Dissertation (MMed Pediatrics and Child Health)Background: Community Acquired Pneumonia is among the leading cause of morbidity and mortality among children below five years of age in developing countries. It is a second course of morbidity and mortality next to neonatal birth complications and bacteremia is one of complication which accelerates this. Different studies show different prevalences of bacteremia among children with CAP and managed to isolate common organisms with associated features which helped them to change management form the standard treatment. Objectives: To assess the prevalence, aetiology and factors associated with bacteremia among children aged 2 months to 5 years hospitalized with community acquired pneumonia (CAP) at Dodoma Regional Referral Hospital. Methods: This was a hospital based cross sectional study. A total of 195 children aged 2 months to 5 years were recruited in a period of 6 months (October 2018 – March 2019). A blood sample for Blood culture, FBP, Malaria and HIV were collected and investigated. Results: Out of 217 eligible children, 195 were enrolled. Two third (66.2%) of the study participants were male while 60.5% (118/195) of participants were infants. Bacteremia was detected in 7.2% (14/195) of study participants. Staphylococcus aureus (57.1%) and Enterobacter’s (28.6%) were the most common isolated organisms. The factors which independently showed significant association with bacteremia were fever >38.5°C [AOR 5.7 (CI 1.016 – 31.57) P= 0.005], Oxygen saturation < 90% [AOR 2.7 (CI 1.05 – 72.25) P = 0.015], needs for oxygen therapy [AOR 2.1 (CI 1.41 – 7.676) P=0.022], high respiratory rate > 60 circles/minute [AOR 6.7 (CI 2.018 – 22.47) P= 0.002] and leucocytosis of > 15,000/μl [AOR 8.8 (CI 1.387 – 31.112) P = 0.004]. Penicillin was completely resistant to all isolated organisms, Amoxicillin was 25% sensitive to Enterobacter’s and resistant to other isolated organisms. Gentamycin was 25% and 37.5% sensitive to Enterobacter’s and Staphylococcus aureus respectively. Ceftriaxone was 50% sensitive to Enterobacter’s and 37.5% sensitive to S. aureus. Clindamycin was 100% sensitive to S.aureus and 75% sensitive to Enterobacter’s. Ciprofloxacin was 75% sensitive to S.aureus and 100% sensitive to all other isolated organisms. Conclusion: Staphylococcus aureus was the most causative agent of bacteremia in children hospitalized with CAP. Signs of severe respiratory distress (high respiratory rate, hypoxia and needs for oxygen therapy) and sepsis (fever and leukocytosis) were the independent associated factors with bacteremia. First line antibiotics Ampicillin, Penicillin and Gentamycin shows highly resistance, Ceftriaxone was less sensitive. Ciprofloxacin and Clindamycin were the most sensitive antibiotics.