HPA FOI request re E Coli

name removed 23 Oct 2012 (Account suspended) made this Freedom of Information request to Health Protection Agency

This request has been closed to new correspondence from the public body. Contact us if you think it ought be re-opened.

Waiting for an internal review by Health Protection Agency of their handling of this request.

name removed 23 Oct 2012 (Account suspended)

Dear Health Protection Agency,

I made a Freedom of Information Request to you on 8 December 2011 by email but not via WhatDoTheyKnow.

Could you please check your inbox and discover what has happened to my FOI Request regarding E Coli identified in a lab report of South London Healthcare NHS Trust

In that email I stated:

"I know that on 19 April 2011 there was E Coli identified in the London Borough of Bromley. This was identified in a catheterised urinary sample as identified in South London Healthcare NHS Trust laboratory."

and in consequence, I requested, and make this as a REPEATED request as I have not heard from you that I can find in my email inbox:

"Under Freedom of Information, I wish to request

1] how many people have been diagnosed as having E Coli in Green Parks House this year? [ie 2011]

2] how many people have been diagnosed as having E Coli by South London Healthcare NHS Trust Laboratory?

3] how many reports of E Coli having been diagnosed have been made to the Environmental Health Agency by South London Healthcare NHS Trust laboratory in 2011?

4] how many reports of E Coli having been diagnosed have been made to the ACDP HPA / HPA by South London Healthcare NHS Trust laboratory in 2011?

5] how many reports of E Coli have been reported to London Borough of Bromley by South London Healthcare NHS Trust in 2011?

6] how many reports of E Coli have been reported to London Borough of Bromley by Oxleas NHS Foundation Trust in 2011?

7] how many reports of E Coli have been reported to the Department of Health by South London Healthcare NHS Trust in 2011?

8] What strain/s of E Coli - if any - was/were identified between 8 to 19 April 2011 inclusive by South London Healthcare NHS Trust of any Oxleas patients?

9] What strain/s of E Coli - if any - was/were identified between 12 March to 8 April 2011 inclusive by South London Healthcare NHS Trust of any of its patients?

10] What strain of E Coli was identified in the South London Healthcare NHS Trust in December 2010 that led to fatality?

11] Has E Coli been eradicated from London Borough of Bromley in 2011?

12] How many Bromley residents were identified as suffering from E Coli in 2011?"

In the interests of public safety I am making this Freedom of Information Request. If you did indeed respond, I am sorry to trouble you to re-send it to me with your reply.

Thank you very much for your help, and I look forward to receiving your response.

Please treat this as an Internal Review of the original FOI Request because although I did not make the original FOI via WhatDoTheyKnow, I would be most grateful to have your answer via this website as I believe it to be in the public interest to know about E Coli.

Thank you very much,

Yours sincerely,

[first name removed] [last name removed]

Freedom Of Information, Health Protection Agency

1 Attachment

Dear Ms [last name removed]

Thank you for your email. The Health Protection Agency did respond to your request dated 8 December on the 15 December via the email address that you provided in your original request. Please find attached a copy of that letter.

Kind regards

Freedom OF Information Officer

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name removed 23 Oct 2012 (Account suspended)

Dear Freedom Of Information,

Thank you very much for this re-sending of your reply to me, for which I am most grateful. I have had difficulty in my inbox and although I thought you had indeed responded, I simply could not find it.

In consequence of what I have read on the response, may I enquire specifically about a serious outbreak of E Coli that affected South London Healthcare NHS Trust in December 2010.

Which specific E Coli strain was this?

And in April 2011 there was found on a South London Healthcare NHS Trust laboratory sample of E Coli which showed significant numbers >100,000 organisms/ml of E Coli in a catheterised sample where it showed that the E Coli were sensitive [S] to 4 drugs:

Gentamicin S
Nitrofurantoin S
Trimethropin S
Ampicillin S

as well as White Cells ++ = 50-200 /ul

How responsive are E Coli to antibiotics when a person is catheterised? Are there any extra precautions that must be taken when a person is catheterised?

In a sample where there are White Cells 50-200 / ul what does this signify? I am not a medic and therefore do not know what it means. I have tried asking other sources including NHS Direct but had no luck.

Is it standard to have White Cells ++ or does this signify systemic infection?

What is the difference between bacteruric patients with catheter in situ [indwelling catheter] and those who do not have a catheter at all? Is there any difference in likely susceptibility to infection by E Coli and damage to internal organs?

I note from your website reference that there are several types of E Coli and whilst it is indeed helpful to know that certain strains are worse than others, I still do not know the answer to the question I asked - namely are any E Coli actually safe?

And I also asked and have not been given the answer - and I could not find it on your website - whether over-colonisation of E Coli is a major problem? For it seems it is as much a question of how many E Coli organisms there are rather than having E Coli at all is the problem, bearing in mind that E Coli naturally inhabit the gut.

What concerns me about E Coli in a surgical setting, though, is the fact that catheters are widely used as a means of draining urine in people who normally would not be having a catheter at all. Is there not a very real danger of setting up the ideal environment for fecal E Coli to colonise an indwelling catheter?

And for a patient to be systemically unwell in consequence of having a Urinary Tract Infection whether or not it be E Coli, and to be deemed to be psychotic in consequence of infection which has not been diagnosed?

I have witnessed at first hand such an instance - it was very distressing to see someone being so confused by UTI that they were not acting or thinking normally.

And the Royal College of Anaesthetists explained that post-surgical psychosis related to anaesthesia is common and can cause delirium.

So if there is infection as well as delirium this could lead carers or staff to consider that a person is maybe psychiatrically ill rather than in fact suffering from a UTI and/or responding in a confused state to major anaesthesis.

I look forward to having this as an internal review please and to consider my points as being part of the review as I am explaining what I need to know.

I am most grateful for your kind help,

Yours sincerely,

[first name removed] [last name removed]

Freedom Of Information, Health Protection Agency

Dear Ms [last name removed],

The Freedom of Information team acknowledges your request for information.

You will receive a response within 20 working days.

Kind regards,

Neville

Please reply to [Health Protection Agency request email]

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name removed 23 Oct 2012 (Account suspended)

Dear Neville, Freedom Of Information,

Thank you very much for your kind help,

With best wishes,

[first name removed]

Freedom Of Information, Health Protection Agency

1 Attachment

 

Dear Ms [last name removed]

 

Please find attached the Health Protection Agency’s response to your 3
requests for information. I have responded to each request in one letter.

 

Feel free to contact me if you require further clarification.

 

Kind regards

 

Freedom of Information Officer

 

 

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name removed 23 Oct 2012 (Account suspended)

6 April 2012

Dear Freedom Of Information Health Protection Agency, Mr Lansley Secretary of State for Health, Mr Turner MP for the Isle of Wight,

Please pass this on to the person who conducts Freedom of Information reviews.

I am writing to request an internal review of Health Protection Agency's handling of my FOI request 'HPA FOI request re E Coli'.

I thank the Health Protection Agency Officer who responded to my 3 FOI Requests regarding E.coli.

I am somewhat concerned that the Health Protection Agency could not answer certain questions.

I therefore request that the HPA take an internal review of its decision not to answer certain of my questions under Freedom of Information, and, if they still refuse to answer under FOI, could they please simply answer my questions as they are in the public interest to know, I aver?

Thank you very much for your help,

Yours sincerely,

[first name removed] [last name removed]

Campaigner for legal reform, liberty, truth and justice

Re: 3 requests regarding E.coli

"Thank you for your three emails dated 16, 17 and 18 January 2012 regarding E.coli and the Summercroft surgery.

I can confirm in accordance with section 1 (1) (a) of the Freedom of Information Act 2000 the Health Protection Agency (HPA) is obliged to confirm whether or not it holds the requested information.

The HPA is unable to confirm it holds the requested information with certainty as the information specified in your request is unclear.

When we say unclear, we do not mean that the written questions are unclear we mean the information that may fall into the scope of such questions is unclear.

In accordance with our section 16 duty to advise and assist the applicant the HPA has endeavoured to respond to your questions posed in so far as we can.

With due respect, the questions posed, over simplify the science and many of them would require expert scientific interpretation of the literature base in order to generate comprehensive answers.

Statutory access legislation does not require public authorities to create new information in response to questions posed.

I have responded to your questions in the order you raised them below.

Request dated 16 January - Ref 021
1. ….there are many varieties of E Coli, and I am trying to find out precisely what is the strain of E Coli which is Sensitive to
Ampicillin, Gentamicin, Trimethoprim, Nitrofurantoin. >100,000 organisms/ml. Escherichia coli isolated. white blood cells ++ = 50-200/ul

This pattern of antibiotic resistance does not indicate a particular strain as more than one strain could show this pattern.

14 February 2012
2. How safe is it for a catheterised patient with an indwelling catheter in situ, with these results, to have antibiotics? What is the increase in risk when catheterised of having an E Coli infection that might cause damage to the bladder or kidneys?

This is not a valid Freedom of Information request because it asks us to respond to a question, which requires us to create information rather than supply information that is held at the time the request was made. In order to comprehensively answer this
question the HPA would need to conduct a literature review.

3. If antibiotics are not used, can a patient be very irritated by a catheter and find themselves itching and finding their genitalia very irritated by a catheter with E Coli found concurrently?

This is not a valid Freedom of Information request because it asks us to respond to a question, which requires us to create information in response rather than supply information that was held when the request was made.

4. Is bacteruric E Coli different from bacteraemic E Coli? If so, what is the difference in morbidity and risk of damage to internal organs?

Bacteriuria is a term implying presence of bacteria in urine.

Bacteraemia is the presence of bacteria in the blood.

A range of E.coli strains can cause both.

5. I am aware that there was an outbreak in December 2010 which included South London Healthcare NHS Trust and would like to know which E Coli strain that one was. Would the description I have given you be the same or a similar strain to that of the one found in December 2010 at South London Healthcare NHS Trust?

As stated in our response letter to you dated 15 December 2011, reference number 11/12/09/nc/347, the HPA does not hold this information.

Request dated 17 January - Ref 022
May I enquire specifically about a serious outbreak of E Coli that affected South London Healthcare NHS Trust in December 2010. Which specific E Coli strain was this?

As stated in our response letter to you dated 15 December 2011, reference number 11/12/09/nc/347, the HPA does not hold this information.

And in April 2011 there was found on a South London Healthcare NHSTrust laboratory sample of E Coli which showed significant numbers
>100,000 organisms/ml of E Coli in a catheterised sample where it showed that the E Coli were sensitive [S] to 4 drugs:
Gentamicin S Nitrofurantoin S Trimethropin S Ampicillin S as well as White Cells ++ = 50-200 /ul

How responsive are E Coli to antibiotics when a person is catheterised? Are there any extra precautions that must be taken when a person is catheterised?
In a sample where there are White Cells 50-200 / ul what does this signify?

Is it standard to have White Cells ++ or does this signify systemic
infection?

What is the difference between bacteruric patients with catheter in situ [indwelling catheter] and those who do not have a catheter at all? Is there any difference in likely susceptibility to infection by E Coli and damage to internal organs?

I note from your website reference that there are several types of E Coli and whilst it is indeed helpful to know that certain strains are worse than others, I still do not know the answer to the
question I asked - namely are any E Coli actually safe?

And I also asked and have not been given the answer - and I could not find it on your website - whether over-colonisation of E Coli is a major problem? For it seems it is as much a question of how many E Coli organisms there are rather than having E Coli at all is the problem, bearing in mind that E Coli naturally inhabit the gut. What concerns me about E Coli in a surgical setting, though, is the fact that catheters are widely used as a means of draining urine in people who normally would not be having a catheter at all. Is there not a very real danger of setting up the ideal environment for fecal E Coli to colonise an indwelling catheter?

And for a patient to be systemically unwell in consequence of having a Urinary Tract Infection whether or not it be E Coli, and to be deemed to be psychotic in consequence of infection which has not been diagnosed?

This is not a valid Freedom of Information request because it asks us to respond to a question, which requires us to create information in response rather than supply information that was held when the request was made.

Request dated 17 January - Ref 024
I am coming to you after requesting information from Summercroft Surgery who said they did not have the information and suggested I go to the cluster PCT, and then when I went to them, they said that E Coli is notifiable to the HPA.

E. coli is not notifiable to the HPA apart from E. coli
bacteraemias and E.coli food poisoning (e.g. E.coli O157). We do not hold information about patients specifically registered with Summercroft Surgery and diagnosed at South London Healthcare
Trust."

A full history of my FOI request and all correspondence is available on the Internet at this address:
http://www.whatdotheyknow.com/request/hp...