficie de Marte sugiere la presencia de importantes cantidades de agua líquida durante algunas etapas de su historia geológica. A raíz de este hallazgo, los estudios sobre minerales hidratados en ambientes terrestres como potenciales análogos marcianos han adquirido gran relevancia. En el presente trabajo se han estudiado las características mineralógicas y geoquímicas de minerales hidratados procedentes de varias cuevas y minas españolas y de la región minera de Iglesias-Carbonia (Cerdeña, Italia) mediante técnicas espectroscópicas implicadas en misiones de exploración marciana presentes y futuras, con el fin de evaluar su potencial para la detección de este tipo de minerales. Por un lado, se ha utilizado la espectroscopia Raman, que formará parte de la carga científica de la misión ExoMars de la Agencia Espacial Europea. Por otro lado, la espectroscopia de IR, otra de las técnicas involucradas en esta misión de la ESA, así como la espectroscopia LIBS y la combinación de difracción-fluorescencia de rayos X (DRX-FRX), ambas a bordo de la misión MSL de la NASA. Estas técnicas han permitido identificar sulfatos (yeso, epsomita, jarosita y glaucocerinita), silicatos (hemimorfita) y carbonatos (hidrocincita e hidromagnesita), todos ellos minerales hidratados y algunos de los cuales también han sido descritos en Marte. Por otro lado, se han abordado los procesos de formación de estos minerales y las potenciales analogías con la mineralogénesis en Marte. Del conjunto de técnicas empleadas, la combinación Raman-LIBS se perfila como la opción más eficiente para la detección de minerales hidratados en condiciones marcianas., [EN] The recent discovery of hydrated sulfates on the Martian surface suggests that widespread wet conditions were present during its early geological history. Upon this discovery, a growing interest has emerged in the study of this group of minerals from terrestrial environments as potential Martian analogs. Here, we evaluate the potential of various analytical techniques involved in current and future mission to Mars for detecting hydrated minerals from caves and mines of Spain and the mining district of Iglesias-Carbonia (Sardinia, Italy). Minerals were analyzed by Raman spectroscopy, which will be included in the payload of the ESA’s 2018 ExoMars mission. On the other hand, IR spectroscopy, also included in the ExoMars mission, as well as LIBS spectroscopy and a combined XRD-XRF analyzer, both onboard the Curiosity rover of NASA’s MSL mission, were utilized. Hydrated sulfates (gypsum, epsomite, jarosite and glaucocerinite), silicates (hemimorphite) and carbonates (hydrozincite and hydromagnesite) were characterized. Most of these minerals have also been detected on the Martian surface. The mechanisms involved in the genesis of these minerals and the potential analogies with the minerogenesis on Mars are discussed. The Raman-LIBS combination appears to be the most powerful tool for detecting hydrated minerals in Martian conditions. This technology will probably be considered to be onboard of further planetary missions