| Sumario: | Background: Bloodstream infections cause substantial morbidity and mortality, increasingly exacerbated by antimicrobial resistance. We investigated the prevalence and resistance profiles of bloodstream pathogens in Feni, Bangladesh. Methods: Between October 2024 and March 2025, we conducted a 6‐month cross‐sectional study at a diagnostic center in Feni, Bangladesh. Blood cultures from 498 patients with suspected bloodstream infections were analyzed, and bacterial isolates were identified and tested for antibiotic susceptibility using standard methods. Results: Among 498 blood samples, 49 (9.84%) yielded positive bacterial growth. Infections were most common in patients aged over 49 years (36.7%), with near‐equal distribution between males (51.0%) and females (49.0%). Gram‐negative bacteria predominated (73.5%), including Salmonella spp. (28.6%), Escherichia coli (20.4%), and Salmonella Typhi (14.3%), whereas Staphylococcus aureus (10.2%) was the leading gram‐positive isolate. Gram‐negative isolates exhibited high resistance to ampicillin, amoxyclav, and cefuroxime, whereas amikacin maintained > 70% sensitivity. Gram‐positive isolates were largely resistant to third‐generation cephalosporins but were very susceptible to gentamicin and ciprofloxacin. Conclusion: This study reveals the predominance of gram‐negative bloodstream infections and extensive β‐lactam resistance in Feni, Bangladesh. Amikacin demonstrated the highest efficacy, supporting its empirical consideration pending susceptibility results. These findings highlight the urgent need for local antibiogram development and strengthened regional resistance surveillance.
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