Prevalence of infectious organisms observed in cervical smears between 1997–2014 at mubarak Al-Kabeer hospital, Kuwait

Rana Al-Awadhi, Azza Al-Shaheen, Ahlam Al-Juwaiser, Sara S. George, Prem Sharma, Kusum Kapila

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1 Citation (Scopus)


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.

Original languageEnglish
Pages (from-to)e324-e328
JournalSultan Qaboos University Medical Journal
Issue number3
Publication statusPublished - 1 Aug 2018


  • Candida
  • Cervical smears
  • Cytology
  • Human papilloma virus
  • Infection
  • Kuwait
  • Papanicolaou test
  • Trichomonas vaginalis


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