〔Abstract〕 Objective This study aimed to assess the incidence, etiological characteristic, potential risk factors and clinical outcomes of multidrug-resistant(MDR) infection in patients with peritoneal dialysis associated peritonitis(PDAP). Methods The data of PDAP patients admitted in recent 3 years in our center were collected retrospectively to analyze the distribution of pathogenic bacteria and drug resistance. According to whether the pathogenic bacteria were MDR or not, they were divided into MDR group and non-MDR group. The data of the two groups were compared, and the risk factors and clinical outcomes of MDR infection were analyzed. Results PDAP patients were mainly infected with gram-positive bacteria. Staphylococcus was the most common pathogen isolated from the peritoneal fluid in the MDR group, accounting for 60.6%(43/71), and streptococcus was the most common pathogen isolated in the non-MDR group, accounting for 42.0%(21/50). Multivariate analysis showed that the use of wide-spectrum antibiotics for more than 5 days within 3 months before the onset of PDAP(OR=3.634,P=0.033), gram-positive bacterial infection(OR=3.741,P=0.031), higher lipoprotein(a) level(OR=1.003,P=0.003), and higher platelet-to-albumin ratio(OR=1.198,P=0.038) were independent risk factors for MDR infection in PDAP patients. The incidence of refractory peritonitis in MDR group(29.6%) was higher than that in non-MDR group(12.0%)(χ2=5.229,P=0.022). The incidence of recurrent peritonitis(16.9%) was also higher than that in the non-MDR group(4.0%)(χ2=4.773,P=0.029). Conclusion The main pathogen of MDR infection is staphylococcus in PDAP patients. Compared with the non-MDR group, the MDR group has a higher proportion of wide-spectrum antibiotics used for more than 5 days within 3 months before the onset of PDAP, a higher proportion of gram-positive bacterial infection, higher lipoprotein(a) level, higher platelet-to-albumin ratio, and an increased risk of refractory peritonitis and recurrent peritonitis.