Background: Infection is a continuous problem in cancer patient especially in developing country, multi-drug resistance of Enterobacter spp. are among the most frequent complication in Immunocompromised cancer patients and pose the greatest risk to Immunocompromised cancer patient.

Objectives: Our study aimed to carry out a retrospective study on Enterobacter spp. isolated from various clinical samples among cancer patient in Erbil city and analyze its epidemiology and antibiotics susceptibility pattern test and multi-drug resistance.

 Materials and Methods: A total of 467 from 2016 until 2020 Enterobacter spp. were isolated from 5 clinical samples (Urine, Wound and Ear swabs, Blood and Stool) from patient attending Nanakali Hospital and from both male and female. Only 32 cases had been identified as Enterobacter spp. isolates which was identified by using macroscopical, biochemical tests and Vitek 2 compact system. Also antibiotic susceptibility test was performed by Vitek 2 compact on 19 antibiotics.

Results: Only 32 Enterobacter isolates were isolated from 467 samples distribution according to their source of isolation in cancer patient. Urinary tract infections is the most common in our study followed by otitis media infection, and Skin-wound infection, Blood stream infection, the percentage of females infected with Enterobacter spp. were more than the males, females being 20/467(4.2%) and males being 12/467(2.5%), after 2016 infections by Enterobacter spp. was increased in over than 31 years old people being 9/15(60%) in total, from 2016-2020 Enterobacter spp. infected patients with solid tumor type was 16/32(50%) and leukemia was 9/32(28%) and multiple myeloma was 7/32(22%)for each, Although (Imipenem, Amikicin, Levofloxacin, Ticarcillin/clavulanic acid, Ceftazidime, Amoxicillin, Cephalexin) can be considered as effective agents toward multi-drug resistance strains for empirical antibiotic therapy in cancer patients, Enterobacter Spp. isolates had resistance to 11 antibiotics.

Conclusions: The study findings showed a significant distribution of multi-drug resistance Enterobacter spp. which may increase the burden of healthcare-associated infections in cancer patients. Moreover, mechanisms of resistance should also be investigated for better characterization antibiotic-resistant of Enterobacter spp isolates.