Abstract: OBJECTIV To investigate the difference of clinical distribution and disease burden of bloodstream infection (BSI) due to Klebsiella pneumoniae and Escherichia coli. METHODS A retrospective study was conducted on 436 cases of hospitalized patients with BSI caused by K. pneumoniae or E. coli from Jan. 2014 to Dec. 2015, and their department distribution, duration of hospitalization and hospitalization costs were analyzed and compared. RESULTS Four hundred and thirty-six cases of BSI were enrolled in our study, including 154(35.3%) cases of K. pneumoniae BSI and 282(64.7%) cases of E. coli BSI. The most common clinical department distribution were Department of Hepatobiliary Surgery, Intensive Care Unit and Department of Oncology. K. pneumoniae BSI were more common in Intensive Care Unit (25.3%) and Department of Hepatobiliary Surgery (22.7%), while E. coli BSI were more common in Department of Oncology (17.1%), Department of Hepatobiliary Surgery (16.5%) and Department of Gastroenterology (10.3%). The duration of hospitalization (P=0.007) and hospitalization cost (P＜0.001) of patients with K. pneumoniae infection were significantly higher than those of patients with E. coli BSI. hospitalization time and Hospitalization costs from high to low were Intensive Care Unit, Department of Hematology, Department of Hepatobiliary Surgery and Department of oncology. CONCLUSION Patients with BSI due to K. pneumoniae and E. coli distribute widely in our hospital, and the clinical distribution of the two pathogens was also significantly different. In contrast to BSI due to E. coli, cases of K. pneumoniae BSI are associated with significantly prolonged hospital stay and increased costs. Infection prevention measures should be focused on Department of Hepatobiliary Surgery, Intensive Care Unit and Department of Oncology, so as to more effectively control related infection.