The study examined 358 adult patients hospitalized in Turkey between 2023–2025 with community-acquired urinary tract infection (CA-UTI), of which 117 (32.7%) had current bacteremia. Independent predictors of bacteremia were male gender, shorter duration of symptoms, prior colonization or infection with extended-spectrum β-lactamase- and carbapenem-producing bacteria, Charlson Comorbidity Index (CCI) ≥ 2, diabetes mellitus, qSOFA ≥ 2, and C-reactive protein > 100 mg/L. The eight-item risk factor score predicted bacteremia with AUROCs of 0.83 (full model) and 0.80 (simplified score), with a prevalence of 3.8% for 0–1 factor, 24.7% for 2–3, and 75% for ≥ 4 factors. Overall 30-day mortality was 6.1% (22/358), higher in bacteremic CA-UTI (9.4%) than non-bacteremic (4.6%). In the whole group, bacteremia and qSOFA ≥ 2 were independent predictors of mortality, whereas in the subgroup with bacteremia only qSOFA ≥ 2. Bacteremia indicates a high-risk phenotype, but organ dysfunction according to qSOFA is a major factor in mortality. The score requires external validation before clinical use.