Italian voters were choosing mayors in Rome and other municipalities Sunday in balloting, whose results will be interpreted as a test of ex-Premier Silvio Berlusconi's political influence with possible repercussions on the national government.

Media mogul Berlusconi campaigned for his center-right party's candidate in Rome, incumbent Gianni Alemanno, who is trying for a second term in a runoff against former transplant surgeon Ignazio Marino, who is backed by the center-left. Alemanno trailed in the first round two weeks ago in Italy's capital. In his first run for the office, in 2008, Alemanno also trailed in the first round, but mounted a strong comeback to win in the runoff.

Marino's and Alemanno's parties are the main partners in a coalition of bitter rivals in Premier Enrico Letta's 5-week-old government, and are struggling to spur economic growth in the recession-mired country.

Rome is the only major metropolis at stake. Nearly all races are runoffs, except in the region of Sicily, which is holding its first round of mayoral elections. Voting ends Monday afternoon.

Beset by judicial woes, including a trial expected to yield a verdict later this month on charges that Berlusconi paid for sex with an underage teen and then tried to use his office while premier to cover it up, the 76-year-old billionaire businessman, who denies wrongdoing, tried for an electoral comeback in February parliamentary elections. His conservative People of Freedom party finished second in the national vote, not enough to return him to the premiership, more than a year after he resigned that office when financial markets lost confidence that his government could weather the eurozone debt crisis.

The largest vote-getter, the left-leaning Democratic Party, failed to win enough to control both houses of Parliament. After weeks of internal bickering, it was forced to ask Berlusconi's forces to help it form a coalition government.

The mayoral races will also be watched to see if the Democrats can project a winning image. Local electoral triumphs could help it to wield a stronger hand in the ruling coalition, which quickly gave in to Berlusconi's demands to stop an unpopular property tax. Payment of tax on primary residences has been suspended, while the government scrambles to find alternative revenues for lean state coffers.

February's national vote proved a stunning success for a newcomer to Parliament, the anti-establishment 5-Star Movement, which is led by a comic, Beppe Grillo, who appeals to Italians' disgust with mainstream parties often tarnished by corruption scandals.

But since its surprising third-place electoral debut in Parliament, the grassroots movement has increasingly been distracted by disagreements within its own ranks, recently seeing its first defections among lawmakers. Candidates under the 5-Star banner largely saw poor results in the first round of municipal balloting, failing in most towns to win runoff berths.

Both the early rounds of mayoral voting and the national elections were marked by sharp drops in turnout, in line with opinion polls that have found Italians increasingly distrustful that their political class can solve Italy's problems, including worsening unemployment, especially among young people.

Beyond determining who will be mayor, particularly in Rome, the local balloting Sunday and Monday also serves as an indicator of citizen enthusiasm for politics, political analyst James Walston said.

"As much as looking at the results, of whether it's Marino or Alemanno, we'll be looking at the turnout to see the state of health of all the Italian political system," Walston, who is a professor of international relations at American University of Rome, said.