Department of Neonatology

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Extracerebral choroid plexus papilloma in a newborn: a rare presentation
(PUBMED, 2023) Santosh Kumar Singh; Saikat Patra; Nadia Shirazi; Girish Gupta
Choroid plexus papillomas (CPPs) are extremely rare lesions that originate in the central nervous system. Still rarely, these can occur in heterotopic locations. We report a case of aneonate who presented at fourth week of life with a small swelling in the left side of the oropharynx. There were no other symptoms. MRI scan revealed a cystic lesion with the possibility of lymphatic malformation or teratoma. Swelling which was gradually increasing in size was electively excised. Histopathological examination revealed it to be an extracerebral CPP. Postoperative period was uneventful, and baby had no further complications. CPP is a rare lesion and, almost always, cannot be anticipated before surgery. Imaging only helps in surgical planning. Complete excision is curative.
Novel variant CPLANE 1: c.5051C>A (p.Ser1684Ter) in an Indian neonate with Joubert syndrome
(BMJ Publishing Group, 2023-05-31) Saikat Patra; Garima Goyal; Yasir Ahmad Lone; Girish Gupta
Joubert syndrome (JS) is a rare ciliopathy that presents with the triad of hypotonia, developmental delay and molar tooth sign (MTS) in brain MRI. Next-generation sequencing has identified about 35 genes which are known to cause JS of which CPLANE 1 mutation is found in 8%-10% of cases. We report a case of JS in an Indian neonate who presented with hypotonia, dysmorphic facies, polydactyly, syndactyly and occipital encephalocele. MRI of the brain revealed MTS, and compound heterozygous mutations in CPLANE 1 gene were detected by clinical exome sequencing, one of them a novel variant CPLANE 1: c.5051C>A (p.Ser1684Ter) in exon 26, which was inherited from the parents.
Effect of Recorded Chants of the “OM” Mantra as an Interventional Music Therapy on Reducing Stress in Newborns Admitted to the Neonatal Intensive Care Unit: An Observational Study
(SAGE Publications, 2023-05-31) Shailendra Kumar Singh; Saikat Patra; Chinmay Chetan; Girish Gupta
Introduction Newborns admitted to the neonatal intensive care unit (NICU) are under tremendous stress. The “OM” sound is known to have a calming effect on adults. The effect of administering chants of “OM” to newborns is unknown. Objectives Primary Objective To evaluate the effect of the “OM” sound on vital parameters in newborns admitted to the NICU. Secondary Objectives To observe the duration of the effect of the “OM” sound on vital parameters after the music therapy and to observe its effect at various gestational ages. Methods Prospective observational study was carried out over 4 months. 57 newborns enrolled were administered music therapy by playing recorded chants of “OM” mantra (MTOM). Vitals were recorded before, during, and after MTOM. Results The heart rate (HR) before and with MTOM was 142 ± 7 and 130 ± 11 bpm (p = .001). The decrease in HR persisted even after 1 h of stoppage of MTOM (p = .001). A significant decrease in HR was observed in all gestations (p = .001). There was no significant difference in respiratory rate (RR) and SpO2 before and with MTOM. Conclusion MTOM significantly reduces HR in newborns of all gestational ages, and its effect persists for at least 1 h after stopping MTOM.
Effectiveness of Probiotics and Phototherapy Compared to Phototherapy Alone in Treating Hyperbilirubinemia in Neonates ≥35 Weeks Gestation: A Comparative Observational Study
(SCOPUS, 2023-06-01) Suraj Kumar Singh; Girish Gupta; Sanober Wasim; Rakesh Kumar; Saikat Patra; Chetan Chinmay
Introduction Neonatal jaundice is a common condition in neonatal practice. Phototherapy is accepted first line of therapy in its treatment. Probiotics can be an addition as it decreases enterohepatic circulation and improves gut function. Materials and Methods The observational study was conducted in 40 neonates. Participants were divided into 2 groups, phototherapy alone (PA) and probiotics plus phototherapy (PP). The mean difference in total serum bilirubin (mg/dL) levels, total duration of phototherapy, incidence of rebound hyperbilirubinemia, frequency of stooling after initiation of therapy, feed intolerance, and occurrence of new onset sepsis was compared. Results The mean difference in serum bilirubin level was not statistically significant after 12 hours (p = .321), 24 hours (p = .544) and 48 hours (p = .863) after initiation of phototherapy. An increase in frequency of stool in the first 24 hours was observed in PP group (p = .003). The total duration of phototherapy was less in PP group although not statistically significant (25 hours vs 38 hours, p = .054). Rebound hyperbilirubinemia was significantly higher in PA (p = .023). There were no cases of feed intolerance and sepsis. Conclusion The addition of probiotics did not alter the clinical course of jaundice. However, probiotics can reduce the rebound hyperbilirubinemia and is safe as it did not increase incidence of new onset sepsis or feed intolerance.
Usefulness of Mean Gastric Emptying Time in Late Preterm and Term AGA and SGA Newborns to Determine Feeding Frequency—An Observational Study
(SAGE Publications, 2023-06-14) Ankit Jain; Saikat Patra; Vinayak Madhukar Jedhe; Chinmay Chetan; Girish Gupta
Objectives The primary objective is to calculate and compare mean gastric emptying time in appropriate for gestational age (AGA) and small for gestational age (SGA) newborns. The secondary objective is to compare mean gastric emptying time in SGA babies with or without antenatal Doppler changes and to measure gastric spheroidal volume at various intervals in AGA and SGA newborns with or without antenatal Doppler changes. Methods This prospective observational study was carried over 3 months from November 2022 to January 2023. A total of 30 newborns were enrolled and their gastric spheroidal volume was calculated by ultrasound pre-feed and post-feed every 30 minutes till it reached within 10% of pre-feed volume which was taken as gastric emptying time. Mean gastric emptying time was compared among AGA and SGA newborns and amongst SGA with or without antenatal Doppler changes. Results Mean gastric emptying time of AGA was 124 ± ± 25.01 minutes and for SGA was 132 ± 29.57 minutes which was statistically nonsignificant. Mean gastric emptying time when compared between SGA neonates with or without antenatal Doppler changes was similar (P value .43). The gastric spheroidal volume was significantly smaller in SGA newborns compared to their AGA counterparts in pre-feed state (P value .01) and it persisted till 60 minutes post feed (P value .028); however, the mean gastric emptying time is similar in both the groups. Conclusion Mean gastric emptying time of AGA and SGA newborns is similar and hence a feeding interval of 1.5 to 2.5 hours is appropriate for these late preterm and term newborns. Antenatal Doppler changes in SGA babies did not alter their gastric emptying time hence similar feeding frequency can be used in both.
Double BCG vaccination in a neonate: implications, management and prevention
(PUBMED, 2023-12-01) Chinmay Chetan; Saikat Patra; Shailendra Kumar Singh; Girish Gupta
Tuberculosis is a common cause of morbidity and mortality especially in low-income and middle-income countries like India. BCG vaccination is recommended for all neonates after birth in areas with a high tuberculosis disease burden. Here, we describe a case where a neonate received two doses of the BCG (Chennai strain) vaccine within a span of 4 days after birth due to a vaccination error. Parents were informed about the event. The infant was managed conservatively and followed up till 12 months of life for any possible complication. There were no serious adverse effects apart from the localised reaction and a double scar on the left arm. Measures to avoid any such error in the future and the need for reporting medication error has been highlighted. Parental concerns are frequent in such scenarios and should be actively addressed.
Usefulness of skills in point of care ultrasound and simulation-based training as essential competencies in acute management of neonatal cardiac tamponade
(BMJ Publishing Group, 2023-12-29) Ankit Jain; Saikat Patra; Chinmay Chetan; Girish Gupta
Peripherally inserted central catheter (PICC) insertion is a routine procedure in the neonatal intensive care unit required for prolonged intravenous fluid, nutrition and medication support. Neonatal cardiac tamponade is a serious and rare complication of PICC line insertion. Early detection by point of care ultrasound (POCUS) and management by pericardiocentesis improves the chances of survival. Regular simulation-based training sessions on a mannequin, along with knowledge of POCUS, can assist neonatologists and paediatricians for a quick and appropriate response in this emergency condition.
Neonatal nephrotic syndrome: all is not gloomy
(BMJ Publishing Group, 2024-01-02) Chinmay Chetan; Shailendra Kumar Singh; Saikat Patra; Girish Gupta
Congenital nephrotic syndrome (CNS) is a rare clinical syndrome with a constellation of proteinuria, hypoalbuminemia and oedema, presenting within 3 months of birth. We present a rare case of neonatal nephrotic syndrome with a probable sepsis induced aetiology. The neonate was referred at day of life 15 with Klebsiella pneumonia sepsis and anasarca. On investigation, the patient had nephrotic range proteinuria, hypoalbuminemia, generalized anasarca and ascites. The neonate was started on broad-spectrum antibiotics and furosemide. Genetic and other secondary causes of CNS were ruled out. With supportive management and resolution of sepsis, the neonate improved. This case highlights the rare cause of sepsis-induced nephrotic syndrome (NS), which required only supportive treatment without the need for aggressive management of CNS.
Yellow Fibrous Cord‑Like Penile Discharge in a Preterm Neonate — Fungal Balanoposthitis
(PUBMED, 2024-03-01) Chinmay Chetan; Saikat Patra; Brajendra Singh; Girish Gupta
A 1785 g male neonate was born at 31 wk gestation, to an inadequately treated syphilitic mother. The neonate was diagnosed with congenital neurosyphilis. Injection benzathine penicillin G stat dose along with injection ceftriaxone was started through peripherally inserted central catheter. At DOL 24 he developed thick yellowish cord-like gelatinous odourless discharge from the penis, measuring 9 mm×4 mm (Fig. 1). Physiological phimosis was present, with no signs of inflammation and urinary retention. No perianal rashes were noted. Oral thrush was present. Histopathological examination of discharge and suprapubic urine KOH mount revealed budding yeast cells with pseudohyphae. Local clotrimazole cream and injection fluconazole was started. Local hygiene was maintained. The discharge culture grew Candida albicans sensitive to fluconazole.
Alarming medication error with prostaglandin E1 (PGE1) in a term neonate with critical congenital heart disease
(BMJ case report, 2024-04-08) Saikat Patra; Prachi Patwal; Chinmay Chetan; Girish Gupta
An outborn full-term female newborn with birth weight 2.45kg was admitted to our centre at 24 hours of life with respiratory distress and cyanosis. The baby had tachycardia and oxygen saturation (SpO2 ) 40% at admission to neonatal intensive care unit (NICU). She was mechanically ventilated on synchronized intermittent mandatory ventilation (SIMV) mode. Clinical evaluation raised suspicion of critical congenital heart disease; echocardiogram revealed transposition of the great arteries with 6mm ostium secundum atrial septal defect and small patent ductus arteriosus. The baby was started only on intravenous prostaglandin E1 (PGE1) as per unit protocol, where 1 ampoule (500 µg) of PGE1 is mixed in 49mL of 5% dextrose yielding a concentration of 10 µg/mL and is then started using an infusion pump at a rate of 0.6mL/kg/hour to provide a dose of 0.1 µg/kg/min. She developed tachycardia along with confluent erythematous macules over the scalp, face, neck and trunk, 10 hours after starting PGE1 infusion (figure 1). There was no associated fever or hypertension, while lowest blood pressure recorded was 52/30mm Hg. The skin rash, characterised by bright erythematous macular lesions, rapidly spread to the extremities. It was noticed that PGE1 was wrongly administered at 10 times the expected dose for the last 2hours prior to the cutaneous manifestation. The infusion was immediately stopped, and the baby was given
Infective Endocarditis due to Unusual Pathogens Complicated with Pulmonary Thromboembolism: A Rare Occurrence in a Premature Infant
(SCOPUS, 2024-05-13) Saikat Patra; Prachi Patwal; Chinmay Chetan; Girish Gupta
Background: Survival of low birth weight preterm neonates has increased with the availability of better neonatal care, however, the use of central lines for longer duration increases the risk of bacterial and fungal sepsis. Neonatal infective endocarditis (IE) is a rare presentation of neonatal sepsis and is often associated with complications and high mortality. Clinical Description: A 36 weeker, premature baby, hospitalized for early onset sepsis, was transferred to our hospital on day 15 of life, with an umbilical catheter in situ, with fever, respiratory distress, and persistent thrombocytopenia. Clinical examination revealed decreased oxygen saturation, crepitations in the right lung field, systolic murmur, and hepatomegaly. Management and Outcome: Baseline investigations revealed positive septic screen with thrombocytopenia with meningitis, neonatal cholestasis, and right sided consolidation on chest X ray. A two dimensional echocardiography (ECHO) revealed vegetation on the tricuspid valve, and blood culture from two sites revealed growth of Candida tropicalis and Serratia marcescens. Colistin, tigecycline, and amphotericin B therapy were initiated as per sensitivity along with low molecular weight heparin for prevention of embolization. The baby developed acute worsening in respiratory distress after 4 weeks of therapy. Repeat ECHO revealed increased size of cardiac vegetation and computed tomography of thorax with pulmonary angiography revealed pulmonary thromboembolism. Unfortunately, the baby succumbed to complications of IE. Conclusion: Invasive instrumentations such as umbilical catheterization and prolonged hospitalizations of premature newborns predispose them to develop IE, especially with unusual organisms. Such infections have a complicated course and may be fatal.
Unraveling Patterns of Congenital Structural Malformations in Infants: A Hospital-Based Descriptive Study
(PUBMED, 2024-05-15) Savita Pandey; Yasir A. Lone; Saikat Patra; Braham P. Kalra; Sanyam Modi
Introduction Congenital malformation studies serve several purposes, including establishing baseline rates, monitoring changes over time, exploring the origins of these defects, and helping in planning health services. Increasing public awareness about pediatric surgical interventions is another goal of these studies. However, the impact of congenital malformations is often underestimated in developing countries due to insufficient healthcare data and diagnostic facilities, particularly in rural areas. Families affected by the birth of a child with congenital malformations face significant stress and hardship. Methods The main aims of this study were to evaluate the clinical pattern of congenital structural malformations in our region (Uttarakhand, India), identify possibly associated factors of congenital malformations, and find out the immediate outcome of congenital malformations in enrolled participants. Results Among a total of 150 cases, 73 (48.7%) cases were inborn, whereas 77 (51.3%) cases were outborn. Investigation of congenital malformation revealed cleft lip or palate in 37 (24.7%) cases, congenital heart disease (CHD) in 33 (22%) cases, meningomyelocele (MMC) in 18 (12.0%) cases, anorectal malformation (ARM) in 11 (7.3%) cases, hypospadias in 10 (6.7%) cases, congenital talipes equinovarus (CTEV) in nine (6.0%) cases, tracheoesophageal fistula (TEF) in nine (6.0%) cases, polydactyly in seven (4.7%) cases, pelviureteric junction obstruction (PUJO) in four (2.7%) cases, duodenal atresia in three (2.0%) cases, midgut volvulus in three (2.0%) cases, umbilical sinus in two (1.3%) cases, sacrococcygeal teratoma (SCT) in one (0.7%) case, phimosis in one (0.7%) case, microtia in one (0.7%) case, and micrognathia in one (0.7%) case. Mortality was observed in 11 (7.3%) cases, whereas 105 (70%) cases were successfully discharged. Among 11 mortality cases, the cause of death was CHD in seven (63.2%) cases, TEF+CHD in two (18.1%) cases, MMC in one (9%) case, and duodenal atresia in one (9%) case. Conclusion Contrary to the common belief that advanced maternal age of greater than 35 years is a major cause, 86.6% of the congenital structural anomalies in our hospital-based study in Uttarakhand occurred in babies of mothers belonging to the age group of 18-30 years. Also, consanguineous marriage was observed in only 3.3% of cases, indicating that it may not be a major contributing factor causing congenital structural malformations in our region. External congenital anomalies are most commonly observed (60.7%), with cleft lip and cleft palate being the most common. The most frequently observed internal congenital anomaly is CHD (22%) followed by gastrointestinal (GI) (18.6%) and urinary anomalies (10.1%). Death and referral are commonly seen in CHD.
Assessment of Central Catheter Tip Position in Neonates by Ultrasonography Versus X-ray
(SCOPUS, 2024-06-01) Prachi Patwal; Chinmay Chetan; Brajendra Singh; Vinayak Madhukar Jedhe; Girish Gupta
Central catheters are frequently inserted in neonatal intensive care units. The tip of these catheters should be in the correct position; otherwise, it may lead to life-threatening complications. X-ray has been universally used as a standard imaging modality to localize the position of central lines. Ultrasonography is an upcoming promising modality. We compared the catheter tip localization using ultrasonography versus X-ray.
Dual fluid silhouette in X-ray of the abdomen: a diagnostic flag for neurogenic bladder with urinary ascites
(PUBMED, 2024-06-04) Brajendra Singh; Chinmay Chetan; Aisha Naaz; Girish Gupta
A neonate presented with abdominal distension and decreased urinary output. X-ray revealed dual abdominal fluid condition-ascites with a distended bladder, along with vertebral anomalies. The possibility of urinary ascites and neurogenic bladder was kept, which was further confirmed on evaluation. Here, we emphasise the crucial role of abdominal X-ray as a diagnostic tool in uncovering this intricate medical puzzle. By detailing the clinical presentation, diagnostic approach and treatment strategy, the report contributes insights into the rare and complex abdominal condition.
Small Beginnings, Complex Outcomes: Understanding Birth Size and Health Consequences
(PUBMED, 2024-07-01) Ashish Jain; Shoham Majumder
The neonatal period is a critical phase characterized by rapid growth and development, yet it is also a time of heightened vulnerability. Neonatal mortality, defined as death within the first 28 days of life, remains a pressing public health concern globally, with an estimated 2.3 million neonatal deaths occurring annually [1]. In India, despite notable improvements in maternal and child health in recent years, neonatal mortality rates remain high at 25/1000 live births, accounting for more than half of under-five deaths [2]. The intrauterine course and the point of transition to extrauterine life are the most critical determinants of immediate neonatal course as well as long term health. Within this context, birth size and gestational age play the most pivotal roles in shaping the trajectory of neonatal health outcomes. Low birth weight (LBW), typically defined as weighing less than 2500 grams at birth, and preterm birth, occurring before 37 weeks of gestation, are two key statistical thresholds.
Facial Scalds due to Steam Inhalation in a Neonate – A Case Report
(Journal of Nepal Paediatric Society, 2024-08-01) Chinmay Chetan; Saikat Patra; Aisha Naaz; Girish Gupta
Steam inhalation is a traditional remedy used in all age groups for treating respiratory problems like cough, coryza, pharyngitis, bronchiolitis, etc. Though equivocally beneficial, should be avoided in neonates, due to the risk of burns if not used correctly. We present a case of a term neonate with scalds on his face due to steam inhalation, given by his mother, to treat cough and coryza. First and second-degree burns were present on the face. Oral, nasal cavities, and eyes were unaffected. This case highlights the probable side effects of steam inhalation, a therapeutic approach lacking proven advantages. This reemphasizes the need to avoid such treatment strategy, especially in neonates who are predisposed to such injuries.
To Validate Use of Transmittance Sensor of Peripheral Pulse Oximeter for Forehead Pulse Oximetry in Newborns
(SAGE Publications, 2024-10-01) Talha Rehman; Girish Gupta; Saikat Patra; Chinmay Chetan; Rakesh Kumar; Sanober Wasim
Introduction Peripheral pulse oximeters with continuous monitoring of heart rate and saturation have revolutionized neonatal care. Motion artifacts, hypothermia, and poor perfusion are some of the barriers for reliable reading in the transmittance type of peripheral pulse oximeters. This study was planned to assess the effectiveness of transmittance sensors applied over the forehead for monitoring the heart rate and saturation. Material and Methods An observation study was conducted over a period of 1 month. Two pulse oximeters (Masimo RAD97) were applied simultaneously, one over the periphery (right hand/wrist) and the other over the forehead using an innovative headband. A total of 540 readings of heart rate and saturation (SpO2) from each site were recorded. A difference of more than 5 beats/minute in heart rate and 2% saturation were considered clinically significant. Results Forty-five neonates with mean gestational age of 35.3 ± 3.2 weeks and birth weight of 2109 ± 683 grams were enrolled. Forehead pulse oximeter could pick up the heart rate and SpO2 readings in all the babies. A statistically significant difference of 3.8 beats/minute in heart rate and 2.5% in SpO2 was noted (p-value < 0.0001). The difference in heart rate was not clinically significant. Conclusion We propose that the transmittance type peripheral pulse oximeter sensors can be used over the forehead. It has the potential to avoid erroneous readings due to motion artifacts, hypothermia, or shock. Saturation nomograms for the forehead pulse oximetry need to be established before it can be used to monitor and manage the neonates for the same.
A pilot randomized controlled trial comparing noradrenaline and adrenaline as a first-line vasopressor for fluid-refractory septic shock in neonates
(PUBMED, 2024-10-13) Reema Garegrat1 ,; Suprabha Patnaik; Sonali Suryawanshi; Chinmay Chetan; Nishant Banait; Pari Singh; Aditya Kallimath; Naharmal B. Soni; Yogen Singh; Pradeep Suryawanshi
Background and study design: Limited data exists on noradrenaline therapy in neonatal septic shock. We compared the efficacy of noradrenaline with adrenaline in neonatal septic shock. This single center, open label, pilot randomized controlled trial included neonates with clinical evidence of sepsis and shock. Study outcomes: Primary outcomes were: 1) resolution of shock one hour after treatment, and 2) mortality during hospital stay. Secondary outcomes included: need for additional vasopressors; hemodynamic stability without further administration of vasopressors for ≥2 h; changes in blood pressure and heart rate after 1 h of vasopressor treatment; and morbidities during the hospital stay. Results: Of 65 eligible neonates, 42 were randomized (21 each in adrenaline and noradrenaline treatment arms) between August 2020 and January 2022, at level III neonatal intensive care unit (NICU) of Bharati Vidyapeeth Deemed University Medical College and Hospital (BVDUMCH). The mean (SD) gestational age and mean (SD) birth weight were 36.1(4.2) weeks and 1.8 (0.2) kilograms birth weight for noradrenaline and 36.9 (4.1) weeks and 1.7 (0.7) kilograms for adrenaline. Shock resolved within 1 h of vasopressor therapy in 76.2% neonates in the noradrenaline arm and 61.9% in adrenaline arm (p value-0.53). Mortality during hospital stay was 28.6% (6/21) in noradrenaline group and 33.3% (7/21) in adrenaline group (p value- 0.58). Additional vasopressors were required in 23.8% neonates of the noradrenaline group compared to 38.1% neonates in adrenaline arm (p value-0.53). Median (SD) duration of intensive care stay was 6 (SD) days in the noradrenaline group and 10 (SD) days in the adrenaline group (p value-0.045). Conclusion: Among neonates with septic shock, the efficacy of noradrenaline was comparable to adrenaline in resolving septic shock after one hour of infusion and on the mortality during hospital stay
Biotinidase deficiency-masquerade of primary immunodeficiency disease in neonate
(PUBMED, 2024-12-15) Chinmay Chetan; Brajendra Singh; Saikat Patra; Girish Gupta
Biotinidase deficiency, a rare metabolic disorder characterised by abnormal biotin metabolism, affects the biotin-dependent carboxylase functions. Primarily characterised by neurological and skin disorder, it may present with myriad features. Early recognition is important for preventing long-term morbidities. Here, we describe a case of a neonate presenting with seizures and a clinical picture suggestive of immunodeficiency. Multiple superficial abscesses along with septic arthritis of the left knee and left hip led to suspicion of primary immunodeficiency disorder. On evaluation, there was severe biotinidase deficiency. The neonate was supplemented with biotin, after which there were no further episodes of severe infection requiring hospitalisation, seizures or skin manifestation. This case report highlights the wide spectrum of clinical picture these disorders may present with and the low threshold for their evaluation and treatment.
Elizabethkingia meningoseptica With Targeted Environmental Surveillance in a Tertiary Care Hospital: A Retrospective Cohort Study
(PUBMED, 2025-01-07) Garima Mittal; Rajender Singh; Manish Mittal; Mani Pant; Barnali Kakati; Saikat Patra
Introduction Elizabethkingia meningoseptica (E. meningoseptica) is a multidrug-resistant, non-fermenting Gram-negative bacillus increasingly associated with nosocomial infections, particularly in immunocompromised and critically ill patients. Its intrinsic resistance to multiple antibiotics limits treatment options and contributes to adverse clinical outcomes. Aim and objective The study aimed to investigate the clinical and microbiological characteristics of E. meningoseptica infections among ICU/NICU patients and to explore potential environmental sources through hospital-based surveillance. The objectives of this study were to describe the clinical and demographic profiles of ICU/NICU patients with E. meningoseptica infection; to assess the associated risk factors contributing to these infections; to analyze the antimicrobial susceptibility patterns of the isolated strains using standardized microbiological methods; to evaluate treatment outcomes including morbidity, mortality, and duration of ICU/NICU stay; and to identify potential environmental reservoirs of E. meningoseptica through surveillance activities coordinated by the Hospital Infection Control Committee (HICC). Methods A retrospective cohort study was conducted over 18 months (July 2023 to October 2024) at a tertiary care hospital. A total of 15 patients with culture-confirmed E. meningoseptica infection were included. Demographic, clinical, microbiological, and treatment data were collected. Identification and antimicrobial susceptibility testing were performed using the Vitek-2 automated identification system (bioMérieux, Marcy-l'Étoile, France). HICC conducted routine and targeted environmental sampling as per policy protocol. Results Among the 15 patients with E. meningoseptica infection, nine (60.0%) were adults, and 11 (73.3%) were male individuals. Sepsis was reported in nine (60.0%), and both ventilator-associated pneumonia and septic shock occurred in six patients each (40.0%). Hypertension and diabetes mellitus were present in six (40.0%) and three (20.0%) patients, respectively. Two neonates (13.3%) with low birth weight and prematurity required NICU admission. Outcomes included mortality in six patients (40.0%), discharge in five (33.3%), and four (26.7%) leaving against medical advice. Endotracheal secretions were the most frequent specimen (46.7%), followed by tracheostomy secretions (33.3%) and blood cultures (13.3%). All isolates (100%) were resistant to carbapenems, third-generation cephalosporins, aztreonam, and piperacillin-tazobactam. Resistance to gentamicin, colistin, and cotrimoxazole was observed in 73.3%, 66.7%, and 46.7% of isolates, respectively. Highest susceptibility was seen with minocycline (66.7%), vancomycin (60.0%), and fluoroquinolones (53.3%). Environmental surveillance, conducted from January to March 2023 as part of routine as well as targeted HICC monitoring (as an outbreak of suspected pathogens was suspected from the NICU and ICU), included 98 samples from high-risk ICU/NICU sites such as sinks, ventilators, humidifiers, and suction units. E. meningoseptica was identified in one sample (1.02%), isolated from a NICU sink. Conclusion E. meningoseptica infections are associated with high resistance and mortality. Minocycline, vancomycin, and fluoroquinolones may be effective. Early detection, targeted therapy, and HICC-led surveillance are essential for control.