- Objectives Describing the patterns of antimicrobial resistance causing hospital acquired infections (HAIs), in the Intensive Care Unit (ICU) of a tertiary hospital in Kazakhstan. Methods Retrospective analysis of the resistance to antibiotics in the ICU of the National Research Center for Oncology and Transplantation (NRCOT), Astana (KZ), in the period from January 1 st till December 31st, 2015. Results During the study period, 546 patients were admitted to ICU and 135 developed at least one HAI, corresponding to 24.7%. Most HAIs sustained by gram-positive bacteria were caused by Enterococcus faecalis , being resistant to aminoglycosides in more than 70% cases. Gram-negative bacteria were isolated in around 50% cases, thus representing the greatest burden of HAIs. Here, we showed a very high resistance rates to ceftriaxone, cefotaxime and cefuroxime. Moreover, Pseudomonas aeruginosa and Acinetobacter baumannii resulted to be resistant to carbapenems in less than 20% and in around 45% of cases, respectively. Conclusions our study evidenced the urgent need to implement a more rationale use of antimicrobial drugs in Kazakhstan, which could be done only by establishing a proactive surveillance system along with an appropriate program of infection control.