This study aims to investigate the co-existence of extended spectrum β lactamse (ESBL) and carbapenemase enzymes (CRE) in Enterobacteriaceae isolates. Twenty isolates were collected from patients from Al-Kasr Alaieny hospital. Most patients suffered from urinary tract infection (40%) and respiratory tract infection (15%).The isolates were identified by MALDI-TOF spectroscopy, 80% were identified as Klebsiella pneumoniae and 20% as E. coli. The isolates were resistant to almost all classes of antibiotics and were regarded as pandemic isolates with the exception of some isolates that showed sensitivity to tetracycline and levofloxacin. ESBL producing isolates were 75%, while 50% of the isolates were CRE. The coexistence of both ESBL and CRE were recorded in 8/20 isolates. PCR revealed that all K. pneumonia isolates harbored OXA-48, while 87.5% had TEM gene. This study highlights the emergence of pandemic ESBL-CRE  infections between patients in Egyptian hospitals.