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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Exp Med. Dec 20, 2025; 15(4): 109134
Published online Dec 20, 2025. doi: 10.5493/wjem.v15.i4.109134
Published online Dec 20, 2025. doi: 10.5493/wjem.v15.i4.109134
Stepwise model to differentiate pathogenic from non-pathogenic organisms in urinary isolates: Effectiveness, safety, and feasibility prospective study
Bimalesh Yadav, Jaideep Pilania, Ravi Kant, Prasan Kumar Panda, Department of Medicine, All India Institute of Medical Sciences, Rishikesh 249203, Uttarākhand, India
Balram Ji Omar, Department of Microbiology, All India Institute of Medical Sciences, Rishikesh 249203, Uttarākhand, India
Sandeep Saini, Department of Nephrology, All India Institute of Medical Sciences, Rishikesh 249203, Uttarākhand, India
Vikas Kumar Panwar, Department of Urology, All India Institute of Medical Sciences, Rishikesh 249203, Uttarakhand, India
Yogesh Bahurupi, Department of Community Medicine, All India Institute of Medical Sciences, Nagpur 441108, Mahārāshtra, India
Author contributions: Yadav B and Pilania J contributed to the data collection and data analysis and was involved in manuscript writing; Omar BJ, Saini S, Panwar VK, Bahurupi Y and Panda PK provided the concept, interpreted the analysis, critically reviewed the draft; and all authors approved it for publication.
Institutional review board statement: The study was reviewed and approved by Institutional Ethics Committee, AIIMS Rishikesh, ensuring patient confidentiality, data protection, and adherence to ethical standards in research involving human participants.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: We declare that we have no conflicts of interest.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Data sharing statement: It will be made available to others upon request to the corresponding author.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Prasan Kumar Panda, Professor, Department of Internal Medicine, All India Institute of Medical Sciences, Room No. 409, College Block, Rishikesh 249203, Uttarākhand, India. motherprasanna@rediffmail.com
Received: April 30, 2025
Revised: June 9, 2025
Accepted: October 15, 2025
Published online: December 20, 2025
Processing time: 233 Days and 18.6 Hours
Revised: June 9, 2025
Accepted: October 15, 2025
Published online: December 20, 2025
Processing time: 233 Days and 18.6 Hours
Core Tip
Core Tip: Differentiating true pathogens from colonizers or contaminants in urinary cultures remains a major challenge in clinical practice. This study presents a novel, stepwise model to assess the true pathogenicity of urinary isolates in hospitalized adults. The model identified nearly 10% of culture-positive cases—previously treated as infections—as non-pathogenic. This approach is safe, feasible, and potentially reduces unnecessary antibiotic use, especially in resource-limited settings.