Prevalence of Infectious Organisms Observed in Cervical Smears Between 1997-2014 at Mubarak Al-Kabeer Hospital, Kuwait.

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 species (76.05%), (9.72%), human papillomavirus (HPV; 9.3%), -like organisms (3.23%), (1.27%) and the herpes simplex virus (HSV; 0.43%). There were significantly more cases of species, HPV-associated changes, , and -like organisms detected in conventional compared to modified CS samples ( <0.050 each). However, there was no statistically significant difference in the frequency of HSV-associated changes ( = 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, species were most frequently detected, followed by and HPV. The identification of potential infectious agents is a valuable additional benefit of Papanicolaou smear testing.