To explore peripheral blood indicators that may serve as early indicators for MDR infections in this demographic, with the goal of providing reference suggestions for the clinical prevention of MDR infections in elderly inpatients. (2) Methods: Clinical data of patients were divided into the MDR-infected group (n=488) and the MDR-uninfected group (n=233) according to the results of drug sensitivity experiments, Risk factors for MDR infection and peripheral blood indicators related to MDR infections were analyzed using univariate and multivariate logistic regression in conjunction with the construction of a CHAID decision tree model, considering statistical significance at P-value<0.05. (3) Results: Univariate and multivariate regression analyses revealed that prolonged hospitalization, use of antibiotics pre-admission, duration on antibiotics, invasive procedures or recent surgery, and coexisting lung disease were independent risk factors for contracting MDR. Subsequent analysis comparing the aforementioned influences with peripheral blood cells revealed associations between the number of antibiotic treatment days and increased PLR, NLR, neutrophils, decreased lymphocytes, and increased eosinophils; pre-admission antibiotic use correlated with increased PLR, NLR, neutrophils, and decreased lymphocytes; and invasive manipulation or surgery correlated with increased PLR and NLR. (4) Conclusions: Elevated NLR, PLR, neutrophils, lowered lymphocytes, and eosinophils may serve as early indicators of MDR infections in elderly hospitalized patients.