Objective We investigate the distribution of pathogens, drug resistance and prognostic risk factors in patients with community-acquired bloodstream infection, so as to provide etiological evidence for managing bloodstream infection. Methods Pathogens and clinical data were collected from CABSI patients from January 2017 to December 2019, and the patients were divided into death group and survival group according to the prognosis. Univariate and multivariate analysis were carried out to identify the potential predictors of mortality. Results 323 pathogens were isolated, including 192 Gram-negative strains, 118 Gram-positive strains, 9 fungal strains and 4 anaerobic strains. For Gram-negative strains, the drug resistance rates of cephamycins, carbapenem, and aminoglycosides were all lower than 10%. The resistance rates of Staphylococcus aureus to gentamicin and moxifloxacin were lower than 20%. The resistance rate of Streptococcus app. to penicillins was 6.7%. The overall mortality rate of CABSI was 18.8%. Univariate analysis showed that cerebral infarction, septic shock, Klebsiella pneumoniae infection, α hemolytic streptococcus infection and PCT value were associated with mortality (P<0.05). Cerebral infarction and septic shock are independent risk factors associated with prognosis in CABSI patients (P<0.05). Conclusion Pathogens of CABSI patients had low resistance to clinical antimicrobial agents. Cerebral infarction, septic shock and high PCT values can significantly increase the mortality, so clinicians should take corresponding measures as early as possible to reduce the mortality.