Abstract: OBJECTIVE To investigate the influencing factors for health care-associated infections in chronic renal failure (CRF) patients undergoing maintenance hemodialysis (MHD). METHODS The clinical data were collected from 112 patients with CRF who underwent MHD in Ganzhou Municipal Hospital from May 2023 to Mar 2024. The enrolled patients were divided into the infection group with 21 cases and the no infection group with 91 cases according to the status of health care-associated infections. The baseline data, peripheral blood helper T cell 22 (Th22) and interleukin-22 (IL-22) were observed and compared between the two groups. Multivariate logistic regression analysis was performed for the influencing factors for the health care-associated infections. The values of Th22 and IL-22 in diagnosis of health care-associated infections during the MHD were evaluated by ROC curves. RESULTS Totally 21 (18.75%) patients had health care-associated infections among the 112 CRF patients. The multivariate logistic regression analysis showed that diabetic nephropathy being the primary disease was the risk factor for the health care-associated infections during the MHD(OR=2.512,P=0.002); treatment with levocarnitine was the protective factor(OR=0.162,P＜0.001). ROC curve analysis indicated that the AUCs of the peripheral blood Th22 and IL-22 were respectively 0.870 and 0.854 in diagnosis of health care-associated infections in the CRF patients during the MHD, and the AUC of the joint detection of the two indicators reached up to 0.953(P＜0.05). CONCLUSIONS The CRF patients with the diabetic nephropathy being as the primary disease are at high risk of health care-associated infections during the MHD. Levocarnitine may help to reduce the risk. The percentage of peripheral blood Th22 and serum IL-22 level can assist the early diagnosis of health care-associated infections, which the hospital should attach great importance to.