الملخص الإنجليزي
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
