Objective To explore the source and distribution of patients with multidrug resistant organisms (MDROs) acquired (infections/colonizations) outside the hospital and to provide a reference for guiding proactive interventions for nosocomial transmission of MDROs. Methods Bacterial culture results and clinical data of patients newly admitted to Beijing Anzhen Nanchong Hospital of Capital Medical University & Nanchong Central Hospita1 were retrospectively investigated between January 1st 2022 and December 31st 2023. The types of MDROs infections/colonizations, patient sources, and triple distributions of patients with nosocomial acquisition of MDROs were analyzed. Results A total of 293 patients with 308 infections/colonizations were investigated in the extranocomial infection of MDROs, 198110 newly admitted patients during the same period, and the total case rate of extranocomial infection of MDROs was 0.155% (308/198110). Among them, the case rate of extranocomial infection of methicillin-resistant Staphylococcus aureus (0.062%) and carbapenem resistant Acinetobacter baumannii (0.044%) were higher than those of other types of bacteria. The case rate of extranocomial infection of MDROs was statistically significant in terms of the distribution of the route of admission, gender of the patient, age of the patient, department of admission, and time of admission (P<0.001); The distribution of patients with extranocomial infection of various types of MDROs was correlated with admission route, patient age, and admission department (P<0.001), and the associations with patient gender and admission time were not statistically significant (P>0.05). Conclusions The total case rate of extranocomial infection of MDROs in the institution was at a relatively low level, and conducting large-scale active screening has certain limitations. Active screening factors should be considered in a comprehensive manner to capture differences in epidemiological characteristics of patients with extranocomial infection of MDROs, and targeted prevention and intervention should be carried out to achieve a reduction in infections from MDROs in hospitals.