MATERIALS AND METHODS

Streptococcus pneumoniae (S. pneumoniae) is a major patho-gen of bacterial pneumonia, meningitis, sinusitis and otitis me-dia. Antimicrobial resistance in S. pneumoniae, including mac-rolide resistance, has been a growing problem in recent years due to the increasing numbers of cases with treatment failures of infections caused by macrolide-resistant pneumococci (1). Macrolide resistance in S. pneumoniae is mediated by: the erm (B) gene encodes methylation of the ribosomal macrolide target sites and mef (A) encodes the drug efflux. Deterioration of riboproteins L4 and L22 and mutations in the 23S rRNA genes are involved in the other less common mechanisms (2). In this study, we analyzed the distribution of the phenotypes, genotypes, and clonal relatedness of macrolide-resistant S. pneumoniae strains isolated in our hospital