Evidence map›Paper›PMID 40823668›Full record

ArticleJAC-antimicrobial resistance2025

Antimicrobial resistance burden landscape in Germany in 2019: a comparative country-level estimation.

Tomislav Meštrović, Sebastian Haller, Gisela Robles Aguilar, Annika Meinen, Anna Gershberg Hayoon, Christine Geffers, Achim Dörre, Muna Abu Sin, Authia P Gray, Lucien R Swetschinski and 9 more

Abstract read
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In one paragraph

Article in JAC-antimicrobial resistance, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Tomislav MeštrovićInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Sebastian HallerDepartment of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany.
Gisela Robles AguilarNuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK.
Annika MeinenDepartment of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany.
Anna Gershberg HayoonInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Christine GeffersInstitute of Hygiene and Environmental Medicine, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.
Achim DörreDepartment of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany.
Muna Abu SinDepartment of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany.
Authia P GrayInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Lucien R SwetschinskiInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Kevin S IkutaInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Erin ChungInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.ORCID https://orcid.org/0000-0002-9324-8544
Eve E WoolInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Chieh HanInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Daniel T ArakiInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Rebecca HsuInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Christiane DolecekNuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK.
Tim EckmannsDepartment of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany.
Mohsen NaghaviInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objectives: Our aim was to present the most comprehensive set of pre-COVID-19 antimicrobial resistance (AMR) burden estimates for Germany to date, with a focus on regional variations and hotspots. Methods: The study estimated deaths and disability-adjusted life-years (DALYs) due to AMR for 23 bacterial pathogens and 88 pathogen-drug combinations in Germany in 2019, with the use of two counterfactual scenarios: deaths attributable to AMR (those that would not have occurred if infections were susceptible) and deaths associated with AMR (cases where AMR was present but not necessarily the cause of death). Models were cross-validated for out-of-sample predictive validity, and uncertainty intervals (UIs) calculated. In stratified analyses we compared death estimates and DALYs with previously published estimates. Results: The total burden of mortality and DALYs associated with AMR in Germany were 45 692 (95% UI, 31 281-64 591) deaths and 752 697 (500 313-1 076 187) DALYs, respectively, with the total burden attributable to AMR 9648 (6520-13 918) deaths and 159 032 (105 021-232 459) DALYs, respectively. Bloodstream, respiratory and intra-abdominal infections were the major contributors to the fatal AMR burden. The leading pathogens responsible for AMR-associated deaths were Conclusions: The high resistance levels and significant health burden highlight AMR as a serious public health challenge in Germany, emphasizing the need to further strengthen targeted prevention and control measures against key pathogen-drug combinations.

Identifiers

PMID40823668
PMCPMC12351539

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.