Background:Bloodstream infection is one of the most important causes of morbidityand mortalityrnglobally. Staphylococcus aureus, coagulase negative staphylococci ,Streptococcus pneumonia arernmajor Gram- positive bacteria in causing blood stream infectionEscherichiarncoli,Klebsiellapneumoniae, Pseudomonas aeruginosa,Acinetobacterbaumannii are major Gramnegativernbacteria in causing blood stream infections. Development of multidrug resistance inrnmajor bacteria has increased the morbidity and mortality rate of blood stream infection.rnObjective: To assess the distribution of bacteria implicated in causing blood stream infections andrnprevalence of their multidrug resistance profile and Extended spectrum betalactamase production.rnMethod: The present study was a laboratory based cross-sectional study conducted atrnArsho Advanced Medical laboratory, Addis Ababa, Ethiopia from January to April 2019; Arntotal of 422 blood samples was collected and inoculated on to primary isolation culture followingrnstandards protocols. Species identification and antimicrobial susceptibility testing of bacteriarnwere determined by automated Vitek2 compact system (bio Merieux, France) using AST, GN72rncard for gram negatives and AST,GP71 card for gram positive bacteria.rnResult :Out of a total of 422 samples processed, bacterial pathogens were isolated fromrn89(21.1%) samples. Among the isolates, 52 were Gram- positive and 37 were Gram negativernbacteria.Coagulasenegative staphylococci and Klebsiellaspp were the dominant isolates.rnPenicillin (92.3%) was the least effective antibiotic against Gram-positive bacteria whilerncephalotin (91.1%) and cephazolin (89.2%) were the least effective antibiotic against Gramnegativernbacteria. Linzolid and Tigcyclne(98.1%) were the most effective antibiotic against Gramrnpositive and piperacillin(86.1%) were the most effective antibiotic against Gram-negativernbacteria, Out of 52 isolate of Gram-positive bacteria 30(57.7%) were MDR and out of 37 isolatesrnof gram negative bacteria 20(54%) were MDR.rnConclusion:The magnitude of blood stream bacterial infection and the prevalence rate of multidrugrnresistant bacterial strains causing blood stream infections were high. These findingsrnwarranted the need for continuous investigations bacterial blood stream infection.