In this study, we would explain that NDM-5 CRKP is not only more resistant and the detection rate increases year by year, but also it is the main type of infection in children. Due to the imperfection of children's immune system and the limitation of available drugs, the clinical treatment of NDM-5 CRKP has brought great challenges.</p><p>Small RNA (sRNA), with length of 50-500 nt, influences virulence, drug resistance, and other functions by inhibiting or stabilizing mRNA expression in bacteria. Based on bioinformatics software and our research, we obtained 307 DEGs in NDM-5 CRKP, including 109 up-regulated and 198 down-regulated, which plays major roles in metabolic processes. We totally obtained 268 candidate sRNAs, of which 13 were differentially expressed in NDM-5 CRKP, including 3 up-regulated and 10 down-regulated. Further study showed that sRNA207 with length of 136 nt and without ORF was significantly up-regulated in NDM-5 CRKP. By knockdown sRNA207, we found that sRNA207 stabilized smf-1 expression and promoted biofilm formation, thereby increasing NDM-5 CRKP resistance to carbapenems.