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Abstract BACKGROUND AND OBJECTIVE: Streptococcus pneumoniae is one of the main etiologies of meningitis, pneumonia, sinusitis, and middle ear infection associated with significant morbidity and mortality. This report aims to review and report the serotype distribution and antimicrobial resistance patterns and determine the frequency of S. pneumoniae in Iran. METHODS: A systematic literature review of the literature published from January 1990 to August 2020 was performed to identify articles that have been published in Google Scholar, Scopus, PubMed, SID, IranMedex, and Magiran databases that describe the serotype distribution, antimicrobial resistance patterns and frequency of S. pneumoniae in Iran. The search terms were" Streptococcus pneumoniae, Antibiotic resistance, Serotyping, Systematic review, and Iran". The exclusion criteria were review articles or case reports, reports only emphasizing …