This study aims to explore the high risk factors of Carbapenem-Resistant Enterobacteriaceae (CRE) infection of hospitalized patients in high risk departments.This study is a multicenter, retrospective study, CRE screening positive patients from January 1, 2016 to December 31, 2018 of high-risk departments in five tertiary first-class teaching hospitals in Beijing, collect the patient's CRE test specimen information, CRE infection information and outcomes. The patients were divided into colonization group and infection group for comparative analysis. Logistic regression model was established to explore the risk factors of CRE infection. Subgroup analysis was conducted according to invasive procedures and the type of the infection.344 patients were included in this study, including 85 (24.71%) colonization and 259 (75.29%) infection. 36.09% CRE colonization conversed to infection, and the mean conversion time from colonization to infection was 6.5 (4.0, 18.8) days. Renal disease, Granulocytosis, invasive procedures, and the time form hospital stay to positive CRE were the risk factors for CRE infection. The subgroup analysis showed that the rate of CRE infection in the invasive group was higher than non-invasive group (P<0.001), and the rate of exacerbation or death in the invasive group was also higher than non-invasive group (P=0.019). The average length of ICU and hospitalization in the healthcare-associated infection group were significantly higher than those in the community infection group, but there was no difference in the proportion of final exacerbation or death between them (P=0.727).Kidney disease, granulocytosis, invasive procedures and CRE detection time are the risk factors for CRE infection. Carrying out CRE screening in patients as early as possible and take effective intervention measures in time to avoid adverse consequences.Copyright © 2022. Published by Elsevier Ltd.