Cancer patients admitted to Intensive Care Units (ICUs) and High Dependency Units (HDUs) are at heightened risk of multi-drug resistant (MDR) infections due to immunosuppression from chemotherapy prolonged hospital stays, invasive procedures, and frequent antibiotic exposure.   emergence of multi-drug resistant (MDR) (1) pathogens—defined as microorganism’s resistant to at least one agent in three or more antimicrobial categories.   (2) The rise of MDR pathogens, including carbapenem-resistant Enterobacteriaceae (CRE), extended-spectrum beta-lactamase(ESBL) producers, methicillin-resistant Staphylococcus aureus (MRSA), and Acinetobacter baumannii, poses a significant challenge in oncology critical care. These infections lead to higher mortality, prolonged ICU stays, increased healthcare costs, and delays in cancer treatment, necessitating urgent epidemiological and clinical investigations.

Studies report 20–40% prevalence of MDR bacterial infections in hospitalized cancer patients, with higher rates in hematologic malignancies (e.g., leukemia, lymphoma) due to prolonged neutropenia.  Prevalence increases to 40–60% due to invasive devices (ventilators, catheters) and broad-spectrum antibiotic use. Healthcare-associated infections (HAIs) are a leading cause of morbidity and mortality globally, contributing to an estimated 7 lakhs (700,000) deaths annually, with vulnerable populations such as cancer patients disproportionately affected. MDR Acinetobacter and CRE are dominant in ICUs, with mortality rates exceeding 50–70%. In Oncology ICU Higher incidence due to immunosuppression: 20–50 MDR infections per 1,000 ICU days. Carbapenem-resistant Enterobacteriaceae (CRE) incidence is 2–5 times higher in cancer ICUs vs. general ICUs. This study aims to determine the incidence of MDR infections in critically ill cancer patients, identify risk factors, and compare clinical outcomes (mortality, ICU stay, complications) between MDR and non-MDR groups. Findings will guide infection control policies, antibiotic stewardship programs, and empirical treatment protocols in oncology ICUs.