Rana Al-Awadhi1, Azza Al-Shaheen2, Ahlam Al-Juwaiser2, Sara S George3, Prem Sharma4, Kusum Kapila3. 1. Department of Medical Laboratory Sciences, Faculty of Allied Health Sciences, Kuwait University, Kuwait. 2. Cytology Laboratory, Mubarak Al-Kabeer Hospital, Kuwait. 3. Department of Pathology, Faculty of Medicine, Kuwait University, Kuwait. 4. Department of Research & Biostatistics Unit, Faculty of Medicine, Kuwait University, Kuwait.
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 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.
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.
Authors: Kusum Kapila; Sara S George; Azza Al-Shaheen; M S Al-Ottibi; Shahed K Pathan; Zafar A Sheikh; Bahiya E Haji; Mrinmay K Mallik; Dilip K Das; Issam M Francis Journal: Med Princ Pract Date: 2006 Impact factor: 1.927
Authors: Diane Solomon; Diane Davey; Robert Kurman; Ann Moriarty; Dennis O'Connor; Marianne Prey; Stephen Raab; Mark Sherman; David Wilbur; Thomas Wright; Nancy Young Journal: JAMA Date: 2002-04-24 Impact factor: 56.272