{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T12:50:12Z","timestamp":1788267012470,"version":"build-2803163510"},"reference-count":41,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,3,30]],"date-time":"2021-03-30T00:00:00Z","timestamp":1617062400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,3,30]],"date-time":"2021-03-30T00:00:00Z","timestamp":1617062400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Gastroenterol"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>This study aimed to investigate the frequency and the antibiotic resistance patterns of<jats:italic>Salmonella<\/jats:italic>species that were isolated from infectious diarrhea samples taken from pediatric patients in central Iran.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study analyzed 230 stool specimens that were cultured on XLD, MacConkey agar and GN broth. Polymerase chain reaction (PCR) assay was used to identify the<jats:italic>Salmonella<\/jats:italic>genus. The antibiotic resistance profiles and the frequency of quinolone and integron genes were obtained.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Out of 230 samples of infectious diarrhea, 21 (9.1%) cases of<jats:italic>Salmonella<\/jats:italic>spp. were identified using culture methods. Another 28 (12.1%) samples had positive PCR results, with<jats:italic>S.<\/jats:italic>serovar Paratyphi B and C (9\/21; 42.8%) and<jats:italic>S.<\/jats:italic>Typhi (3\/21; 14.3%) being the most recognized. The highest antibiotic resistance rates were found for nalidixic acid (15\/21; 71.4%), tetracycline (9\/21; 42.8%). However, six (28.5%) of isolates were found resistant to cotrimoxazole, ampicillin and chloramphenicol. Among the plasmid-mediated quinolone resistance (PMQR) determinants,<jats:italic>qnrS<\/jats:italic>,<jats:italic>qnrA<\/jats:italic>, and<jats:italic>qnrB<\/jats:italic>were positive in (9\/15; 60%), (6\/15; 40%) and (3\/15; 20%) of the isolates, respectively. Class 1 and 2 integrons were identified in 15 (71.4%) and 3 (14.3%) isolates, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>High rates of quinolone resistant and low frequency of MDR<jats:italic>Salmonella<\/jats:italic>spp. isolates were identified in central Iran, similar to findings in other parts of Asia. To prevent the spread of these resistant strains, the antimicrobial resistance of<jats:italic>Salmonella<\/jats:italic>spp. isolates should be under constant surveillance, and empiric antibiotic therapy should be adapted appropriately.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s12876-021-01719-3","type":"journal-article","created":{"date-parts":[[2021,3,30]],"date-time":"2021-03-30T13:02:58Z","timestamp":1617109378000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Quinolone resistant Salmonella species isolated from pediatric patients with diarrhea in central Iran"],"prefix":"10.1186","volume":"21","author":[{"given":"Elnaz","family":"Abbasi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ehsanollah","family":"Ghaznavi-Rad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,3,30]]},"reference":[{"issue":"10051","key":"1719_CR1","doi-asserted-by":"publisher","first-page":"1291","DOI":"10.1016\/S0140-6736(16)31529-X","volume":"388","author":"J Liu","year":"2016","unstructured":"Liu J, Platts-Mills JA, Juma J, Kabir F, Nkeze J, Okoi C, et al. Use of quantitative molecular diagnostic methods to identify causes of diarrhoea in children: a reanalysis of the GEMS case-control study. Lancet. 2016;388(10051):1291\u2013301.","journal-title":"Lancet"},{"issue":"3","key":"1719_CR2","doi-asserted-by":"publisher","first-page":"e255","DOI":"10.1016\/S2214-109X(18)30045-7","volume":"6","author":"C Troeger","year":"2018","unstructured":"Troeger C, Colombara DV, Rao PC, Khalil IA, Brown A, Brewer TG, et al. Global disability-adjusted life-year estimates of long-term health burden and undernutrition attributable to diarrhoeal diseases in children younger than 5 years. Lancet Glob Health. 2018;6(3):e255\u201369.","journal-title":"Lancet Glob Health"},{"issue":"2","key":"1719_CR3","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1007\/s12223-012-0099-4","volume":"57","author":"M Tajbakhsh","year":"2012","unstructured":"Tajbakhsh M, Hendriksen RS, Nochi Z, Zali MR, Aarestrup FM, Garcia-Migura L. Antimicrobial resistance in Salmonella spp. recovered from patients admitted to six different hospitals in Tehran, Iran from 2007 to 2008. Folia Microbiol. 2012;57(2):91\u20137.","journal-title":"Folia Microbiol"},{"issue":"5","key":"1719_CR4","doi-asserted-by":"publisher","first-page":"863","DOI":"10.3390\/ijerph15050863","volume":"15","author":"A Chlebicz","year":"2018","unstructured":"Chlebicz A, \u015ali\u017cewska K. Campylobacteriosis, salmonellosis, yersiniosis, and listeriosis as zoonotic foodborne diseases: a review. Int J Environ Res Public Health. 2018;15(5):863.","journal-title":"Int J Environ Res Public Health"},{"issue":"4","key":"1719_CR5","doi-asserted-by":"publisher","first-page":"901","DOI":"10.1128\/CMR.00002-15","volume":"28","author":"JA Crump","year":"2015","unstructured":"Crump JA, Sj\u00f6lund-Karlsson M, Gordon MA, Parry CM. Epidemiology, clinical presentation, laboratory diagnosis, antimicrobial resistance, and antimicrobial management of invasive Salmonella infections. Clin Microbiol Rev. 2015;28(4):901\u201337.","journal-title":"Clin Microbiol Rev"},{"issue":"10","key":"1719_CR6","doi-asserted-by":"publisher","first-page":"e0006779","DOI":"10.1371\/journal.pntd.0006779","volume":"12","author":"CD Britto","year":"2018","unstructured":"Britto CD, Wong VK, Dougan G, Pollard AJ. A systematic review of antimicrobial resistance in Salmonella enterica serovar Typhi, the etiological agent of typhoid. PLoS Negl Trop Dis. 2018;12(10):e0006779.","journal-title":"PLoS Negl Trop Dis"},{"key":"1719_CR7","doi-asserted-by":"publisher","first-page":"1535","DOI":"10.2147\/IDR.S203654","volume":"12","author":"E Abbasi","year":"2019","unstructured":"Abbasi E, Abtahi H, van Belkum A, Ghaznavi-Rad E. Multidrug-resistant Shigella infection in pediatric patients with diarrhea from central Iran. Infect Drug Resist. 2019;12:1535.","journal-title":"Infect Drug Resist"},{"issue":"7","key":"1719_CR8","doi-asserted-by":"publisher","first-page":"1080","DOI":"10.1089\/mdr.2018.0455","volume":"25","author":"E Abbasi","year":"2019","unstructured":"Abbasi E, van Belkum A, Ghaznavi-Rad E. Quinolone and macrolide-resistant campylobacter jejuni in pediatric gastroenteritis patients from Central Iran. Microb Drug Resist. 2019;25(7):1080\u20136.","journal-title":"Microb Drug Resist"},{"key":"1719_CR9","doi-asserted-by":"publisher","first-page":"1387","DOI":"10.2147\/IDR.S247732","volume":"13","author":"E Abbasi","year":"2020","unstructured":"Abbasi E, Mondanizadeh M, van Belkum A, Ghaznavi-Rad E. Multi-drug-resistant diarrheagenic Escherichia coli pathotypes in pediatric patients with gastroenteritis from central Iran. Infect Drug Resist. 2020;13:1387.","journal-title":"Infect Drug Resist"},{"issue":"2","key":"1719_CR10","first-page":"172","volume":"8","author":"E Abbasi","year":"2019","unstructured":"Abbasi E, Amouzandeh-Nobaveh A, Ghaznavi-Rad E. Frequency of Listeria monocytogenes Isolated from diarrhea samples of pediatric patients at central Iran. Rep Biochem Mol Biol. 2019;8(2):172.","journal-title":"Rep Biochem Mol Biol"},{"issue":"1","key":"1719_CR11","first-page":"15","volume":"5","author":"E Abbasi","year":"2016","unstructured":"Abbasi E, Khansari-nejad B, Abtahi H, Akbari M, Ghaznavi-rad E. Low prevalence of Aeromonas hydrophilain infectious diarrhea samples of pediatric patients in Arak, Iran. Rep Biochem Mol Biol. 2016;5(1):15.","journal-title":"Rep Biochem Mol Biol"},{"key":"1719_CR12","doi-asserted-by":"crossref","unstructured":"Mazaheri M, Haji Rezaei M, Aalinezhad M, Sharif MR, Akhavan T. Clinical and laboratory characteristics of pediatric Campylobacter spp. Acute Gastroenteritis. Arch Pediatric Infect Dis. 2016:1\u20136.","DOI":"10.5812\/pedinfect.35730"},{"key":"1719_CR13","unstructured":"Patel J, Cockerill III F, Eliopoulos G, Jenkins S, Lewis J, Limbago B, et al. M100 Performance standards for antimicrobial susceptibility testing. United State: Clinical and Laboratory Standards Institute. 2017:240."},{"issue":"9","key":"1719_CR14","doi-asserted-by":"publisher","first-page":"1573","DOI":"10.3390\/ijerph16091573","volume":"16","author":"A Harb","year":"2019","unstructured":"Harb A, Abraham S, Rusdi B, Laird T, O\u2019Dea M, Habib I. Molecular detection and epidemiological features of selected bacterial, viral, and parasitic enteropathogens in stool specimens from children with acute diarrhea in Thi-Qar Governorate, Iraq. Int J Environ Res Public Health. 2019;16(9):1573.","journal-title":"Int J Environ Res Public Health"},{"issue":"4","key":"1719_CR15","doi-asserted-by":"publisher","first-page":"184","DOI":"10.1179\/2047773215Y.0000000022","volume":"109","author":"W Guo","year":"2015","unstructured":"Guo W, Shan K, Xu B, Li J. Determining the resistance of carbapenem-resistant Klebsiella pneumoniae to common disinfectants and elucidating the underlying resistance mechanisms. Pathog Global Health. 2015;109(4):184\u201392.","journal-title":"Pathog Global Health"},{"key":"1719_CR16","doi-asserted-by":"crossref","unstructured":"Mamuye Y, Metaferia G, Birhanu A, Desta K, Fantaw S. Isolation and antibiotic susceptibility patterns of Shigella and Salmonella among under 5 children with acute diarrhoea: A cross-sectional study at selected public health facilities in Addis Ababa, Ethiopia. Clinical Microbiology: Open Access. 2015.","DOI":"10.4172\/2327-5073.1000186"},{"issue":"1","key":"1719_CR17","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1556\/030.64.2017.007","volume":"64","author":"R Ranjbar","year":"2017","unstructured":"Ranjbar R, Bolandian M, Behzadi P. Virulotyping of Shigella spp isolated from pediatric patients in Tehran Iran. Acta Microbiol Immunol Hung. 2017;64(1):71\u201380.","journal-title":"Acta Microbiol Immunol Hung"},{"issue":"Pt 4","key":"1719_CR18","doi-asserted-by":"publisher","first-page":"432","DOI":"10.1099\/jmm.0.000043","volume":"64","author":"A Saeed","year":"2015","unstructured":"Saeed A, Abd H, Sandstrom G. Microbial aetiology of acute diarrhoea in children under five years of age in Khartoum, Sudan. J Med Microbiol. 2015;64(Pt 4):432.","journal-title":"J Med Microbiol"},{"key":"1719_CR19","unstructured":"Farahani NN, Jazi FM, Nikmanesh B, Asadolahi P, Kalani BS, Amirmozafari N. Prevalence and antibiotic susceptibility patterns of Salmonella and Shigella species isolated from pediatric diarrhea in Tehran. Archives of Pediatric Infectious Diseases. 2018 (in press)."},{"key":"1719_CR20","unstructured":"Asrat D. Shigella and Salmonella serogroups and their antibiotic susceptibility patterns in Ethiopia. 2008."},{"issue":"3","key":"1719_CR21","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1007\/s10344-004-0052-1","volume":"50","author":"K Vlahovi\u0107","year":"2004","unstructured":"Vlahovi\u0107 K, Matica B, Bata I, Pavlak M, Pavi\u010di\u0107 \u017d, Popovi\u0107 M, et al. Campylobacter, Salmonella and Chlamydia in free-living birds of Croatia. Eur J Wildl Res. 2004;50(3):127\u201332.","journal-title":"Eur J Wildl Res"},{"issue":"3","key":"1719_CR22","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1080\/21553769.2015.1051243","volume":"8","author":"S-K Eng","year":"2015","unstructured":"Eng S-K, Pusparajah P, Ab Mutalib N-S, Ser H-L, Chan K-G, Lee L-H. Salmonella: a review on pathogenesis, epidemiology and antibiotic resistance. Front Life Sci. 2015;8(3):284\u201393.","journal-title":"Front Life Sci"},{"key":"1719_CR23","doi-asserted-by":"publisher","first-page":"288","DOI":"10.3389\/fmicb.2013.00288","volume":"4","author":"MB Zaidi","year":"2013","unstructured":"Zaidi MB, Estrada-Garc\u00eda T, Campos FD, Chim R, Arjona F, Leon M, et al. Incidence, clinical presentation, and antimicrobial resistance trends in Salmonella and Shigella infections from children in Yucatan, Mexico. Front Microbiol. 2013;4:288.","journal-title":"Front Microbiol"},{"key":"1719_CR24","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1016\/j.micpath.2017.05.023","volume":"109","author":"S Mahmoudi","year":"2017","unstructured":"Mahmoudi S, Pourakbari B, Moradzadeh M, Eshaghi H, Ramezani A, Ashtiani MTH, et al. Prevalence and antimicrobial susceptibility of Salmonella and Shigella spp. among children with gastroenteritis in an Iranian referral hospital. Microbial Pathog. 2017;109:45\u20138.","journal-title":"Microbial Pathog"},{"issue":"08","key":"1719_CR25","doi-asserted-by":"publisher","first-page":"981","DOI":"10.3855\/jidc.3817","volume":"8","author":"FN Qamar","year":"2014","unstructured":"Qamar FN, Azmatullah A, Kazi AM, Khan E, Zaidi AKM. A three-year review of antimicrobial resistance of Salmonella enterica serovars Typhi and Paratyphi A in Pakistan. J Infect Dev Ctries. 2014;8(08):981\u20136.","journal-title":"J Infect Dev Ctries"},{"issue":"04","key":"1719_CR26","doi-asserted-by":"publisher","first-page":"289","DOI":"10.3855\/jidc.224","volume":"2","author":"R Hasan","year":"2008","unstructured":"Hasan R, Zafar A, Abbas Z, Mahraj V, Malik F, Zaidi A. Antibiotic resistance among Salmonella enterica serovars Typhi and Paratyphi A in Pakistan (2001\u20132006). J Infect Dev Ctries. 2008;2(04):289\u201394.","journal-title":"J Infect Dev Ctries"},{"issue":"4","key":"1719_CR27","doi-asserted-by":"publisher","first-page":"436","DOI":"10.1002\/fsn3.119","volume":"2","author":"YO Adesiji","year":"2014","unstructured":"Adesiji YO, Deekshit VK, Karunasagar I. Antimicrobial-resistant genes associated with Salmonella spp. isolated from human, poultry, and seafood sources. Food Sci Nutr. 2014;2(4):436\u201342.","journal-title":"Food Sci Nutr"},{"issue":"4","key":"1719_CR28","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1089\/fpd.2010.0736","volume":"8","author":"R Ranjbar","year":"2011","unstructured":"Ranjbar R, Giammanco GM, Farshad S, Owlia P, Aleo A, Mammina C. Serotypes, antibiotic resistance, and class 1 integrons in Salmonella isolates from pediatric cases of enteritis in Tehran, Iran. Foodborne Pathog Dis. 2011;8(4):547\u201353.","journal-title":"Foodborne Pathog Dis"},{"issue":"3","key":"1719_CR29","doi-asserted-by":"publisher","first-page":"318","DOI":"10.1111\/j.1472-765X.2007.02311.x","volume":"46","author":"C Yoke-Kqueen","year":"2008","unstructured":"Yoke-Kqueen C, Learn-Han L, Noorzaleha A, Son R, Sabrina S, Jiun-Horng S, et al. Characterization of multiple-antimicrobial-resistant Salmonella enterica subsp. enterica isolated from indigenous vegetables and poultry in Malaysia. Lett Appl Microbiol. 2008;46(3):318\u201324.","journal-title":"Lett Appl Microbiol"},{"issue":"4","key":"1719_CR30","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1016\/j.puhe.2004.04.009","volume":"119","author":"K Akinyemi","year":"2005","unstructured":"Akinyemi K, Smith S, Oyefolu AB, Coker A. Multidrug resistance in Salmonella enterica serovar typhi isolated from patients with typhoid fever complications in Lagos, Nigeria. Public Health. 2005;119(4):321\u20137.","journal-title":"Public Health"},{"key":"1719_CR31","doi-asserted-by":"publisher","first-page":"299","DOI":"10.3389\/fmicb.2017.00299","volume":"8","author":"BR Pribul","year":"2017","unstructured":"Pribul BR, Festivo ML, Rodrigues MS, Costa RG, Rodrigues ECdP, de Souza M, et al. Characteristics of quinolone resistance in Salmonella spp isolates from the food chain in Brazil. Front Microbiol. 2017;8:299.","journal-title":"Front Microbiol"},{"key":"1719_CR32","doi-asserted-by":"publisher","first-page":"189","DOI":"10.2174\/1874285801711010189","volume":"11","author":"S Malehmir","year":"2017","unstructured":"Malehmir S, Ranjbar R, Harzandi N. The molecular study of antibiotic resistance to quinolones in Salmonella enterica strains isolated in Tehran, Iran. Open Microbiol J. 2017;11:189.","journal-title":"Open Microbiol J"},{"key":"1719_CR33","doi-asserted-by":"crossref","unstructured":"Akinyemi K, Coker A. Trends of antibiotic resistance in Salmonella enterica serovar typhi isolated from hospitalized patients from 1997 to 2004 in Lagos, Nigeria. 2007.","DOI":"10.4103\/0255-0857.37369"},{"issue":"06","key":"1719_CR34","doi-asserted-by":"publisher","first-page":"467","DOI":"10.3855\/jidc.419","volume":"3","author":"Y Kumar","year":"2009","unstructured":"Kumar Y, Sharma A, Mani KR. High level of resistance to nalidixic acid in Salmonella enterica serovar Typhi in Central India. J Infect Dev Ctries. 2009;3(06):467\u20139.","journal-title":"J Infect Dev Ctries"},{"issue":"1","key":"1719_CR35","doi-asserted-by":"publisher","first-page":"31","DOI":"10.4103\/0255-0857.124292","volume":"32","author":"V Geetha","year":"2014","unstructured":"Geetha V, Yugendran T, Srinivasan R, Harish B. Plasmid-mediated quinolone resistance in typhoidal Salmonellae: a preliminary report from South India. Indian J Med Microbiol. 2014;32(1):31.","journal-title":"Indian J Med Microbiol"},{"issue":"2","key":"1719_CR36","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1007\/s00580-010-1078-2","volume":"21","author":"M Rad","year":"2012","unstructured":"Rad M, Kooshan M, Mesgarani H. Quinolone resistance among Salmonella enterica and Escherichia coli of animal origin. Comp Clin Pathol. 2012;21(2):161\u20135.","journal-title":"Comp Clin Pathol"},{"issue":"8","key":"1719_CR37","doi-asserted-by":"publisher","first-page":"2575","DOI":"10.1128\/JCM.00062-07","volume":"45","author":"H Solnik-Isaac","year":"2007","unstructured":"Solnik-Isaac H, Weinberger M, Tabak M, Ben-David A, Shachar D, Yaron S. Quinolone resistance of Salmonella enterica serovar Virchow isolates from humans and poultry in Israel: evidence for clonal expansion. J Clin Microbiol. 2007;45(8):2575\u20139.","journal-title":"J Clin Microbiol"},{"issue":"7","key":"1719_CR38","first-page":"12","volume":"2","author":"A Hindi","year":"2014","unstructured":"Hindi A, Addos S, Ahmed E. Molecularstudy on multidrug resistant of Salmonella enterica isolated from patients with enteric fever in Najaf-Province\/Iraq. Int Res J Med Sci. 2014;2(7):12\u20136.","journal-title":"Int Res J Med Sci"},{"issue":"6","key":"1719_CR39","doi-asserted-by":"crossref","first-page":"432","DOI":"10.7883\/yoken.JJID.2009.432","volume":"62","author":"Y Jin","year":"2009","unstructured":"Jin Y, Ling J. Prevalence of integrons in antibiotic-resistant Salmonella spp, Hong Kong. Jpn J Infect Dis. 2009;62(6):432\u20139.","journal-title":"Jpn J Infect Dis"},{"issue":"5","key":"1719_CR40","doi-asserted-by":"publisher","first-page":"639","DOI":"10.1093\/jac\/dki076","volume":"55","author":"HY Kang","year":"2005","unstructured":"Kang HY, Jeong YS, Oh JY, Tae SH, Choi CH, Moon DC, et al. Characterization of antimicrobial resistance and class 1 integrons found in Escherichia coli isolates from humans and animals in Korea. J Antimicrob Chemother. 2005;55(5):639\u201344.","journal-title":"J Antimicrob Chemother"},{"issue":"2","key":"1719_CR41","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1016\/j.ijantimicag.2017.10.004","volume":"51","author":"M Kaushik","year":"2018","unstructured":"Kaushik M, Kumar S, Kapoor RK, Virdi JS, Gulati P. Integrons in Enterobacteriaceae: diversity, distribution and epidemiology. Int J Antimicrob Agents. 2018;51(2):167\u201376.","journal-title":"Int J Antimicrob Agents"}],"container-title":["BMC Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12876-021-01719-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12876-021-01719-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12876-021-01719-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,24]],"date-time":"2023-10-24T11:20:10Z","timestamp":1698146410000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcgastroenterol.biomedcentral.com\/articles\/10.1186\/s12876-021-01719-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,30]]},"references-count":41,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["1719"],"URL":"https:\/\/doi.org\/10.1186\/s12876-021-01719-3","relation":{},"ISSN":["1471-230X"],"issn-type":[{"value":"1471-230X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,30]]},"assertion":[{"value":"30 September 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 March 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 March 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study received ethical approval from the Arak University of Medical Sciences (Numbers: 2137 and 2571). Informed consent was obtained from a parent and\/or guardian for participants under 16\u00a0years old. A signed consent form was obtained from each patient. There was no access to any information that enabled authors to identify individual patients.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors stipulate that they have no conflict of interest in regard to this study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"140"}}