Prevalence of cervical pathogens in women with and without inflammatory changes on smear testing.

OBJECTIVE--To assess correlation between nonspecific cervicitis, inflammation, or exudate on cervical smears tests and confirmed presence of known cervical pathogens. DESIGN--Investigation of women attending a family practice clinic for smear test by microbiological screening for Chlamydia trachomatis, Mycoplasma hominis, Ureaplasma urealyticum, Trichomonas vaginalis, Candida species, group B streptococcus, Gardnerella vaginalis, and Neisseria gonorrhoeae. SETTING--Family practice teaching clinic in a university hospital. PATIENTS--411 women presenting for a smear test. MAIN OUTCOME MEASURES--Prevalence of genital infections associated with presence or absence of inflammatory changes on cervical smear. RESULTS--Of the 132 women with inflammatory changes on cervical smear, 64 (48%) had positive cultures. Of the 248 without inflammatory changes, 117 (47%) had positive cultures. Subgroup analysis on individual organisms also showed no significant difference between the two groups. CONCLUSION--Reports of inflammatory changes on cervical smear testing are a poor indicator of infection.

[1]  K. Noller,et al.  Detection of chlamydial cervicitis by Papanicolaou stained smears and culture. , 1983, American journal of clinical pathology.

[2]  L. Koss Diagnostic cytology and its histopathologic bases , 1968 .

[3]  R. Percival-Smith,et al.  Prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae in two different populations of women. , 1981, Canadian Medical Association journal.

[4]  D. Addiss,et al.  Selective screening for Chlamydia trachomatis infection in nonurban family planning clinics in Wisconsin. , 1987, Family planning perspectives.

[5]  K. Holmes,et al.  Cytologic manifestations of cervical and vaginal infections. II. Confirmation of Chlamydia trachomatis infection by direct immunofluorescence using monoclonal antibodies. , 1985, JAMA.

[6]  B. A. Kelly,et al.  The inflammatory cervical smear: a study in general practice. , 1990, The British journal of general practice : the journal of the Royal College of General Practitioners.

[7]  J. Wilson,et al.  Implications of inflammatory changes on cervical cytology. , 1990, BMJ.

[8]  K. Chew,et al.  Chlamydial endocervical infections and cytologic findings in sexually active female adolescents. , 1985, American journal of obstetrics and gynecology.

[9]  R. Remis,et al.  Chlamydia trachomatis cervical infection: prevalence and determinants among women presenting for routine gynecologic examination. , 1991, CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne.

[10]  R. Blake,et al.  Inflammation on the cervical Papanicolaou smear: the predictive value for infection in asymptomatic women. , 1992, Family medicine.

[11]  T. Kline,et al.  Diagnostic Cytology and Its Histopathologic Bases , 1969 .

[12]  L. Pereira,et al.  Prevalence of Chlamydia trachomatis and genital mycoplasmas in asymptomatic women. , 1985, Canadian Medical Association journal.

[13]  J. W. Segura,et al.  Recovery of Chlamydia and Genital Mycoplasma transported in sucrose phosphate buffer and urease color test medium. , 1977, Health laboratory science.

[14]  M. Griffiths Implications of inflammatory changes on cervical cytology , 1990 .