1. Introduction
In human beings, the urinary system plays an important role in filtering blood by eliminating waste materials and extra water in the form of urine. The urinary system consists of several important organs like kidneys, ureters, urinary bladder, and urethra. Urine is either sterile or has a very low concentration of pathogenic germs in healthy individuals, but for individuals with a higher concentration of pathogens, urinary tract infections prevail [1]. Urinary tract infections (UTIs) are a common bacterial ailment, affecting 150 million people annually and carrying a high risk of morbidity and expensive medical expenses. These infections can affect the urethra, the urinary bladder, or the kidneys. UTIs typically involve members of the Enterobacteriaceae family, with Uropathogenic Escherichia coli being the most common pathogen to be isolated [2]. UTIs initiate when adhesins in the lower alimentary canal begin to nurture pathogens that gradually reach the urethra and then the urinary bladder. The bacteria start to develop and produce toxins and enzymes that help them counter the host’s inflammatory reaction to flush the toxins. Bacteria may develop from subsequent kidney colonization if the infection penetrates the kidney epithelial barrier.
A urine culture tests urine samples for bacterial or fungal (yeast) infections, as identified and quantified by trained microbiologists. Now, this is a labor-intensive and time-consuming process, which is also prone to human error that often leads to delays in diagnosis and treatment.
Over the last few decades, artificial intelligence has shown promising results thanks to the availability of large-scale datasets. Besides several interdisciplinary domains, artificial intelligence has revolutionized the fields of medical diagnosis, by recognizing certain critical features of importance. Convolutional neural networks (
In recent years, numerous research have manifested the power of machine intelligence for medical diagnosis and experienced satisfactory results. Agrawal et al. contributed a Content-Based Medical Image Retrieval (CBMIR) system using deep neural models with transfer learning for lung disease detection using COVID-19 X-ray images, which resulted in an improvement in diagnostic metrics across subclasses in their research [6]. Sheikh and Chachoo, in their research, introduced a class-wise dictionary learning approach for low-rank representation-based medical image classification improving robustness against noise by learning patterns for each class as tuples in the dictionary, addressing performance degradation caused by outliers in medical images. The model achieved good results based on its performance on the biomedical database [7]. Asghari developed an IoT-based predictive model using smart wearable embedded systems for early colorectal cancer (CRC) detection in elderly patients, analyzing vital health indicators using machine learning methods in his research. The model achieved good results, especially in its implementation during the COVID-19 pandemic [8]. Singh and Kumar, in their contribution, developed Inception network block (InDAENET)-integrated Denoising Autoencoders with an Inception network block to improve the quality of histopathological images of breast cancer. The proposed approach has been validated on the BreakHis dataset and is found to outperform traditional Denoising Autoencoder methods [9]. Singh and Agarwal developed a novel convolutional neural network (CNN) architecture for the automated classification and segmentation of brain tumors from MRI images through their research. The proposed model was tested on contrast-enhanced T1 MRI images and achieved a classification accuracy of 92.50% using ten-fold cross-validation [10]. Mahajan et al. contributed an ontology-based intelligent system for the prognosis of Myasthenia Gravis (MG) using ontology, semantic web rules, and reasoners to determine patient status (positive or negative) through their research [11].
The diagnosis of microbial infections (like urinary tract infections) has traditionally relied on culture-based methods, biochemical assays, and molecular techniques—like polymerase chain reaction (PCR) [12], 16S rRNA sequencing [13], and matrix-assisted laser desorption/ionization–time of flight mass spectrometry (MALDI-TOF MS) [14]. These techniques often offer good specificity and therefore accurate identification of pathogens, but they require specialized equipment, trained personnel, and higher costs for their operation. Computer vision-based techniques can reduce the additional constraints of cost and equipment, and can assist expert supervision using machine intelligence. The specific advantages such techniques can offer are as follows: They can come up with rapid preliminary results, allowing molecular testing to focus only on clinically relevant cases, thus reducing stress on traditional techniques. It will enhance pathogen identification (overall) by combining phenotypic (culture-based) and genotypic (molecular-based) data. Additionally, such techniques are generally much more scalable; i.e., even in places where resources of traditional techniques do not exist, such techniques can be taken into account. Particular to molecular biology, multiple works have cited the improved accuracies and scalability of artificial intelligence (computer vision)-based techniques for the diagnosis of microbial infections. Goździkiewicz and her colleagues performed a review of AI-based techniques for the diagnosis of urinary tract infections [15]. They reported that “AI models achieve a high performance in retrospective studies”. They further added that though technically relevant, computer vision is a comparatively new field, thus requiring further research. Shelke et al. identified the application of artificial intelligence to improve existing disease management, antibiotic resistance, epidemiological monitoring, etc. [16]. They also reported faster, precise, and scalable applications. Further, Tsitou et al. reviewed the transformative impact of artificial intelligence on microbiology [17]. They suggested the need of “interpretable AI models that align with medical and ethical standards” to digitalize the diagnosis of microbial infections. The need of the hour is therefore to integrate machine intelligence with expert knowledge, and therefore make the diagnostics much more affordable, reliable, scalable, and robust.
In this research, a dataset consisting of urine culture on Petri dishes as contributed by da Silva et al. [18] is considered, and further, some deep learning models (e.g.,
The organization of the research is as follows: Section 2 presents the dataset and its relevant details, along with the deep learning methodologies developed for this research. Section 3 presents the results on a few well-known metrics. In Section 4, we summarize the pros and cons of the proposed
2. Data and Methods
This section discusses the urine culture dataset, and further, the deep learning methodologies that have been utilized to label them. The dataset and the relevant statistics are delineated in Section 2.1, and the deep learning models are discussed in Section 2.2.
2.1. Data
Gabriel Rodrigues da Silva, from the University of São Paulo, along with his colleagues, provided a dataset [18] consisting of a collection of images of urine culture Petri dishes, captured under standardized lighting and placement conditions to ensure consistency. The authors added that the images were acquired using a hardware chamber equipped with a smartphone camera (12 MP resolution) and an LED lighting source, ensuring uniform illumination; the culture plates were incubated at 35 °C for a minimum duration of 24 h, following standard microbiological procedures. When no significant growth was observed after 24 h, the incubation was extended to 48 h before any verdict. For preliminary screening [19], cultures producing two or more Colony-Forming Units (CFUs) of the same morphology were classified as Positive. These plates were considered ready for result interpretation after 24 h of incubation. Cultures showing no bacterial growth (0 CFU) were labeled as Negative, whereas cultures with only one CFU or mixed colony growth were categorized as Uncertain. While this classification framework facilitates the early identification of microbial growth, it does not align with traditional clinical microbiology cut-offs, where significant bacteriuria is typically defined as ≥ CFU/mL for symptomatic patients and ≥ CFU/mL for asymptomatic individuals. The choice of two CFUs as a threshold in this dataset (as chosen by da Silva et al.) was designed for the automated detection of early microbial growth in the cultures, thus enabling computer vision-based diagnostics.
Figure 1 illustrates examples from the dataset, showcasing three different samples for each of the three categories. Quantitatively, the dataset consists of 498 Positive, 500 Negative, and 502 Uncertain annotated urine sample images, providing a balanced distribution for deep learning model training and evaluation.
2.2. Methods
Getting supervised by the training dataset as described in Section 2.1, the deep learning models would be able to classify the urine cultures based on bacterial presence. For the context of this research, we have classified the datasets using models inheriting Multi-Layered Perceptrons and the Kolmogorov–Arnold Network architecture.
2.2.1. Multi-Layered Perceptrons
Multi-Layered Perceptrons (
Let be a variable, nonlinear, bounded, and continuous function. Assume is a unit dimensional hypercube, and the set of all continuous functions on is denoted as ; then, for any function , there exists and constants , and , such that
Multi-Layered Perceptrons, also known as “nonlinear regressors”, are widely used in machine learning. However, they have certain inherent drawbacks. For example, in
The deep learning models with the
VGG-16 andVGG-19 [21] with 16 and 19 layers, respectively, achieving excellent performance on image recognition tasks.Tiny VGG [22], a simplified, lightweight, and efficient version of the VGG architecture.Vision Permutator [23], which focuses on permuting the input data across different dimensions, enabling efficient and flexible attention mechanisms for visual tasks.Vision Transformer [24], which applies theTransformer [20] architecture directly to image patches, treating them as sequences.ViT has demonstrated state-of-the-art performance on image classification tasks.Class-Attention in Vision Transformers [25], which incorporates attention weights that emphasize the relevance of image patches to a particular class during the classification process.Other well-implemented models like
DenseNet [26],Xception [27],ResNet-18 [28], andGoogLeNet [29].
2.2.2. Kolmogorov–Arnold Networks
Recently, Liu, Wang et al., in their groundbreaking contribution, “KAN: Kolmogorov–Arnold Networks” [30], addressed the same issue and proposed a network that possesses learnable activation (here, B-Splines) functions rather than weights on the edges. The segments are further combined using the Kolmogorov–Arnold Representation Theorem (refer to Theorem 2).
Assume is a unit dimensional hypercube, and the set of all continuous functions on is denoted as ; then, for any function , there exist uni-variate, continuous functions , , and , such that
Figure 2b gives a pictorial demonstration of a shallow
and , considering theK2AN (refer to Figure 3a), with aKAN network after the convolution operations made usingKAN-Convolution . Herein, the input features are followed by two consecutive layers ofKAN-Convolution and a two-dimensionalMax-Pooling layer. The result is eventually flattened to pass through aKAN-Linear layer (for any supervised learning problem with a training set, , where are the feature vectors and are the respective targets,KAN layer of input dimension , an output dimension , with , and ), and finally gives a ternary output on whether the input urine culture image is “positive”, “negative”, or “uncertain”.KAN-C-Norm (refer to Figure 3b), with a batch-normalized version ofKAN-Convolution [31] (for any given image , theKAN-Convolution , inheriting from the basics ofKAN-Linear is defined as). Herein, the input features are followed by a sequence of two consecutive
2D-Convolution and2D-Batch-Normalization layers. The result is passed through a two-dimensionalMax-Pooling layer, then flattened to pass through aKAN-Linear layer, and finally gives a ternary output on whether the input urine culture image is “positive”, “negative”, or “uncertain”.KAN-C-MLP (refer to Figure 3c), with a combination ofKAN-Convolution , together with the traditionalMLP substructure. Herein, the input features are followed by two consecutive layers ofKAN-Convolution and a two-dimensionalMax-Pooling layer. The result is eventually flattened to pass through two consecutiveLinear layers, and finally gives a ternary output on whether the input urine culture image is “positive”, “negative”, or “uncertain”.
Figure 3 gives the block diagram of the different architectures.
3. Experimental Results
This section compares the well-known deep learning models named in Section 2.2 based on their ability to effectively classify the different samples of urine culture. For comparison, we considered the common metrics for benchmarking classifiers, which are discussed under Section 3.1. Further, the real-time comparison (or contrast) is as in Table 1 under Section 3.2, and the implementational details, especially for the architectures following the substructure of the Kolmogorov–Arnold Networks, are discussed under Section 3.3.
3.1. Metrics
The most common metrics for a classifier model in machine learning (or deep learning) are Accuracy (validation), Precision, Recall, and F1-Score [32]. For simplicity, let us consider patterns belonging to two classes and , with and data points, respectively, such that , where c is the total number of data points. Suppose the classifier can classify accurately out of , and out of data points. Thus, we can annotate the classifications into four categories, namely True Positive ( entities), True Negative ( entities), False Positive ( entities), and False Negative ( entities). Based on these annotations, the metrics can be represented mathematically as follows:
Accuracy: The ratio of correctly classified instances to the total number of instances evaluated by the classifier. This includes both True Positives and True Negatives among the correctly predicted instances. Mathematically, it is expressed as in Equation (1).
(1)
Precision: The ratio of True Positives evaluated by the classifier to the total number of correctly classified instances. It can also be interpreted as the accuracy of the positive predictions. Mathematically, it is expressed as in Equation (2).
(2)
Recall: The ratio of True Positives evaluated by the classifier to the actual positively classified instances. It can also be interpreted as the ability of the classifier to capture positive predictions. Mathematically, it is expressed as in Equation (3).
(3)
F1-Score: The harmonic mean of precision and recall, balancing the trade-off between them, especially useful when dealing with imbalanced datasets. Mathematically, it is expressed as in Equation (4).
(4)
Apart from these, the time needed to train the respective models (TrT, in seconds) and time to inference (IrT, in milliseconds) are reported in Table 1.
3.2. Comparative Analysis
A comparative analysis is performed to benchmark the efficiency of the deep learning models on their ability to classify the urine culture samples well. The contrast involves deep learning-based models involving both the Multi-Layered Perceptrons and Kolmogorov–Arnold Network architectures (refer to Section 2.2). Also, for each of the models, a set of 10 executions are performed, and the reported values are the arithmetic average of the observations made throughout the 10 iterations. The standard deviation of the mean is also reported. It is evident from Table 1 that the
3.3. Implementation
This research focuses mainly on a computer vision problem that involves implementing several deep learning models on the urine culture dataset. Each of these models had varying parameters and complexities, and especially due to computational limitations on our local machine, we carried out the experimentations of the research on the Google Colab Platform with a 12.7 GB System RAM, 100 GB Disk Space, and an NVIDIA T4 GPU. The models were supported by the PyTorch-2.0 framework as a backend. Though the
4. Discussion
This study highlights the significant potential of Kolmogorov–Arnold Networks (
5. Conclusions
Artificial intelligence and the large-scale availability of data have benefited many branches of sciences, technology, engineering, and management. Not only are the tasks supported by the higher accuracy of deep learning-based models, but also, they are time-efficient. Medical science has long been supported by the strong judgmental capabilities of medical professionals, but despite this, there are some false positives or false negatives, which affect the diagnosis process. Urine culture is performed in a clinical setting to identify the bacterial growth in one’s urine samples, which further fosters the diagnosis of UTIs. Studying urine samples requires expert supervision, and takes a considerable amount of time. This research suggested making use of deep learning-based image recognition techniques to effectively identify the presence of bacteria in one’s urine sample. Further, while the long-hailed Multi-Layered Perceptron architecture was able to detect UTI presence with an accuracy of nearly 80%, a state-of-the-art Kolmogorov–Arnold Network architecture was able to beat the accuracy benchmark and achieve an overwhelming accuracy of nearly 87%.
As addressed previously, a limitation of this proposed urine culture classification system is that it does not differentiate between bacterial species. For example, Staphylococcus epidermidis, a common skin commensal, is frequently isolated in urine cultures due to improper sample collection, which may result in false positives. In contrast, the presence of high CFU counts of uropathogenic
Conceptualization, A.D.; methodology, A.D. and A.R.; software, P.K.K. and M.G.L.; supervision, P.K.K.; validation, P.K.K. and A.R.; visualization, A.R.; writing—original draft, A.D.; writing—review and editing, M.G.L. All authors have read and agreed to the published version of the manuscript.
Not applicable.
Not applicable.
The dataset of interest in this article can be accessed from the article,
The authors declare no conflicts of interest.
Footnotes
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Figure 1. An instance of the urine culture dataset. Each image in the first column corresponds to the Positive category, wherein there exist [Forumla omitted. See PDF.] CFUs. The second column corresponds to the Negative category, wherein there is 0 CFU, and the third column corresponds to the Uncertain category, wherein there is either 1 CFU or growth of mixed colonies.
Figure 1. An instance of the urine culture dataset. Each image in the first column corresponds to the Positive category, wherein there exist [Forumla omitted. See PDF.] CFUs. The second column corresponds to the Negative category, wherein there is 0 CFU, and the third column corresponds to the Uncertain category, wherein there is either 1 CFU or growth of mixed colonies.
Figure 2. Contrast between a Multi-Layered Perceptron and the Kolmogorov–Arnold Network based on their architectural view. While the network in the left subfigure is a pictorial demonstration of the well-known Fully Connected Neural Network (which adheres to the Universal Approximation Theorem), the subfigure on the right gives a novel representation of the same Fully Connected Neural Network, where, unlike the weight distribution on the edges, learnable functions are deployed, resulting in better (parametrized) modeling of the data distribution. (a) Architectural view of a shallow Multi- Layered Perceptron, wherein each intermittent node is composed of a fixed activation function [Forumla omitted. See PDF.] and the edges of learnable weights [Forumla omitted. See PDF.]. They are combined as per the Universal Approximation Theorem, [Forumla omitted. See PDF.]. These are further stacked for deeper networks. (b) Architectural view of a shallow Kolmogorov–Arnold Network, wherein each intermittent node is composed of summation operators and the edges of learnable activation functions [Forumla omitted. See PDF.]. They are combined as per the Kolmogorov–Arnold Representation Theorem, [Forumla omitted. See PDF.].
Figure 3. Different architectures using the KAN substructure using KAN-Linear and KAN-Convolution. (a) Dual KAN Convolution (K2AN); (b) KAN Convolution with batch normalization (KAN-C-Norm); (c) Dual KAN Convolution with MLP (KAN-C-MLP).
Figure 4. Confusion matrices for the three top-performing models in chronological order by their achieved accuracies. (a) Confusion matrix for Visual Permutation (achieved accuracy: 79.66%); (b) confusion matrix for Visual Transformer (achieved accuracy: 80.33%); (c) confusion matrix for KAN-C-MLP (proposed) (achieved accuracy: 87.16%).
Figure 5. A few instances of misclassified data points (along with their true labels). In most of these cases, the samples classified under the Uncertain category were misclassified. (a) True Label—Uncertain, and Predicted Label—Positive; (b) True Label—Uncertain, and Predicted Label—Negative; (c) True Label—Positive, and Predicted Label—Negative; (d) True Label—Negative, and Predicted Label—Positive; (e) True Label—Uncertain, and Predicted Label—Negative; (f) True Label—Positive, and Predicted Label—Uncertain.
Tabular contrast between several deep learning models inheriting
Models | Metrics | |||||
---|---|---|---|---|---|---|
Accuracy | Precision | Recall | F1 Score | TrT (s) | IrT (ms) | |
| 67.66 | 69.05 | 65.48 | 0.6722 | 512.4 | 4.3 |
(1.5391) | (0.9323) | (0.8235) | (0.0862) | (12.6) | (0.5) | |
| 74.66 | 77.37 | 67.48 | 0.7209 | 923.1 | 6.8 |
(2.7392) | (1.1347) | (1.0925) | (0.0572) | (21.7) | (0.7) | |
| 73.33 | 72.51 | 72.33 | 0.7242 | 1058.6 | 7.4 |
(0.4823) | (1.9723) | (1.8241) | (0.0214) | (18.2) | (0.6) | |
| 78.66 | 80.22 | 74.25 | 0.7712 | 672.9 | 5.1 |
(3.0419) | (1.8452) | (1.8091) | (0.0627) | (14.5) | (0.4) | |
| 78.01 | 77.57 | 77.05 | 0.7731 | 588.3 | 3.9 |
(1.6528) | (0.7139) | (0.6482) | (0.1012) | (16.9) | (0.3) | |
| 79.66 | 80.21 | 78.95 | 0.7957 | 734.2 | 6.2 |
(2.0987) | (0.9135) | (0.8925) | (0.0514) | (19.8) | (0.5) | |
| 76.01 | 74.74 | 75.40 | 0.7507 | 892.7 | 5.9 |
(1.5763) | (0.8945) | (0.7936) | (0.1128) | (23.4) | (0.4) | |
| 78.66 | 78.57 | 77.75 | 0.7816 | 1001.4 | 8.1 |
(2.6345) | (1.6345) | (1.8415) | (0.0912) | (27.1) | (0.6) | |
| 76.33 | 75.34 | 75.92 | 0.7563 | 1187.9 | 7.6 |
(1.8724) | (1.3497) | (1.1095) | (0.0785) | (22.5) | (0.5) | |
| 80.33 | 80.51 | 79.08 | 0.7979 | 1403.5 | 9.2 |
(0.9156) | (1.4802) | (1.3496) | (0.0459) | (30.2) | (0.7) | |
| 75.21 | 75.55 | 73.63 | 0.7458 | 678.5 | 4.7 |
(1.1187) | (0.4921) | (0.2839) | (0.0063) | (12.8) | (0.3) | |
| 86.95 | 75.57 | 74.02 | 0.7479 | 532.9 | 3.5 |
(0.5634) | (0.4283) | (0.3991) | (0.0127) | (11.6) | (0.3) | |
87.16 | 77.03 | 68.01 | 0.7224 | 529.3 | 3.2 | |
(0.9654) | (1.2136) | (1.1906) | (0.1921) | (10.4) | (0.2) |
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Abstract
Medical diagnostics is an important step in the identification and detection of any disease. Generally, diagnosis requires expert supervision, but in recent times, the evolving emergence of machine intelligence and its widespread applications has necessitated the integration of machine intelligence with pathological expert supervision. This research aims to mitigate the diagnostics of urinary tract infections (UTIs) by visual recognition of Colony-Forming Units (CFUs) in urine culture. Recognizing the patterns specific to positive, negative, or uncertain UTI suspicion has been complemented with several neural networks inheriting the Multi-Layered Perceptron (MLP) architecture, like Vision Transformer, Class-Attention in Vision Transformers, etc., to name a few. In contrast to the fixed model edge weights of MLPs, the novel Kolmogorov–Arnold Network (KAN) architecture considers a set of trainable activation functions on the edges, therefore enabling better extraction of features. Inheriting the novel KAN architecture, this research proposes a set of three deep learning models, namely,
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1 Department of Computer Science and Engineering, Government College of Engineering and Textile Technology, Serampore 712201, Calcutta, India
2 Department of Mathematics, St. Joseph’s Institute of Technology, Chennai 600119, Tamil Nadu, India;
3 Department of Mathematics, Saveetha Engineering College, Chennai 602105, Tamil Nadu, India;
4 Department of Information Technology, Government College of Engineering and Textile Technology, Serampore 712201, Calcutta, India;