Objective: To investigate the impact of ESKAPE bloodstream infection on the prognosis and complications in patients with acute necrotizing pancreatitis (ANP). Methods: Eighty-seven ANP patients admitted from January 2003 to July 2014 with blood culture results were retrospectively studied. Of the patients, 49 cases had negative and 38 cases had positive blood culture. The impact of bloodstream infection, especially ESKAPE bloodstream infection on therapeutic outcomes of these ANP patients was analyzed. Results: In the 69 pathogen test results from the 38 ANP patients with positive blood culture, 40.6% were ESKAPE pathogens that included Acinetobacter baumanni (50.0%), Enterococcus faecium (14.3%), Klebsiella pneumonia (10.7%), Enterobacter species (10.7%), Staphylococcus aureus (7.1%) and Pseudomonas aeruginosa (7.1%). Patients with bloodstream infection had significantly increased incidence of shock, respiratory failure, renal failure and digestive tract bleeding and mortality, as well as increased hospital expenses and prolonged length of ICU stay compared with those without bloodstream infection (all P<0.05). Patients with ESKAPE bloodstream infection had higher incidence of shock and hospital expenses than those with non-ESKAPE bloodstream infection (both P<0.05). Conclusion: Bloodstream infection can significantly increase the complications and mortality in ANP patients. ESKAPE are the major pathogens resulting in bloodstream infection in ANP patients, and are also closely associated with occurrence of shock in the patients.