The aims of this study were to identify the risk factors and describe molecular epidemiology carbapenem‑resistant Acinetobacter calcoaceticus‑baumannii complex (ACB complex) at a district hospital in Taiwan. Materials and Methods: This is a case–control study at a district hospital in the Penghu Islands, Taiwan, from May 2014 to June 2016. Patients with carbapenemresistant ACB complex and controls with carbapenem‑nonresistant ACB complex were identified, and relevant clinical data obtained from them were compared. Risk factors for carbapenem‑resistant ACB complex isolation were searched using bivariable and multivariable analysis. The available isolates from patients were genotyped using a pulsed‑field gel electrophoresis (PFGE) method. Results: A total of 70 patients were included in this study (36 cases and 34 controls). A bivariable analysis showed that patients who had a hospital admission within the past 3 months and had a recent nasogastric tube insertion had a tendency for subsequent carbapenem‑resistant ACB complex isolation (P = 0.066 and 0.051, respectively). Previous exposure to fluoroquinolones was significantly associated with the occurrence of carbapenem‑resistant ACB complex (P = 0.028). Further multivariable analysis showed that previous exposure to fluoroquinolones (odds ratio, 10.477; 95% confidence interval, 1.117–98.270; P = 0.040) was an independent risk factor associated with the occurrence of carbapenem‑resistant ACB complex. According to PFGE for available carbapenem‑resistant ACB complex isolates, one major clone was disseminated in the hospital. Conclusions: The antibiotic selective pressure of fluoroquinolone and interpatient dissemination contributed to the occurrence of carbapenem‑resistant ACB complex.