Abstract: OBJECTIVE To understand the risk factors for carbapenem-resistant Klebsiella pneumoniae（CRKP） healthcare-associated infection（HAI） and colonization. METHODS From Jan 1, 2020 to Dec 31, 2020, the hospitalized patients who were detected with K.pneumoniae in Peking University were recruited as the study subjects, a retrospective survey was conducted to understand the basic information of the infection. By means of case-control study, totally 59 patients with CRKP HAI and colonization were assigned as the case group, and 79 patients with carbapenem-sensitive K.pneumoniae HAI and colonization were assigned as the control group. The risk factors for the CRKP HAI and colonization were investigated. RESULTS A total of 105 strains of CRKP were isolated from the sites of 86 patients between Jan 2020 and Dec 2020, including 31 strains isolated from 26 cases of community-acquired infection, 1 strain of colonization, 51 strains isolated from 46 cases of HAI, and 22 strains isolated from 21 cases of nosocomial colonization. The incidence rate of CRKP HAI was 0.11 case/1000 hospitalization days, the colonization rate was 0.35‰. Univariate analysis showed that the no less than 65 years of age, male, respiratory failure, hospitalization for emergency treatment, emergency detention time no less than 48 hours, use of carbapenems before the admission, infection before the admission, use of ventilator plus artificial airway during hospital stay, urinary catheter indwelling, long length of hospital stay, intensive care unit（ICU） stay, use of carbapenems, cephalosporins（more than 7 days）, tetracyclines, quinolones, glycopeptides and combined use of antibiotics could increase the risk of CRKP HAI or colonization（P＜0.05）. Multivariate analysis indicated that the no less than 65 years of age, infection before the admission and use of carbapenems were the risk factors for the CRKP HAI or colonization（P＜0.05）. CONCLUSION It is necessary to focus on the highly prevalent sites of infection, emergency treatment patients and management of carbapenems so as to prevent and control the CRKP HAI and colonization.