Bloodstream range of organisms have been isolated

Bloodstream infection (BSI) is a systematic disease caused by micro-organisms or their toxins in the blood. BSI is invasiveness of the blood circulatory system caused by bacteria or fungi (Dagnew et al., 2013). BSIs are an important cause of mortality and morbidity in hospitalized patients throughout the world. It ranges from self-limiting infections to life threatening sepsis including admission to intensive care unit or prolonged hospital stay that require rapid and antimicrobial treatment (Ogunlowo et al., 2014) & (Barati et al., 2009).The epidemiology of BSI and their antibiotic susceptibility pattern varies substantially depending on the geographic location and age. Inappropriate use of antibiotics has led to an increase in the multidrug-resistant bacteria (Ahmed et al., 2017).BSI occurs as any localized infection disseminate to the bloodstream although the most common primary foci for bacteremia are intravascular devices like catheters, surgery, the respiratory tract, the urinary tract and gastro intestinal sites (Reimer et al., 1997).Bacteremia is a state in which bacteria circulate through vascular system where as Septicemia is a life-threatening bacteremia in which the bacteria multiply and release toxin in to the blood stream and trigger the release of cytokines, causing fever, chills, malaise, hypotension and lethargy with difficulty in breathing (Qureshi and Aziz, 2011).A wide range of organisms have been isolated in BSIs among these, gram-negative bacteria such as Acinetobacter species, Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae and Neisseria meningitidis. Gram positive bacteria including coagulase negative staphylococci (CoNS), Staphylococcus aureus, Streptococcus agalactiae, Streptococcus pyogenes, Enterococcus spp  and alpha hemolytic streptococci (Hailu et al., 2016) & (Zenebe et al., 2011).Bloodstream infections are life threatening and require rapid identification and antibiotic susceptibility testing of the causative pathogen. Both Gram positive and Gram-negative bacteria causes bacteremia and septicemia. The time to onset of bacteremia varies depending on the infecting organism (Karchmer, 2000).BSIs can be healthcare associated or community associated. Health care associated BSI is if it is occurred more than 48 hours after hospital admission or associated with the presence of an indwelling medical device or it occurred within thirty days of a surgical procedure. Community-associated BSIs were if it is manifested within 48 hours after admission to the hospital (Bhatta, 2014) (Ammerlaan et al., 2012).                                Blood culture is the most significant diagnosis method which is used for the isolation of the blood Stream pathogens and to know about the sensitivity pattern of the isolates. It remains the definitive diagnosis and the management of BSIs (Pandey et al., 2013).      Microbial invasion of the bloodstream can have serious consequences such as shock, multiple organ failure and death. Increasing antimicrobial resistance is a worldwide concern. The infection caused by multi drug resistance organism (MDR) prolongs the hospital stay, increase the risk of death and requires treatment with more expensive antibiotics (Singh et al., 2014).It is recommended to initiate treatment with an empirical choice of antibiotics that is informed by the epidemiology of causative agents and sensitivity patterns in a given locality until the result of culture is known (Garg et al., 2007).