Abstract
The World Health Organization (WHO) has ranked antibiotic resistance as one of the 10 biggest global threats, leading to significant morbidity, mortality, and economic burden. In Germany the developing resistance situation is critical. The resistance data of the most relevant drug-bug combinations are calculated with data from the German Antibiotic Resistance Surveillance (ARS) system. For four of these drug-bug combinations, incidence reduction targets for 2030 (bloodstream infections per 100,000 inhabitants) have been outlined in the German Antimicrobial Resistance Strategy (DART 2030) action plan. The incidence for the gram-positive vancomycin-resistant Enterococcus (VRE) and methicillin-resistant Staphylococcus aureus (MRSA) are currently within the target range. However, this is not the case for Escherichia coli with resistance to third generation Cephalosporins and Carbapenem-resistant Klebsiella pneumoniae, both of which are increasing in incidence. In an EU comparison, the incidence of AMR in Germany ranks in the middle.In addition to the resistance data and incidence, the Measuring Infectious Causes and Resistance Outcomes for Burden Estimation (MICROBE) project presents the absolute numbers of mortalities from infections with antimicrobial-resistant pathogens. In Germany, 40,000 deaths per year are associated with antibiotic-resistant infections, and in almost 10,000 of these cases the death was attributable to the antibiotic-resistant pathogen. This means that more people in Germany are dying from antibiotic-resistant infections than other infectious diseases.The effects on the healthcare system are substantial; the increasing antibiotic resistance in particular leads to greater burden of disease in haemato-oncological diseases and poses challenges to effective perioperative antibiotic prophylaxis.