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This prospective, longitudinal exploratory study applied a structured stepwise model to assess urinary isolates over 24 months at AIIMS Rishikesh, using REDCap for data capture and SPSS for analysis. Among 275 adult culture-positive patients, 90.54% were classified as pathogenic and 9.45% as non-pathogenic, showing safety and feasibility.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/stepwise-model-to-differentiate-pathogenic-from-non-pathogenic-organisms-in-urinary-isolates-effectiveness-safety-and-feasibility-prospective-study/435103/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/stepwise-model-to-differentiate-pathogenic-from-non-pathogenic-organisms-in-urinary-isolates-effectiveness-safety-and-feasibility-prospective-study/435103.png","ImageObject",300,407,{"name":92,"@type":93},"Kurz","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":52},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What problem does the study address in urinary tract infection management?","Question",{"text":112,"@type":113},"The study targets the difficulty of distinguishing true pathogens from commensals, colonizers, or contaminants when interpreting urine culture results, which strongly affects treatment decisions.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How does the stepwise model classify urinary isolates?",{"text":117,"@type":113},"It uses a structured stepwise approach to determine whether an isolate is pathogenic (commensal, colonizer, or direct pathogen) or non-pathogenic (commensal, colonizer, or contaminant).",{"name":119,"@type":110,"acceptedAnswer":120},"What were the main outcomes regarding safety and feasibility?",{"text":121,"@type":113},"The model identified about one in ten initially considered pathogenic isolates as non-pathogenic. 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The interpretation of urine culture results is influenced by proper sample collection, the patient's clinical context, and organism-specific characteristics. However, thereis currently no definitive method to determine whether a urinary isolate is truly pathogenic. This distinction is critical, as treatment decisions hinge on it. This pioneering study systematically applies a stepwise model to differentiate pathogenic from non-pathogenic urinary isolates—an approach not previously described.  \nAIM  \nTo determine whether a urinary isolate is pathogenic (commensal, colonizer, or direct pathogen) or non-pathogenic (commensal, colonizer, or contaminant) using a structured, stepwise approach.  \n WJEM  [https://www.wjgnet.com](https://www.wjgnet.com) 1 December 20, 2025  Volume 15  Issue 4   \nYadav B et al. Models for differentiating microorganisms in urine fractions  \nMETHODS  \nThis prospective, longitudinal, exploratory study was conducted over 24 months, starting in January 2022, at All India Institute of Medical Sciences Rishikesh, following approval from the Institutional Ethics Committee. A stepwise model developed by the investigators was applied to assess the nature of the isolates. Data recorded using REDCap, and analysis was performed using SPSS Version 25.  \nRESULTS  \nA total of 275 consecutive patients aged over 18 years with positive urine cultures—initially treated with antibiotics based on microbiological and clinical assessment—were included. The stepwise model classified 90.54% of cases as pathogenic (commensals: 61.81%, colonizers: 14.18%, and direct pathogens: 14.54%) and 9.45% as non-pathogenic. The model showed that there co","cbCaim2HxhXTjgnQ","https://ap.wps.com/l/cbCaim2HxhXTjgnQ","pdf",1372189,12,"English","# Abstract\n## Background\n## Aim\n## Methods\n## Results\n## Conclusion\n# Core Tip","[{\"question\":\"What problem does the study address in urinary tract infection management?\",\"answer\":\"The study targets the difficulty of distinguishing true pathogens from commensals, colonizers, or contaminants when interpreting urine culture results, which strongly affects treatment decisions.\"},{\"question\":\"How does the stepwise model classify urinary isolates?\",\"answer\":\"It uses a structured stepwise approach to determine whether an isolate is pathogenic (commensal, colonizer, or direct pathogen) or non-pathogenic (commensal, colonizer, or contaminant).\"},{\"question\":\"What were the main outcomes regarding safety and feasibility?\",\"answer\":\"The model identified about one in ten initially considered pathogenic isolates as non-pathogenic. It is reported as safe and feasible, with potential benefits including reduced hospital stay and antibiotic cost savings in the non-pathogenic cohort.\"}]","Stepwise model to differentiate pathogenic from non-pathogenic organisms in urinary isolates - Effectiveness, safety, and feasibility prospective study | PDF",1790671928]