Abstract: OBJECTIVE To investigate the distribution and sources of elderly patients with multidrug-resistant organisms (MDROs) infections in intensive care unit (ICU) so as to provide guidance for development of targeted strategies for prevention of MDROs infection in the elderly patients. METHODS The clinical data were collected from the patients with MDROs infection who were treated in 8 ICUs of Jiangsu Province Hospital from Jul 2017 to Jun 2019, the enrolled patients were divided into the elderly patient group (more than 65 years old) and the non-elderly patient group (no more than 65 years old). The sources of MDROs infection were divided into the nosocomial infection (transferred from the hospital and acquired from department) and the out-of-hospital infection (transferred from outside hospital and acquired from community). RESULTS A total of 852 strains of MDROs were isolated from the elderly patients with infection in ICUs, and 1 045 strains of MDROs were isolated from the non-elderly patients. Carbapenem-resistant Acinetobacter baumannii (CRAB) and carbapenem-resistant Enterobacteriaceae (CRE) were dominant among the MDROs causing the infection in the elderly patients and the non-elderly patients. The lower respiratory tract and blood stream ranked the top 2 infection sites of the two groups of patients with MDROs infections. The proportion of the elderly patients with lower respiratory tract infection was 86.74%, significantly higher than 79.23% of the non-elderly patients (P<0.001). The proportions of the two groups of patients with out-of-hospital MDROs infection (53.87% and 55.89%)were higher than those of the two groups of patients with nosocomial MDROs infections (46.13% and 44.11%). Among the 8 ICUs in which the elderly patients had CRE infection, the general ICU (33.92%), geriatric ICU (26.53%) and neurosurgery ICU (9.51%) ranked the top 3. Among the elderly ICU patients with MDROs infections, 23.24% were transferred from foreign hospitals, 30.63% were community-acquired, 6.92% were transferred from the hospital, and 39.20% were department-acquired. There were significant differences in the sources of CRAB, CRPA and CRE infections among the ICUs (P<0.001). CONCLUSION The distribution of the elderly ICU patients with MDROs infection is specific, the sources of the infections are diverse in the ICUs, and it is necessary to take targeted measures according to the characteristics so as to realized the precise prevention.