INTRODUCTION: Blood stream infections (BSI) accounts for the most serious infection encountered in hospital. It has high rate of morbidity and mortality with high cost of treatment including high end antibiotics. Therefore, early detection, identification of the pathogens with their antibiogram is very important. With the advent of increasing antibiotic resistance, a close monitoring of change in the antibiotic resistance pattern is essential. Thus, the present study was undertaken to study the bacteriological profile with antibiogram of the aerobic pathogens isolated from the automated blood (BACTEC) culture system from 2012-2016. MATERIALS AND METHODS: It was a retrospective study conducted at Clinical Microbiology Department, MES Medical College Hospital, Perinthalmanna. All the positive BACTEC blood culture samples from January 2012 to December 2016, of patients above 18 years of age, were included in the study. RESULTS: During the study period of 5 years, out of 11,966 BACTEC samples, 932 (7.78%) were positive. The gram positive bacteria constituted for 539 (57.83%) compared to 393 (42.16%) Gram negative isolates. Staphylococcus aureus (41.41%) was the most common isolate among Gram positive and Escherichia coli (16.41%) among the gram negative isolate. During the study period 2012-2016, there was steady rise in the Methicillin Resistant Staphylococcus aureus (MRSA) from 0.86%, 1.07%, 2.25%, 3.76%, 6.12%. Among the Gram negative isolates, the resistance for 3rd Cephalosporins, Fluoroquinolones, β lactum- β lactum inhibitors, Carbapenems have also increased. CONCLUSION: In the present study, we have observed the rise in multidrug resistant isolates especially MRSA, Escherichia coli, Acinetobacter species. This helped us to update the empirical antibacterial regime for the patient with suspected sepsis.