International Scientific Congress for Students, Young Physicians and Pharmacists Marisiensis 2014

Interest in the microflora of the vagina and cervix has stemmed from the recognition of its significant association with vaginal and upper genital tract infections. Yet a clear understanding of the range of microbial types which are consistent with a normal genital tract and the factors which control the flora are elusive.

Cervico-vaginal infection is one of the most common problems in clinical medicine. Although the cytologic evaluation reveals a wide range of tissue modifications caused by multiple factors ( microorganism infections), usually, the cause of these changes is HPV infection. In most cases these changes in the tissue structure are reversible, still they can lead to cancer development.

Acute vaginitis is one of the most common diseases seen in the practice of office gynecology. Large survey studies of women with lower genital tract symptoms suggestive of vaginitis have demonstrated the presence of three major etiologic categories in acute vaginitis: (1) nonspecific vaginosis (Gardnerella vaginalis), (2) vulvovaginal candidiasis (Candida albicans), and (3) trichomoniasis (Trichomonas vaginalis). Effective treatment of acute vaginitis requires that an accurate diagnosis be established and etiologic microorganism(s) be identified

Our aim was to determine the prevalence of pathogenic microorganisms infections in cervicovaginal smears.

It was a retrospective study including 250 cytodiagnosis reports between March 2011 and March 2014. Of the patients included 32% were menopausal, 25% pregnant and 40% in normal menstrual period.

We collected data from any patient who had a pap smear during this period of time in an private practice in Radauti. Vaginal examination and taken smear was carried out by physician. The smears were fixed with methanol and send to clinical pathology laboratory. The smears were evaluated by a pathologist.

This information includes the sample adequacy, the type of (e.g. squamous, glandular, and metaplastic), benign cellular alterations (e.g. infl ammation), and the type of genital infections (e.g. T. vaginalis and Candida sp).

Performing a detailed analysis on the data we received we found that the frequencies of the pathogenic microorganisms were as follow:

We also confirmed a relation between the presence of Candida and the benigne modifications of the tissue prelevated by creating and analysing a contingency table.

We statistically proved that Candida infection affects in equal proportion women in non-menopausal group rather than the meopausal one

Although, our study is confirmed by publications which indicate that candidiasis is the most common vaginal infection in most countries, but the prevalence rate of infective agents obtained from the current study was lower in comparison with other studies

The current study showed that the highest prevalence rate of Candida (34%) was seen in the non-menopausal group.

This study showed that the proportion of women with LSIL (4,4%) and HSIL (2,8%) was low. This result was obtained by cytology tests and furthermore these findings were associated with the presence of type 16, 18 and 35 HPV.

Infections can be diagnosed in cervical smears through identification either of the organism or of characteristic cytological cellular changes. Moreover, vaginal infections produced by drug resistance of infectious agents should be noticed in treatment.

Trichomonas, Candida, and Gardnerella in Cervical Smears of Iranian Women for Cancer Screening Narges Kalantari, Salman Ghaffari1, Masomeh Bayani2

Importance of differential diagnosis in acute vaginitis. Am J Obstet Gynecol. 1985 Aug 1;152(7 Pt 2):921-3.

Bacteriology of the vagina. Scand J Urol Nephrol Suppl. 1984;86:23-39. Trichomonas, Candida, and gardnerella in cervical smears of Iranian women

for cancer screening. N Am J Med Sci. 2014 Jan;6(1):25-9. doi: 10.4103/1947-2714.125861.

Prevalence of cervical-vaginal infections in the pap-smear samples in Iran. Glob J Health Sci. 2013 Dec 19;6(1):201-6. doi: 10.5539/gjhs.v6n1p201.

Epidemiologic differences between candidial and trichomonal infections as detected in cytologic smears in Taiwan. Public Health.1995 Nov;109(6):443-50.

Prevalence of high-grade cervical lesion in women with LSIL and HSIL cytology and prevalence of invasive cancer in women cytologically positive for malignancy.

Asian Pac J Cancer Prev. 2008 Oct-Dec;9(4):715-8.