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Objective To investigate the prognostic value of thrombocytopenia in bloodstream infections caused by various bacterial pathogens. Methods Clinical data of patients with bloodstream infections caused by different bacteria from February 2015 to June 2023 were retrospectively analyzed. Mortality rates were calculated for each pathogen group, and Kaplan-Meier survival curves were plotted for patients with different platelet (PLT) levels. The receiver operator characteristics (ROC) curve was used to assess the predictive value of the lowest PLT value and the percentage of decrease in PLT for prognosis in each pathogen group. Multivariate logistic regression analysis was performed to identify independent risk factors for PLT reduction in each pathogen group. Results The mortality rates in different pathogen groups increased with the severity of PLT reduction, with no statistically significant difference in the Staphylococcus group (P=0.124). The survival rate of bloodstream infection patients within 30 days decreased with PLT decrease, especially in the severe reduction group (P＜0.05). The percentage decrease in PLT was a suitable predictor for 30-day survival in Escherichia coli (E.coli) and Klebsiella pneumoniae (KPN) bloodstream infections, with sensitivity and specificity of 77.10% and 75.00%, 94.60% and 77.80%, respectively. The lowest PLT value was a suitable predictor for 30-day survival in KPN and Pseudomonas aeruginosa (PA) bloodstream infections, with sensitivity and specificity of 94.60% and 72.20%, 90.90% and 80.00%, respectively. For E.coli bloodstream infections, lactate, neutrophil percentage, and procalcitonin (PCT) >20 ng/mL were independent risk factors for thrombocytopenia. For KPN bloodstream infections, shock, white blood cell count, and PCT were independent risk factors for thrombocytopenia. For PA bloodstream infections, shock and white blood cell count were independent risk factors for thrombocytopenia, and PCT was an independent risk factor for Staphylococcus bloodstream infections. Conclusion Thrombocytopenia-related indicators exhibit varied prognostic value in bloodstream infections caused by different pathogens, and the independent risk factors for thrombocytopenia differ among these infections. [ABSTRACT FROM AUTHOR]