To describe new developments in the epidemiology and outcomes associated with bloodstream infections (BSIs) in ICUs.The incidence and outcomes associated with BSI among patients admitted to ICUs have been changing as a result of increasing numbers of older patients with comorbid medical illnesses suffering critical illness. Community-onset healthcare-associated BSIs are recognized as important causes of BSIs in ICUs and are distinct from community-acquired and nosocomial BSIs. Electronic surveillance systems are evolving that provide efficient information about the occurrence of BSIs and for tracking the emergence of resistance.The incidence of healthcare-associated BSIs increases and is associated with bacteria resistant to antimicrobials used in community-acquired infections. The recent years have witnessed the emergence of extensively resistant bacteria in many regions worldwide, and this is associated with major implications for failure of antimicrobial therapies. Enhanced preventive efforts and optimization of therapy are needed in order to reduce the major burden of BSIs in critically ill patients and to minimize the further emergence of resistance.