Dear FOI contact,

I am writing to request your assistance with an open government request according to the Freedom of Information Act 2000.

Please kindly complete the below questions.

Questions for clinical team(s):

1. Of the following, which guidelines does your Trust follow for the diagnosis and treatment of meningitis/encephalitis: (Please answer: Yes/No)
• NICE Guidelines (CG102) - Bacterial meningitis in under 16s: recognition, diagnosis and management
• UK Joint Specialist Societies guideline on the diagnosis and management of acute meningitis and meningococcal sepsis in immunocompetent adults (published 2016)
• Association of British Neurologists and British Infection Association National Guidelines – Management of suspected viral encephalitis in adults (published 2011)
• Association of British Neurologists and British Paediatric Allergy, Immunology and Infection Group National Guidelines – Management of suspected viral encephalitis in children (published 2011)

2. Does your Trust have any locally developed/adapted guidelines for the diagnosis and treatment of meningitis/encephalitis in both adults and paediatric patients?
If yes, please state which guidelines have been adapted and please provide a copy of your local guidelines.

3. What are the top 3 roles in your Trust, in order of involvement, that are responsible for the development of local pathways and guidelines for meningitis/encephalitis?

4. Does your Trust typically take samples of blood cultures from patients with suspected meningitis/encephalitis within: (Please select answer)
• 1 hour of admission?
• 2-4 hours of admission?
• 4-8 hours of admission?
• 8> hours of admission?

5. Does your Trust consistently carry out lumbar punctures in patients with no contradictions who have suspected meningitis/encephalitis? (Yes/No)
If yes, who performs the lumbar puncture? (Please specify job role)

6. Does your Trust consistently take cerebrospinal fluid (CSF) samples via lumbar puncture from patients with suspected meningitis/encephalitis within: (Please select answer)
• 1 hour of admission?
• 1-2 hours of admission?
• 2-4 hours of admission?
• 4-8 hours of admission?
• 8-12 hours of admission?
• >12 hours of admission?

7. Does your Trust administer antibiotics to patients where appropriate prior to taking blood culture and CSF samples? (Yes/No)

8. Does your Trust consistently administer antibiotics to patients with suspected meningitis/encephalitis within: (Please select answer)
• 1 hours of admission?
• 2-4 hours of admission?
• 4-8 hours of admission?
• 8> hours of admission?

Questions for lab team(s):

9. Which of the following guidelines does your Trust follow for the microbiological investigation of meningitis/encephalitis: (Please select: Yes/No)
• UK Standards for Microbiology Investigations – Meningoencepahilits (published 2014)
• UK Standards for Microbiology Investigations – Investigation of Cerebrospinal Fluid (published 2017)

10. Does your Trust have any local adaptations or amendments to the two UK Standards for Microbiology Investigations listed in the above question?
If yes, please provide a copy of your local amendments.

11. Following lumbar puncture on a patient with suspected meningitis/encephalitis, how long are the turnaround times from point of receiving specimen to result on the following tests: (Please select answer for each result)
a) Cell count (<1 hour, 1-2 hours, 2-4 hours or >4 hours)
b) Gram staining (<1 hour, 1-2 hours, 2-4 hours or >4 hours)
c) Bacterial culture (<1 hour, 1-2 hours, 2-4 hours or >4 hours)
d) PCR (<1 hour, 1-2 hours, 2-4 hours or >4 hours)

12. Where does your Trust process CSF samples?

13. Does your Trust perform PCR testing to test samples from patients with suspected meningitis/encephalitis? (Yes/No)

14. If PCR testing is carried out in your Trust, which bacterial and viral pathogens are tested for? (Please separate your answer by bacterial and viral pathogens)

Thank you for taking the time to supply this information.

Yours faithfully,
Kimrin Pannu