Automatic image classification for the urinoculture screening

Smart Diagnosis of Urinary Tract Infections: is Artificial Intelligence the Fast-Lane Solution?

PURPOSE OF REVIEW

Artificial intelligence (AI) can significantly improve physicians' workflow when examining patients with UTI. However, most contemporary reviews are focused on examining the usage of AI with a restricted quantity of data, analyzing only a subset of AI algorithms, or performing narrative work without analyzing all dedicated studies. Given the preceding, the goal of this work was to conduct a mini-review to determine the current state of AI-based systems as a support in UTI diagnosis.

RECENT FINDINGS

There are sufficient publications to comprehend the potential applications of artificial intelligence in the diagnosis of UTIs. Existing research in this field, in general, publishes performance metrics that are exemplary. However, upon closer inspection, many of the available publications are burdened with flaws associated with the improper use of artificial intelligence, such as the use of a small number of samples, their lack of heterogeneity, and the absence of external validation. AI-based models cannot be classified as full-fledged physician assistants in diagnosing UTIs due to the fact that these limitations and flaws represent only a portion of all potential obstacles. Instead, such studies should be evaluated as exploratory, with a focus on the importance of future work that complies with all rules governing the use of AI. AI algorithms have demonstrated their potential for UTI diagnosis. However, further studies utilizing large, heterogeneous, prospectively collected datasets, as well as external validations, are required to define the actual clinical workflow value of artificial intelligence.

A Comprehensive Survey with Quantitative Comparison of Image Analysis Methods for Microorganism Biovolume Measurements

With the acceleration of urbanization and living standards, microorganisms play an increasingly important role in industrial production, bio-technique, and food safety testing. Microorganism biovolume measurements are one of the essential parts of microbial analysis. However, traditional manual measurement methods are time-consuming and challenging to measure the characteristics precisely. With the development of digital image processing techniques, the characteristics of the microbial population can be detected and quantified. The applications of the microorganism biovolume measurement method have developed since the 1980s. More than 62 articles are reviewed in this study, and the articles are grouped by digital image analysis methods with time. This study has high research significance and application value, which can be referred to as microbial researchers to comprehensively understand microorganism biovolume measurements using digital image analysis methods and potential applications.

Synthesis and properties of maleic anhydride-modified agar with reversibly controlled gel strength

Agar is modified by chemical methods to improve its functional properties and meet the increasing demand of the market. Some of the functional properties of agar are improved after chemical modification, while other properties are reduced, especially gel strength. This study aimed to comprehensively improve the functional properties of agar through acylation and crosslinking by reacting with maleic anhydride. ¹³C NMR indicated the maleylation reaction was preferred at the C2 hydroxyl group of D-galactose, and the crosslinking reactions occurred at the C2 and C6 hydroxyl groups of D-galactose in different agar chains. Interestingly, the maleylated agar monoester had higher gel transparency (1.5%, w/v) of up to 76% than the native agar (58%). However, it showed a significant decrease in gel strength from 783 g/cm² to 403 g/cm², while crosslinking endowed agar with higher gel strength (845 g/cm²) and gel transparency (78.4%). The high transparency of the modified agar plate made colony observation and colony counting easy. Maleylation of agar further enhanced the freeze-thaw stability of agar gel (24.8%, 7th freeze-thaw cycles). Overall, the maleylated agar possessed superior functional properties, and it could be used as food, bacteriological, and biotechnological agar.

A comprehensive review of image analysis methods for microorganism counting: from classical image processing to deep learning approaches

Microorganisms such as bacteria and fungi play essential roles in many application fields, like biotechnique, medical technique and industrial domain. Microorganism counting techniques are crucial in microorganism analysis, helping biologists and related researchers quantitatively analyze the microorganisms and calculate their characteristics, such as biomass concentration and biological activity. However, traditional microorganism manual counting methods, such as plate counting method, hemocytometry and turbidimetry, are time-consuming, subjective and need complex operations, which are difficult to be applied in large-scale applications. In order to improve this situation, image analysis is applied for microorganism counting since the 1980s, which consists of digital image processing, image segmentation, image classification and suchlike. Image analysis-based microorganism counting methods are efficient comparing with traditional plate counting methods. In this article, we have studied the development of microorganism counting methods using digital image analysis. Firstly, the microorganisms are grouped as bacteria and other microorganisms. Then, the related articles are summarized based on image segmentation methods. Each part of the article is reviewed by methodologies. Moreover, commonly used image processing methods for microorganism counting are summarized and analyzed to find common technological points. More than 144 papers are outlined in this article. In conclusion, this paper provides new ideas for the future development trend of microorganism counting, and provides systematic suggestions for implementing integrated microorganism counting systems in the future. Researchers in other fields can refer to the techniques analyzed in this paper.

Trends in Incidence of Urinary Tract Infection in Mainland China from 1990 to 2019

Purpose

Urinary tract infection (UTI) is the second-most-common type of infection in China. This study aimed to determine the long-term trends in the incidence of UTI in Mainland China between 1990 and 2019.

Materials and Methods

Data were extracted from the Global Burden of Disease Study 2019 and were analyzed with the age–period–cohort framework.

Results

The net drift in the incidence of UTI was –0.37% (95% CI: –0.40%, –0.35%) in males and –0.25% (95% CI: –0.29%, –0.20%) in females. For males, the local drift was lower than 0 (P<0.05) among those younger than 90 years. For females, the local drift was lower than 0 (P<0.05) among those younger than 60 years and higher than 0 (P<0.05) in those aged 65–79 years. In the same birth cohort, the incidence of UTI was higher in females than in males in all age groups (P<0.05). The period relative risk (RR) showed a decreasing pattern after 2005 in both sexes. The cohort RR showed a downward trend of the birth cohort after 1905 for males and 1960 for females.

Conclusion

The incidence has increased significantly among older females over the past 30 years. It is necessary to develop a comprehensive intervention plan for reproductive health services covering females and males of all ages.

Consolidation of Clinical Microbiology Laboratories and Introduction of Transformative Technologies

Clinical microbiology is experiencing revolutionary advances in the deployment of molecular, genome sequencing-based, and mass spectrometry-driven detection, identification, and characterization assays. Laboratory automation and the linkage of information systems for big(ger) data management, including artificial intelligence (AI) approaches, also are being introduced. The initial optimism associated with these developments has now entered a more reality-driven phase of reflection on the significant challenges, complexities, and health care benefits posed by these innovations. With this in mind, the ongoing process of clinical laboratory consolidation, covering large geographical regions, represents an opportunity for the efficient and cost-effective introduction of new laboratory technologies and improvements in translational research and development. This will further define and generate the mandatory infrastructure used in validation and implementation of newer high-throughput diagnostic approaches. Effective, structured access to large numbers of well-documented biobanked biological materials from networked laboratories will release countless opportunities for clinical and scientific infectious disease research and will generate positive health care impacts. We describe why consolidation of clinical microbiology laboratories will generate quality benefits for many, if not most, aspects of the services separate institutions already provided individually. We also define the important role of innovative and large-scale diagnostic platforms. Such platforms lend themselves particularly well to computational (AI)-driven genomics and bioinformatics applications. These and other diagnostic innovations will allow for better infectious disease detection, surveillance, and prevention with novel translational research and optimized (diagnostic) product and service development opportunities as key results.

Image generation by GAN and style transfer for agar plate image segmentation

BACKGROUND AND OBJECTIVES

Deep learning models and specifically Convolutional Neural Networks (CNNs) are becoming the leading approach in many computer vision tasks, including medical image analysis. Nevertheless, the CNN training usually requires large sets of supervised data, which are often difficult and expensive to obtain in the medical field. To address the lack of annotated images, image generation is a promising method, which is becoming increasingly popular in the computer vision community. In this paper, we present a new approach to the semantic segmentation of bacterial colonies in agar plate images, based on deep learning and synthetic image generation, to increase the training set size. Indeed, semantic segmentation of bacterial colony is the basis for infection recognition and bacterial counting in Petri plate analysis.

METHODS

A convolutional neural network (CNN) is used to separate the bacterial colonies from the background. To face the lack of annotated images, a novel engine is designed - which exploits a generative adversarial network to capture the typical distribution of the bacterial colonies on agar plates - to generate synthetic data. Then, bacterial colony patches are superimposed on existing background images, taking into account both the local appearance of the background and the intrinsic opacity of the bacterial colonies, and a style transfer algorithm is used for further improve visual realism.

RESULTS

The proposed deep learning approach has been tested on the only public dataset available with pixel-level annotations for bacterial colony semantic segmentation in agar plates. The role of including synthetic data in the training of a segmentation CNN has been evaluated, showing how comparable performances can be obtained with respect to the use of real images. Qualitative results are also reported for a second public dataset in which the segmentation annotations are not provided.

CONCLUSIONS

The use of a small set of real data, together with synthetic images, allows obtaining comparable results with respect to using a complete set of real images. Therefore, the proposed synthetic data generator is able to address the scarcity of biomedical data and provides a scalable and cheap alternative to human ground-truth supervision.

Automatic hemolysis identification on aligned dual-lighting images of cultured blood agar plates

BACKGROUND AND OBJECTIVE

The recent introduction of Full Laboratory Automation systems in clinical microbiology opens to the availability of streams of high definition images representing bacteria culturing plates. This creates new opportunities to support diagnostic decisions through image analysis and interpretation solutions, with an expected high impact on the efficiency of the laboratory workflow and related quality implications. Starting from images acquired under different illumination settings (top-light and back-light), the objective of this work is to design and evaluate a method for the detection and classification of diagnostically relevant hemolysis effects associated with specific bacteria growing on blood agar plates. The presence of hemolysis is an important factor to assess the virulence of pathogens, and is a fundamental sign of the presence of certain types of bacteria.

METHODS

We introduce a two-stage approach. Firstly, the implementation of a highly accurate alignment of same-plate image scans, acquired using top-light and back-light illumination, enables the joint spatially coherent exploitation of the available data. Secondly, from each segmented portion of the image containing at least one bacterial colony, specifically designed image features are extracted to feed a SVM classification system, allowing detection and discrimination among different types of hemolysis.

RESULTS

The fine alignment solution aligns more than 98.1% images with a residual error of less than 0.13 mm. The hemolysis classification block achieves a 88.3% precision with a recall of 98.6%.

CONCLUSIONS

The results collected from different clinical scenarios (urinary infections and throat swab screening) together with accurate error analysis demonstrate the suitability of our system for robust hemolysis detection and classification, which remains feasible even in challenging conditions (low contrast or illumination changes).

Hyperspectral image analysis for rapid and accurate discrimination of bacterial infections: A benchmark study

With the rapid diffusion of Full Laboratory Automation systems, Clinical Microbiology is currently experiencing a new digital revolution. The ability to capture and process large amounts of visual data from microbiological specimen processing enables the definition of completely new objectives. These include the direct identification of pathogens growing on culturing plates, with expected improvements in rapid definition of the right treatment for patients affected by bacterial infections. In this framework, the synergies between light spectroscopy and image analysis, offered by hyperspectral imaging, are of prominent interest. This leads us to assess the feasibility of a reliable and rapid discrimination of pathogens through the classification of their spectral signatures extracted from hyperspectral image acquisitions of bacteria colonies growing on blood agar plates. We designed and implemented the whole data acquisition and processing pipeline and performed a comprehensive comparison among 40 combinations of different data preprocessing and classification techniques. High discrimination performance has been achieved also thanks to improved colony segmentation and spectral signature extraction. Experimental results reveal the high accuracy and suitability of the proposed approach, driving the selection of most suitable and scalable classification pipelines and stimulating clinical validations.

Innovations in healthcare and medicine editorial

This special issue editorial begins with a brief discussion on the current trends of innovations in healthcare and medicine driven by the evolution of sensing devices as well as the information processing techniques, and the social media revolution. This discussion aims to set the stage for the actual papers accepted for the special issue which are extensions of the papers presented at the InMed 2014 conference held in San Sebastian, Spain, in July 2014.