Background and objectives: STREPTOCOCCUS PNEUMONIAE is a bacterial pathogen most commonly associated with acute otitis media and pneumonia and the second most important pathogen in cases of meningitis in children under 2 years old. Currently more than 90 pneumococcal serotypes have been identified based on their antigenic differences in the capsular polysaccharides, with distribution varying according to age group, clinical symptoms, and geographic area. The aim of this study was to determine the most prevalent type of STREPTOCOCCUS PNEUMONIAE associated with different infectious diseases in Tehran medical centers.Materials and methods: in total 50 clinical isolates of STREPTOCOCCUS PNEUMONIAE were collected from Tehran medical centers and re – identified using standard identification tests. Quelling test was used for serotyping of the isolates as per Statens Serum Institute guideline. The data were analyzed using SPSS software. Results: in this study, the distribution of isolated STREPTOCOCCUS PNEUMONIAE in relation to site of infection were: respiratory tract, 18 isolates (36%); blood, 13 isolates (26%); eye, 10 isolates ( 20%) and other sites, 7 isolates (14%). The most common serotypes were 6A and 6B. The prevalent serotypes in adults and infants were serotype 2 and 19 (19A, 19B, 19C, 19F) respectively. The prevalent serotypes according to the site of infection were: respiratory tract, 7; blood, 4; and eye, 19.Conclusion: the finding of this study showed that serotype 6 in common serotype in both adults and infants. The common serotypes in adults and infants in this study were 75.5% and 72.2% in concordance with other European similar studies respectively.

Background: Antimicrobial resistance of STREPTOCOCCUS PNEUMONIAE (S. PNEUMONIAE) has shown major changes in recent years. On the other hand, macrolide antibiotics are being increasingly used in clinical practice. Several studies have reported increased resistance to this group of antibiotics, while there is no comprehensive information in this area. Accordingly, the present study was designed to estimate the resistance of S. PNEUMONIAE to macrolides in Iran. Materials and Methods: In this review, articles (2000-2017), evaluating the level and type of S. PNEUMONIAE resistance to macrolides in Iran, were extracted by searching different databases, and the results were analyzed. Results: A total of 25 relevant articles were retrieved and analyzed. Overall, 2723 cases had been recruited in these studies. The mean percentage of resistance to macrolides was estimated at 48. 43% (CI, 38. 8-57. 9%). In the majority of reported cases, the resistance mechanisms included ribosomal methylation (i. e., ermB mutation), dual resistance, and efflux-mediated resistance. Conclusion: Based on the findings, the resistance rates are considerable in different cities of Iran. Therefore, without determining the type of drug resistance in clinical samples, use of macrolides is not recommended for treatment purposes. In addition, considering the type of resistance mechanisms in Iran, use of higher drug doses is probably ineffective.