# The Phenomenon of Antimicrobial Resistance in Southern Italy: An Overview of the Current Situation

## TL;DR

This study examines antimicrobial resistance patterns in Southern Italy, highlighting gender and age differences in resistance rates among common pathogens.

## Contribution

The study provides region-specific insights into AMR trends in Southern Italy, emphasizing gender-related differences in resistance profiles.

## Key findings

- Escherichia coli was the most frequently isolated pathogen (52.3%), followed by Klebsiella pneumoniae (14.9%).
- Males showed higher resistance to ciprofloxacin and levofloxacin, while females showed greater resistance to amoxicillin/clavulanate.
- Women aged 70 and older displayed particularly elevated resistance rates compared to age-matched men and younger females.

## Abstract

Antimicrobial resistance (AMR) is an escalating global health challenge with region-specific implications. This study investigated AMR prevalence in Southern Italy, with particular attention to demographic variables such as gender and age.

A retrospective analysis of antibiograms from 146 patients (68 males and 78 females, aged 36–101 years) collected between 2022 and 2023 was conducted. Given the retrospective design and reliance on routinely collected clinical data from a local hospital microbiology laboratory, molecular analyses were not feasible, as isolates were processed solely for diagnostic purposes and not preserved.

The most frequently isolated pathogens were Escherichia coli (52.3%), Klebsiella pneumoniae (14.9%), Enterococcus faecalis (6.9%), Proteus mirabilis (6.3%), Staphylococcus aureus (4.6%), and Pseudomonas aeruginosa (4.3%). In males, the highest resistance rates were recorded for ciprofloxacin (47.9%), levofloxacin (47.2%), and trimethoprim/sulfamethoxazole (40.5%). Female patients showed greater resistance to amoxicillin/clavulanate, levofloxacin, and trimethoprim/sulfamethoxazole, with women≥70 years displaying particularly elevated resistance compared with age-matched men and younger females.

Despite the absence of molecular data, phenotypic surveillance through antibiograms remains a critical tool for monitoring AMR trends in underrepresented regions. Incorporating gender-specific differences into clinical practice may improve therapeutic efficacy and stewardship strategies. These findings provide a foundation for future molecular and epidemiological investigations.