Abstract: OBJECTIVE To establish the risk assessment scale of nosocomial infection for the patients with multidrug-resistant organisms (MDROs) infections so as to provide basis for prevention and control of MDROs infections in hospitalized patients. METHODS A total of 1 327 patients who were hospitalized in the Renmin Hospital of Wuhan University and were detected with MDROs from Jan 2022 to Dec 2022 were recruited as the research subjects, 375 of whom had MDRO nosocomial infection and were assigned as the case group, and 952 who had non-MDRO nosocomial infection were assigned as the control group. The scale items were established by logistic regression, the weight was determined based on odds ratio (OR), the accuracy of the scale was judged by receiver operating characteristic (ROC) curves, the diagnostic threshold was determined, and the risk level was assigned by quartile method. The outcomes of the patients with MDRO infection (the validation group) were prospectively predicted in the first quarter of 2023, and the real infection rate was compared among the patients with different grades of risk. RESULTS Totally 11 indexes were included in the univariate analysis, 6 variables were brought into the model; Hosmer-Lemeshow test showed that the coincidence degree of the model was P=0.686, the accurate differentiation of types was 77.3%. The weights of the items were determined based on assignment standards, it was 0 point for negative. The risk scoring scale for MDRO nosocomial infection was initially established; the area under ROC curve (AUC) of the scale was 0.8(95%CI=0.774-0.826,P＜0.001), the diagnostic threshold was 17 points, 0-16 points as no risk, 17-22 points as low risk, 23-27 points as medium risk, no less than 28 points as high risk. The risk scores of the validation group were grades according to the grade of risk, the incidence rate of infection showed upward trend with the rise of risk grade, and there was significant difference in the incidence rate of infection among the risk grade groups(P＜0.001). CONCLUSION The risk assessment scale for MDRO infection is simple, accurate and true, and it can be used for screening of the high-risk patients.