ObjectiveThis study aims to investigate the distribution and drug resistance of bacteria in clinical blood culture specimens from children in Jiangxi province in recent years and to provide a foundation for preventing and treating bloodstream infection diseases in children.MethodsThe study involved a statistical analysis of the isolation and drug resistance of bacterial strains obtained from blood culture specimens of children in Jiangxi province between 2017 and 2021. The analysis was performed using the WHONET 5.6 software.ResultsA total of 7,977 bacterial strains were isolated from the blood samples of children between 2017 and 2021. Of these, 2,334 strains (29.3%) were identified as Gram-negative bacteria, and 5,643 strains (70.7%) were identified as Gram-positive bacteria. The most commonly isolated pathogens were coagulase-negativeStaphylococcus,Escherichia coli, andStaphylococcus aureus.Among the Gram-negative bacteria,Escherichia coli(840 strains, 36.0%),Klebsiellapneumoniae (385 strains),Salmonella(283 strains),Acinetobacter baumannii(137 strains), andPseudomonas aeruginosa(109 strains) were the most prevalent. Among the Gram-positive bacteria, coagulase-negativeStaphylococcus(3,424 strains, 60.7%),Staphylococcus aureus(679 strains),Streptococcus pneumoniae(432 strains),Enterococcussp. (292 strains), andStreptococcus agalactiae(192 strains) were the most common. Resistance to third-generation cephalosporins (cefotaxime/ceftriaxone) was observed in 45.9% and 56.0% ofEscherichia coliandKlebsiella pneumoniaestrains, respectively, while resistance to carbapenems was observed in 4.6% and 20.3% of these strains, respectively. Resistance to third-generation cephalosporins (cefotaxime/ceftriaxone) was observed in 15.5% ofSalmonellastrains, while resistance to imipenem was absent. Carbapenem resistance was observed in 17.1% (20/117) and 13% (14/108) ofAcinetobacter baumanniiandPseudomonas aeruginosastrains, respectively. Methicillin-resistantStaphylococcus aureus(MRSA) was detected in 32.7% of the strains, while methicillin-resistant coagulase-negativeStaphylococcuswas detected in 64.3% of the coagulase-negativeStaphylococcusstrains. NoStaphylococcusbacteria resistant to vancomycin were detected. Four strains of vancomycin-resistantEnterococcus faeciumwere detected over the 5-year period, and one strain of linezolid-resistantEnterococcus faecaliswas detected.ConclusionGram-positive cocci were the most commonly isolated clinical pathogens in blood specimens from children in Jiangxi province. The composition of the pathogen species showed a slight change over the years. The detection ratios of pathogens varied with age group and season. Although the isolation rate of common carbapenem-resistant Enterobacter bacteria has decreased, it remains high. It is necessary to monitor the antimicrobial resistance of pathogens causing bloodstream infections in children more closely, and antimicrobial agents should be used with caution.