Abstract: OBJECTVE To investigate the influencing factors and economic burden of pneumonia caused by carbapenem-resistant Acinetobacter baumannii（CRAB） in stroke patients.METHODS Targeted surveillance of nosocomial infections in stroke patients in the neurosurgery department of a tertiary hospital was carried out from January 1, 2016 to December 31, 2018. A total of 33 pairs were matched in 1∶1 match case-control study between the CRAB pneumonia group and the non-infected group, and the demographic characteristics, clinical characteristics of the disease, healthcare-associated infection information, and hospitalization expenses were collected. Risk factors of pneumonia caused by carbapenem-resistant A. baumannii in stroke patients were analyzed, and hospitalization costs and hospital length of stay were compared between the CRAB pneumonia group and the non-infected group.RESULTS A total of 816 stroke patients were enrolled, of which 35 suffered CRAB pneumonia. ASA score, tracheotomy, and mechanical ventilation were risk factors for CRAB pneumonia（P＜0.05）. The median hospitalization costs of the CRAB pneumonia group and the non-infected group were 156 723.72（110 505.78, 197 645.56） yuan and 73 279.31（44 474.85, 98 153.65） yuan, respectively; the direct economic burden of CRAB pneumonia was 84 201.56（42 592.15, 125 220.73） yuan. The median hospital length of stay of the CRAB pneumonia group was 22.00（15.50, 27.50） days, extended by 8.00（2.00, 16.50） days due to CRAB pneumonia than that of the non-infected group 13.00（10.00, 17.00） days.CONCLUSION ASA score, tracheotomy, and mechanical ventilation might increase the risk of CRAB pneumonia. Pneumonia increased the medical expenses of patients, prolonged the length of hospital stay, and brought economic burden to patients.