ABSTRACT
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 19972014 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