Abstract: OBJECTIVE To observe the molecular epidemiological characteristics of carbapenem-resistant Enterobacteriaceae (CRE) strains isolated from the patients with infectious pancreatic necrosis (IPN) and analyze the risk factors. METHODS A total of 198 patients with IPN who were treated in Huzhou Central Hospital of Zhejiang Province from Jan. 2022 to Dec. 2024 were enrolled in the study, 45 of whom were detected with CRE and were assigned as the CRE group, and the rest of 153 patients were assigned as the non-CRE group. The carbapenemase genes were analyzed by PCR, the species of CRE and drug resistance rates were observed. The major clinical characteristics were compared between the CRE group and the non-CRE group, and the risk factors for CRE infections in the IPN patients were analyzed. RESULTS Totally 72 strains of CRE were cultured from the 45 patients, 28 (38.89%) of which were Escherichia coli, 24 (33.33%) were Klebsiella pneumoniae, and 14 (19.44%) were Enterobacter cloacae. The strains carrying bla_NDM gene accounted for 75.00%, the strains carrying bla_KPC gene 58.33%, the strains carrying bla_IMP gene 62.50%, the strains carrying bla_OXA-48 gene 55.56%. The drug resistance rates of the E. coli, K. pneumoniae and E. cloacae strains were less than 30%, and the drug resistance rates to other antibiotics were more than 50%. The length of hospital stay was longer and the nosocomial mortality rate was higher in the CRE group than in the non-CRE group (P＜0.05). The age (OR=1.032,95%CI:1.006 to 1.059), the ratio of acute to chronic blood glucose (OR=4.073,95%CI:1.707 to 9.715), surgical procedures(OR=2.750,95%CI:1.142 to 6.622) and ICU stay(OR=2.524,95%CI:1.132 to 5.627) were the risk factors for the CRE infections in the IPN patients. CONCLUSIONS The isolation rates of CRE strains are high among the peritoneal drainage fluid specimens obtained from the IPN patients. E. coli, K. pneumoniae and E. cloacae are the most common species. The drug resistance rates are high, which is associated with the poor prognosis. It is necessary to strengthen the implementation of prevention and control measures for the risk factors.