Prevalence of infectious organisms observed in cervical smears between 1997-2014 at Mubarak al-Kabeer Hospital, Kuwait

Abstract EN

Objectives: This study aimed to examine gynaecological infectious agents observed in conventional and modified Papanicolaou cervical smears (CS) at a tertiary care hospital in Kuwait.

Methods: This retrospective study analysed 121,443 satisfactory CS samples collected between 1997–2014 at the Mubarak Al-Kabeer Hospital, Kuwait.

Conventional CS samples were obtained between 1997–2005, while modified CS were obtained between 2006–2014 following the introduction of ThinPrep® testing (Hologic Corp., Bedford, Massachusetts, USA).

All samples were initially screened by cytoscreeners before being analysed by cytopathologists to determine the presence of specific infectious agents.

Results: Overall, 8,836 (7.28%) of the cervical samples had infectious agents; of these, 62.48% were conventional and 37.52% were modified CS samples.

The most frequently observed infectious agents were Candida species (76.05%), Trichomonas vaginalis (9.72%), human papillomavirus (HPV; 9.3%), Actinomyces-like organisms (3.23%), Chlamydia trachomatis (1.27%) and the herpes simplex virus (HSV; 0.43%).

There were significantly more cases of Candida species, HPV-associated changes, C.

trachomatis, T.

vaginalis and Actinomyces-like organisms detected in conventional compared to modified CS samples (P <0.050 each).

However, there was no statistically significant difference in the frequency of HSV-associated changes (P = 0.938).

The presence of two infectious agents in the same sample was identified in 0.87% of samples.

Conclusion: Among CS samples collected during an 18-year period, Candida species were most frequently detected, followed by T.

vaginalis and HPV.

The identification of potential infectious agents is a valuable additional benefit of Papanicolaou smear testing.