Abstract: OBJECTIVE To analyze the distribution characteristics and prognostic factors of hospital-associated infection caused by Klebsiella aerogenes in a tertiary children's hospital. METHODSA retrospective study was conducted on hospitalized children with hospital-associated infection caused by K. aerogenes at the Guangzhou Women and Children's Medical Center from Jan.1, 2014 to Jun. 30, 2025. The epidemiological characteristics and prognostic factors of hospital-associated infection were analyzed. RESULTSThere were 97 cases of hospital-associated infection caused by K. aerogenes, with an incidence rate of 12.19 per 100 000 hospitalizations, showing a fluctuating upward trend. The median age at infection was 1.72 (0.83-4.54) months, with 71.13% of infection being multidrug-resistant, and there was a phenomenon of sensitive strains turning into resistant strains. The infection mainly occurred in the neonatal intensive care unit (NICU) (67.01%), with infection related to three tubes (mechanical ventilation, central venous catheterization and urinary catheterization) accounting for 45.36%. The most common infection sites were respiratory tract infection (39.18%) and bloodstream infection (38.14%), with corresponding incidence rates of 4.78 per 100 000 and 4.65 per 100 000 hospitalizations, respectively. The 30-day all-cause mortality rate was 9.28%, with the highest rate observed in other ICU departments (21.43%), followed by the NICU department (9.23%). Multivariate analysis showed that a short duration of antibacterial agent use after infection (divided into three groups: ≥14 days, 8-13 days and ≤7 days) (OR adjusted: 8.812, 2.510-30.943, P=0.001) was an independent risk factor for 30-day all-cause mortality. CONCLUSIONHospital-associated infection caused by K. aerogenes in hospitalized children show an increasing trend year by year and can result in death. Attention should be paid to infection control in ICU and administration of antibacterial agent, and active intervention measures should be taken.