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This study was undertaken to understand the overall burden of 4MRGN infections in Germany in the context of a Health Technology Appraisal (HTA) for Ceftazidime\/Avibactam (CAZ\/AVI). Besides, the incidences mortality was an endpoint of interest.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>To assess infections with carbapenem-resistant gram-negative bacteria and related mortality, three different data sources have been used. From the German statistics office (DESTATIS) data have been retrieved to obtain the overall frequency these pathogens. Via two other databases, the German analysis database (DADB) and a Benchmarking of\u2009&gt;\u2009200 hospitals in a representative sample (BM-DB), the distribution of the infections and the mortality have been analyzed.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>DESTATIS data showed a total of 11,863 carbapenem-resistant gram-negative bacteria codings, of which 10,348 represent infections and 1515 carriers. The most frequent infections were complicated urinary tract infections (cUTI) (<jats:italic>n\u2009<\/jats:italic>=\u20092,337), followed by pneumonia (<jats:italic>n<\/jats:italic>\u2009=\u20091006) and intra-abdominal infections (<jats:italic>n<\/jats:italic>\u2009=\u2009730). A considerable amount of patients had multiple infections in one hospital episode (<jats:italic>n<\/jats:italic>\u2009=\u20091258). In-hospital mortality was 18.6% in DADB and 14.3% in the BM-DB population, respectively. In cases with additional bloodstream infections, DADB mortality was correspondingly higher at 33.0%. DADB data showed an incremental mortality increase of 5.7% after 30\u00a0days and 10.0% after 90\u00a0days resulting in a cumulative 90\u00a0day mortality of 34.3%.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Infections with carbapenem-resistant gram-negative bacteria are still rare (6.8\u201312.4 per 100,000) but show a significant increase in mortality compared to infections with more sensitive pathogens. Using different data sources allowed obtaining a realistic picture.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s15010-022-01843-6","type":"journal-article","created":{"date-parts":[[2022,5,31]],"date-time":"2022-05-31T10:02:47Z","timestamp":1653991367000},"page":"1535-1542","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Carbapenem-resistant gram-negative bacteria in Germany: incidence and distribution among specific infections and mortality: an epidemiological analysis using real-world data"],"prefix":"10.1007","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0294-1897","authenticated-orcid":false,"given":"Michael H.","family":"Wilke","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birgit","family":"Preisend\u00f6rfer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Seiffert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Kleppisch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Schweizer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Rauchensteiner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,5,31]]},"reference":[{"key":"1843_CR1","doi-asserted-by":"publisher","first-page":"204993612091204","DOI":"10.1177\/2049936120912049","volume":"7","author":"M Bassetti","year":"2020","unstructured":"Bassetti M, Peghin M. 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He is also shareholder of Pfizer Inc. He received honoraria for lectures and research grants unrelated to this research from Orion Pharma, Shionogi, Abbott, Accelerate, and bioM\u00e9rieux. BP is senior consultant at inspiring-health GmbH. AS is senior researcher at GFL, which received honoraria for providing the data from DADB. MK, CS, and SR are employees of Pfizer Pharma GmbH which funded this research.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"An approval of an ethics committee was not necessary. This study was performed with retrospective, anonymized patient data from large databases.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}