42 Chapter 3 Figure 2. Prevalence of pAmpC producing E. coli from 2013 to 2016 with 95% confidence interval. Discussion The present study shows a significant decline in the prevalence of cAmpC producing E. coli measured in four yearly point prevalence surveys. The pAmpC prevalence remained stable over time. To the best of our knowledge, there are no other studies published on trends in rectal carriage of both cAmpC and pAmpC positive isolates in hospitalised patients, which prohibits a comparison of trends with other studies. Few studies have looked at pAmpC carriage in hospitalised patients. Garrido et al found a low prevalence of 0.59% pAmpC in faecal samples of a Spanish hospitalised population (Garrido et al. 2014). In the same year Husickova et al. published a survey on rectal carriage of pAmpC producing isolates and found a prevalence of 0.3% (Husickova et al. 2012). These results are slightly lower in comparison to our study. However, both studies did not use a (selective) pre-enrichment broth, which may explain the lower pAmpC prevalence (M. F.Q. Kluytmans-Van Den Bergh et al. 2015). No studies were performed on the occurrence of rectal carriage of cAmpC isolates in hospitalised patients. Data on the prevalence of AmpC rectal carriage in the community within the North Western European region is more extensively described, although not all studies screened or confirmed cAmpC production in E. coli isolates. In Norway, Ulstad et al.
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