Emergence of antimicrobial resistance is turning to be a life threatening problem in the treatment of patients with severe sepsis and septic shock. Many organisms display a multidrug resistant (MDR) pattern, which limits the treatment options. Aim: The purpose of this study was to assess the prevalence of pathogens including the resistant types causing severe sepsis and septic shock as well as their antimicrobial resistance patterns. Methods: This was a prospective, observational study conducted at emergency department of a tertiary care hospital. A total of 293 bacterial isolates obtained during April 2015-16 inclusive, from severe sepsis and septic shock patients underwent susceptibility testing. Results: Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Candida albicans and Candida non-albicans were the most common organisms.With respect to the specimen source, majority of the isolates (38.6%) were obtained from urine specimens followed by blood (27%), skin/soft tissue specimen (16.4%) and respiratory specimen (15%). Escherichia coli showed good susceptibility to amikacin, meropenem and piperacillin-tazobactam. Klebsiella pneumoniae showed high rates of resistance to all the tested antimicro- This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. 359 patients had a single site infection while 47 patients had multiple site infections. Overall, 293 isolates were obtained (240 isolates from severe sepsis patients and 53 isolates from septic shock patients). With regard to specimen source, 38.6% (113/293) of the organisms were obtained from urine specimens, 27% (79/293) from blood, 16.4% (48/293) from skin/ soft tissue specimens, and 15% (44/293) from respiratory specimens. The remaining organisms were obtained from ascitic/peritoneal fluid, synovial fluid and bone. Most common microorganisms isolatedIn the present study, gram negative organisms were predominant (177/293, 60.4%) followed by gram positive (68/293, 23.2%) and fungi (48/293, 16.4%). Overall, the most common isolates were Escherichia coli (20.8%), Klebsiella pneumoniae (18.8%), Pseudomonas aeruginosa (7.8%), Candida albicans (6.1%) and Candida non-albicans (5.8%). The most common isolates among severe sepsis patients were Escherichia coli (52/240, 21.7%), Klebsiella pneumoniae (44/240, 18.3%), Pseudomonas aeruginosa (21/240, 8.8%), Candida albicans (15/240, 6.3%), Candida non-albicans (14/240, 5.8%). The most common isolates among septic shock patients were Klebsiella pneumoniae (11/53, 20.8%), Escherichia coli (9/53, 17%), Candida albicans (3/53, 5.7%), Candida non-albicans (3/53, 5.7%) and Candida tropicalis (3/53, 5.7%). The distribution of prevalent microbial species were found to be similar between patients with severe sepsis and septic shock. Most common microorganisms isol...