Abstract Background and aim: Infection in patients with decompensated liver cirrhosis is a leading cause of mortality in ‎developing countries such as Egypt; this has paralleled the increase in antibiotics ‎resistance. Knowledge of local antimicrobial susceptibility patterns is critical to decreasing ‎morbidity, hospitalization cost and mortality associated with these infections. Our aim was ‎to evaluate the bacterial resistance profile in ICU admitted patients with decompensated ‎liver cirrhosis‎.‎ Methods: ‎‎‎This study included 1339 samples from patients with decompensated liver cirrhosis and ‎suspected infection admitted to the intensive care unit - department of Tropical medicine, ‎Zagazig University hospitals, Egypt, between August 2018 and August 2019. ‎Demographical, clinical, microbiological and antimicrobial susceptibility were evaluated‎‎.‎ Results: Out of 1339 total samples collected, 237 positive cultures were obtained; the majority ‎‎(60.4%) had urinary tract infection, 18.1% had sepsis, 9.3% had chest infection, 8.4% had ‎spontaneous bacterial peritonitis (SBP), 3.8% had other infections. ‎One hundred and ninety-nine (199) of the 237 isolates were multi drug resistant (MDR). ‎Among them 72.4% were gram negative organisms (GNO); Extended Spectrum Beta ‎Lactamase (ESBL) Ecoli and Klebsiella Sp. were 32.2%, and 83.3% of acinetobacter were ‎MDR. ‎GNO represent 70.9% and Gram positive organisms (GPO) 29.1% of isolated bacteria, ‎GPO were 27.6% of total MDR organisms, mostly Staphlycoccus haemolyticus followed ‎by enterococcus fecalis and fecium. All isolated staphylococcus aureus are methicillin ‎resistant and 25% of them are MDR‎‎‎. Conclusion: In patients with decompensated liver cirrhosis and suspected infection, high frequency of ‎multidrug resistance was recorded. Gram negative bacteria showed high resistance to 3rd ‎generation cephalosporins and quinolones‎‎‎‎‎‎‎‎‎.