Hafnia alvei Pneumonia: A Rare Cause of Infection in a Patient with COVID-19

Abstract

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.

Emergence of Mobile Colistin Resistance Genes within Los Angeles County Wastewater

“…Given the gaps in our draft genome assembly, we cannot confirm if the mcr -9.1 identified in this study is encoded in the H. alvei chromosome or a part of an unassembled plasmid. Despite reports of increased H. alvei infections in immunocompromised patients during the COVID-19 pandemic, − there were no corresponding sequenced data in the NCBI database. For WS to reach its full potential, there is a need for more routine sequencing of clinical bacteria genomes particularly when ARGs (e.g., mcr ) can be harbored in intrinsically resistant bacterial hosts.…”

"Hafnia alvei Urinary Tract Infection in A Patient with Multimorbidity After Covid19 - A Case Report"

“…Except for a urinary infection in a healthy child [11], all the other cases regard immunocompromised patients, thus underlining the role of Hafnia alvei as an opportunistic pathogen. Until now, there are three known cases of patients who developed Hafnia alvei infections in the context of COVID-19, a bloodstream coinfection with Candida auris and two cases of ventilator-associated pneumonia [22,34,35]. We present a case of a successfully treated…”

“…enterocolitis followed by reactive arthritis [29] and pneumonia [30][31][32][33][34][35][36]. Except for a urinary infection in a healthy child [11], all the other cases regard immunocompromised patients, thus underlining the role of Hafnia alvei as an opportunistic pathogen.…”

Prevention and treatment of ventilator-associated pneumonia in COVID-19

“…Besides, COVID-19 could lead to severe organ dysfunction and prone to secondary bacterial infections, and then even facilitate the emergence of infectious diseases caused by rare microorganisms. There are also studies of VAP contributed by the rare bacteria Hafnia alvei ( Cutuli et al, 2021 ; Méndez et al, 2021 ).…”