{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T14:32:59Z","timestamp":1787581979539,"version":"build-2736575974"},"reference-count":51,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T00:00:00Z","timestamp":1787443200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Background: Antimicrobial resistance (AMR) remains a major public health threat in Italy, where high incidence and mortality persist. In this study we aimed to describe national and regional trends in AMR rates from 2015 to 2024. Methods: We conducted an ecological time-series analysis using publicly available data from the Italian AMR surveillance system (AR-ISS). We included six priority pathogens: methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus faecium (VRE-faecium), third-generation cephalosporin-resistant Escherichia coli (3GCREC), carbapenem-resistant Klebsiella pneumoniae (CRKP), Pseudomonas aeruginosa (CRPA), and Acinetobacter spp. (CRAS). We analyzed annual resistance rates at national and regional level. Temporal trends were estimated using linear regression models, with calendar year as the independent variable. Regression coefficients, 95% CIs, and p-values were used to assess direction and significance. Relative percentage changes were calculated for 2015\u20132024 and, when relevant, for 2023\u20132024. Results: Resistance declined over time for four of six pathogens, but increased markedly for VRE-faecium, from 11.1% to 34.9%. Significant downward trends were observed for MRSA (\u03b2 = \u22120.91, 95% CI: \u22121.35; \u22120.48, p = 0.0013), 3GCREC (\u03b2 = \u22120.53, 95% CI: \u22120.99; \u22120.06, p = 0.0304), CRKP (\u03b2 = \u22120.94, 95% CI: \u22121.35; \u22120.53, p = 0.0008), and CRPA (\u03b2 = \u22120.86, 95% CI: \u22121.44; \u22120.27, p = 0.0095); VRE-faecium showed a strong upward trend (\u03b2 = +2.76, 95% CI: 2.58; 2.94, p &lt; 0.0001). CRAS remained consistently high throughout the study period. Considerable regional heterogeneity was observed across pathogens and geographical areas. Conclusions: Despite progress for several pathogens, AMR remains a critical challenge in Italy. The persistent increase in VRE-faecium and the high burden of CRAS support the need for strengthened surveillance, stewardship, and region-specific infection prevention interventions.<\/jats:p>","DOI":"10.3390\/antibiotics15090819","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T13:20:43Z","timestamp":1787577643000},"page":"819","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Antimicrobial Resistance in Six Priority Bacteria in Italy: Trends and Regional Variation, 2015\u20132024"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-5015-2725","authenticated-orcid":false,"given":"Luigi","family":"Russo","sequence":"first","affiliation":[{"name":"Section of Hygiene, Department of Life Sciences and Public Health, Universit\u00e0 Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8295-4523","authenticated-orcid":false,"given":"Sofia","family":"Mao","sequence":"additional","affiliation":[{"name":"Section of Hygiene, Department of Life Sciences and Public Health, Universit\u00e0 Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tindara","family":"Scirocco","sequence":"additional","affiliation":[{"name":"Section of Hygiene, Department of Life Sciences and Public Health, Universit\u00e0 Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5889-1780","authenticated-orcid":false,"given":"Michela","family":"Sabbatucci","sequence":"additional","affiliation":[{"name":"Department of Health Prevention, Research and Emergencies, Ministry of Health, Viale Giorgio Ribotta 5, 00144 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Zovi","sequence":"additional","affiliation":[{"name":"Department of Human, Animal and Ecosystem Health (One Health), and International Relations, Ministry of Health, Viale Giorgio Ribotta 5, 00144 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Vitiello","sequence":"additional","affiliation":[{"name":"Department of Health Prevention, Research and Emergencies, Ministry of Health, Viale Giorgio Ribotta 5, 00144 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7357-2892","authenticated-orcid":false,"given":"Maria Rosaria","family":"Gualano","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, UniCamillus, Saint Camillus International University of Health and Medical Sciences, Via di Sant\u2019Alessandro 8, 00131 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5655-688X","authenticated-orcid":false,"given":"Walter","family":"Ricciardi","sequence":"additional","affiliation":[{"name":"Section of Hygiene, Department of Life Sciences and Public Health, Universit\u00e0 Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9375-8731","authenticated-orcid":false,"given":"Leonardo","family":"Villani","sequence":"additional","affiliation":[{"name":"Section of Hygiene, Department of Life Sciences and Public Health, Universit\u00e0 Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy"},{"name":"Faculty of Medicine, UniCamillus, Saint Camillus International University of Health and Medical Sciences, Via di Sant\u2019Alessandro 8, 00131 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,23]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2025, October 17). 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