BACKGROUND: Analysis of detection trends, infection prognosis, and risk factors for nosocomial infections (NI) in multidrug-resistant bacteria (MDRB) can help improve infection control efforts. METHODS: Using data from inpatients of a single-centre hospital in China from 2019 to 2023, we analysed trends of detection rate of carbapenem-resistant Klebsiella pneumoniae (CRKP), carbapenem-resistant Acinetobacter baumannii (CRAB), carbapenem-resistant Pseudomonas aeruginosa (CRPA), and methicillin-resistant Staphylococcus aureus (MRSA). The Kaplan-Meier approach was used to evaluate the survival prognosis of patients infected with resistant and sensitive KP, AB, PA, and SA strains. We used a 1:1 matched case-control study to analyse risk factors. RESULTS: The χ CONCLUSION: The high lethality of CRKP infections should not be ignored. Clinical work should focus on CRKP infections of the lower respiratory tract and blood system in the ICU and enhance oversight of the judicious use of antimicrobials.