Capabilities of GPT-4o and Gemini 1.5 Pro in Gram stain and bacterial shape identification

Aim: Assessing the visual accuracy of two large language models (LLMs) in microbial classification.Materials & methods: GPT-4o and Gemini 1.5 Pro were evaluated in distinguishing Gram-positive from Gram-negative bacteria and classifying them as cocci or bacilli using 80 Gram stain images from a labeled database.Results: GPT-4o achieved 100% accuracy in identifying simultaneously Gram stain and shape for Clostridium perfringens, Pseudomonas aeruginosa and Staphylococcus aureus. Gemini 1.5 Pro showed more variability for similar bacteria (45, 100 and 95%, respectively). Both LLMs failed to identify both Gram stain and bacterial shape for Neisseria gonorrhoeae. Cumulative accuracy plots indicated that GPT-4o consistently performed equally or better in every identification, except for Neisseria gonorrhoeae's shape.Conclusion: These results suggest that these LLMs in their unprimed state are not ready to be implemented in clinical practice and highlight the need for more research with larger datasets to improve LLMs' effectiveness in clinical microbiology.