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World J Methodol. Sep 20, 2026; 16(3): 115598
Published online Sep 20, 2026. doi: 10.5662/wjm.115598
Published online Sep 20, 2026. doi: 10.5662/wjm.115598
Stepwise model to differentiate pathogenic from non-pathogenic organisms in lower-respiratory isolates: Effectiveness and feasibility prospective cohort study
Shivnarayan Sahu, Partha Sahu, Department of Medicine, All India Institute of Medical Sciences, Rishikesh 249203, India
Balram Ji Omar, Department of Microbiology, All India Institute of Medical Sciences, Rishikesh 249203, India
Mukesh Bairwa, Division of Internal Medicine, All India Institute of Medical Sciences, Rishikesh 249203, India
Prakhar Sharma, Division of Pulmonary, Sleep and Critical Care Medicine, All India Institute of Medical Sciences Rishikesh, Rishikesh 249203, India
Prasan Kumar Panda, Internal Medicine (ID Division), All India Institute of Medical Sciences, Rishikesh 249203, India
Author contributions: Sahu S and Sahu P designed, collected data, analysed, wrote, reviewed, and approved the manuscript; Panda PK, Omar BJ, Bairwa M, and Sharma P gave the concept, designed, analysed, critically reviewed, and approved the manuscript.
Institutional review board statement: The study was reviewed and approved by Institutional Ethics Committee of All India Institute of Medical Sciences, Rishikesh, India.
Clinical trial registration statement: Considering observational study, it was not registered.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
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: All data was shared in the published article; the corresponding authors can be reached for any other clarification.
Corresponding author: Prasan Kumar Panda, MD, MBBS, Professor, Internal Medicine (ID Division), All India Institute of Medical Sciences, Room No. 409, College Block, Rishikesh 249203, India. motherprasanna@rediffmail.com
Received: October 21, 2025
Revised: December 11, 2025
Accepted: March 4, 2026
Published online: September 20, 2026
Processing time: 263 Days and 0.2 Hours
Revised: December 11, 2025
Accepted: March 4, 2026
Published online: September 20, 2026
Processing time: 263 Days and 0.2 Hours
Core Tip
Core Tip: This prospective cohort study developed a structured clinico-microbiological model to distinguish true pathogens from colonizers in lower respiratory tract infections. Among 145 cases, 90% were identified as pathogens, with treatment outcomes aligning closely with the model’s classifications. The findings highlight that microbiological detection alone is insufficient for diagnosing infection - integrating clinical context and outcome data is crucial for rational antibiotic use and effective antimicrobial stewardship.