Branch-Wise Regularization for Heterogeneous GNN-Based MALDI-TOF AMR Prediction with Biomarker-Consensus Edges

This paper predicts antimicrobial resistance (AMR) from matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectra using DRIAMS, evaluated across 13 species-antibiotic datasets spanning sensitive/resistant imbalance ratios of 2.95:1 to 141.21:1 and raw spectral similarities of 0.9166-0.9946. We propose HetSAGE, a heterogeneous graph neural network (GNN) that combines full-spectrum "raw" edges with consensus "biomarker" edges derived from a 4-method feature-selection vote and applies per-edge-type dropout to regularize the two views separately. HetSAGE outperforms a plain multilayer perceptron (MLP) only when spectral similarity is high, consistent with oversmoothing effects reported in the broader GNN literature; the biomarker view converges on features close to independently established clinical markers: within {+/-}1 Da in Staphylococcus aureus, Oxacillin, and within range in Klebsiella pneumoniae, Meropenem, confirming it is not a black box. At the same time, per-edge-type dropout protects this smaller signal from dilution by regularization tuned for the noisier raw spectrum. Together, these results indicate that heterogeneous graph structure is not a universal win for MALDI-TOF AMR prediction but a conditional one, tied to a measurable property of the data, spectral similarity, rather than to architecture alone. This caveat is largely unaddressed in current DRIAMS-based GNN work. It provides a concrete signal for practitioners deciding when a graph model is worth the added complexity over a plain MLP.