Abstract: OBJECTIVE To analyze the risk factors and drug resistance of carbapenem-resistant Klebsiella pneumoniae (CRKP) causing hospital-associated infections in burn patients, providing a scientific basis for effective clinical prevention and control of CRKP infections. METHODS Clinical data of patients with hospital-associated infections caused by K. pneumoniae (KP) in the burn department of Zhengzhou First People's Hospital from 2015 to 2024 were collected. The clinical distribution characteristics of hospital-associated infections caused by KP were retrospectively analyzed. Based on drug susceptibility results, patients were divided into CRKP and carbapenem-sensitive K. pneumoniae (CSKP) groups. Univariate analysis and logistic regression analysis were used to identify risk factors for CRKP infections in burn patients. Receiver operating characteristic (ROC) curves were adopted to evaluate the performance of risk factors in predicting CRKP infections. RESULTS From 2015 to 2024, a total of 16 990 patients were admitted to the burn department, among whom 132 developed hospital-associated infections caused by KP, with an incidence rate of 0.78%. The primary infection site was the bloodstream. The time to onset of CRKP and CSKP infections was (18.36±12.84) days and (28.34±20.20) days, respectively, showing a statistically significant difference (P=0.001). Logistic regression analysis revealed that indwelling central venous catheters, use of polymyxin antibiotics and use of carbapenem antibiotics were risk factors for CRKP infections in burn patients (P<0.05). The area under the ROC curve was 0.729 (95% CI: 0.644-0.815), with a sensitivity of 0.743 and specificity of 0.613. No significant difference was observed in resistance rates to ampicillin and sulfamethoxazole/trimethoprim between the CRKP and CSKP groups. CRKP exhibited a relatively low resistance rate to minocycline (42.86%). CONCLUSIONS CRKP infections predominated in the early stages among burn patients, with CRKP showing high resistance to commonly used antibiotics. Clinical interventions should be implemented for high-risk patients, and antibiotic use should be standardized to reduce the incidence rate of CRKP infections.