{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T09:14:05Z","timestamp":1769937245595,"version":"3.49.0"},"reference-count":29,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2021,11,17]],"date-time":"2021-11-17T00:00:00Z","timestamp":1637107200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>Herein, we describe a case report of a critically ill patient, a 48-year-old man without comorbidities admitted to the hospital with a serious type 1 (hypoxemic) respiratory insufficiency and confirmed diagnosis of COVID-19. After 5 days with invasive mechanical ventilation, the patient developed a bacterial co-infection, namely a pneumonia by Hafnia alvei, requiring the last line of respiratory support: extracorporeal membrane oxygenation (ECMO). Subsequently, his clinical situation gradually stabilized, until he was discharged from the hospital on day 61, being accompanied in ambulatory consultation by the physical medicine and pulmonology department during the post-COVID-19 recovery. H. alvei is a Gram-negative bacterium that is rarely isolated from human specimens and is rarely considered to be pathogenic. However, COVID-19 disease can cause substantial organ dysfunction and can be associated with bacterial secondary infections which can favor the emergence of rare infectious diseases by uncommon microorganisms.<\/jats:p>","DOI":"10.3390\/microorganisms9112369","type":"journal-article","created":{"date-parts":[[2021,11,17]],"date-time":"2021-11-17T02:42:28Z","timestamp":1637116948000},"page":"2369","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Hafnia alvei Pneumonia: A Rare Cause of Infection in a Patient with COVID-19"],"prefix":"10.3390","volume":"9","author":[{"given":"Luc\u00eda","family":"M\u00e9ndez","sequence":"first","affiliation":[{"name":"Microbiology Research Laboratory on Environmental Health (EnviHealthMicro Lab), Institute of Environmental Health (ISAMB), Faculty of Medicine, Universidade de Lisboa, 1649-028 Lisboa, Portugal"},{"name":"Pulmonology Department, Centro Hospitalar Entre o Douro e Vouga, 4520-221 Santa Maria da feira, Portugal"}]},{"given":"Jorge","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Pulmonology Department, Centro Hospitalar Entre o Douro e Vouga, 4520-221 Santa Maria da feira, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3735-8554","authenticated-orcid":false,"given":"C\u00e1tia","family":"Caneiras","sequence":"additional","affiliation":[{"name":"Microbiology Research Laboratory on Environmental Health (EnviHealthMicro Lab), Institute of Environmental Health (ISAMB), Faculty of Medicine, Universidade de Lisboa, 1649-028 Lisboa, Portugal"},{"name":"Institute of Preventive Medicine and Public Health, Faculty of Medicine, Universidade de Lisboa, 1649-028 Lisboa, Portugal"},{"name":"Microbiology and Immunology Department, Faculty of Pharmacy, Universidade de Lisboa, 1649-003 Lisboa, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2021,11,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1016\/j.ijid.2020.01.009","article-title":"The continuing 2019-nCoV epidemic threat of novel coronaviruses to global health\u2014The latest 2019 novel coronavirus outbreak in Wuhan, China","volume":"91","author":"Hui","year":"2020","journal-title":"Int. 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