Please wait a minute...
Clinical and Experimental Obstetrics & Gynecology  2020, Vol. 47 Issue (2): 253-256    DOI: 10.31083/j.ceog.2020.02.5193
Original Research Previous articles | Next articles
Candida albicans infection of cervix and comparison of Pap smear and culture in diagnosis
T. Cengiz1, T. Toka Özer2, *(), F. Kılınç3, R. Selimoğlu4, H. Yılmaz5
1Department of Obstetrics and Gynecology, Ortadoğu Hospital, Adana, Turkey
2Department of Medical Microbiology, Konya Hospital, Konya, Turkey
3Department of Pathology, Medical Faculty, Necmettin Erbakan University, Konya, Turkey
4Department of Medical Microbiology, Anıt Hospital, Konya, Turkey
5Department of Obstetrics and Gynecology, Şemdinli State Hospital, Hakkari, Turkey
Download:  PDF(5918KB)  ( 391 ) Full text   ( 10 )
Export:  BibTeX | EndNote (RIS)      
Abstract  

Purpose: The Pap smear is a routine screening test for the detection of cervical abnormalities viral, bacterial, and fungal infections of the uterine cervix, The aim of this study is to investigate if Pap smear is an alternative to cervicovaginal culture in the diagnosis of asymptomatic Candida. Materials and Methods: A retrospective analysis of 133 non-pregnant asymptomatic cases were included. Candida spp. positive cases in Pap smear and/or culture were compared. Results: Candida spp. was found in 45 cases in culture and 40 cases of Candida in Pap smear examination. The sensitivity of Pap smear was 88%, specificity was 100%, the positive predictive value was 100%, the negative predictive value was 94%, and the overall power of the test (test validity) was 96%. It was detected that 33.83% of the asymptomatic cases had Candida infection. Conclusion: Pap smear can be used as a first-line examination method.

Key words:  Pap smear      Candida infections      Cervicovaginal culture      Sabourad dextrose agar      Screening test     
Published:  15 April 2020     
*Corresponding Author(s):  T. Toka ?zer     E-mail:  tozer73@hotmail.com

Cite this article: 

T. Cengiz, T. Toka Özer, F. Kılınç, R. Selimoğlu, H. Yılmaz. Candida albicans infection of cervix and comparison of Pap smear and culture in diagnosis. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(2): 253-256.

URL: 

https://ceog.imrpress.com/EN/10.31083/j.ceog.2020.02.5193     OR     https://ceog.imrpress.com/EN/Y2020/V47/I2/253

Figure 1.  Candida in Pap smear.

Table 1  — Distribution of Candida detected cases by both methods according to age groups.
(Group1) (Group2) (Group 3) Total
Age groups
(years)
18-39
n(%)
40-59
n(%)
≥60
n(%)

n(%)
Number of cases in groups 67 (50.38) 53(39.85) 13(9.77) 133(100.00)
Pap smear-Candida (+) 28 (70) 11(27.50) 1(2.5) 40(30.08)
Culture-Candida (+) 31(68.89) 12(26.67) 2 (4.44) 45(33.83)
[1] Kelly B.A., Black S.A.: “The inflammatory cervical smear: a study in general practice”. Br. J. Gen. Pract., 1990, 40, 238.
pmid: 2117946
[2] Sobel J.D.: “Vaginal infections in adult women”. Sex. Transm. Dis., 1990, 74, 1573.
[3] Edwards L.: “The diagnosis and treatment of infectious vaginitis”. Dermatol. Ther., 2004, 17, 10210.
[4] Erdem H., Cetin M., Timuroglu T., Cetin A., Yanar O., Pahsa A.: “Identification of yeasts in public hospital primary care patients with or without clinical vaginitis”. Aust. N. Z. J. Obstet. Gynaecol., 2003, 43, 3126.
[5] Dan M., Poch F., Levin D.: “High rate of vaginal infections caused by non C. albicans Candida species among asymptomatic women”. Med. Mycol., 2002, 40, 3836.
[6] Eckert L.O., Hawes S.E., Stevens C.E., Koutsy L.A., Eschenbach D.A., Holmes K.K.: “Vulvovaginal candidiasis: clinical manifestations, risk factors, management algorithm”. Obstet. Gynecol., 1998, 92, 757.
doi: 10.1016/s0029-7844(98)00264-6 pmid: 9794664
[7] Odds F.C.: “Candida and Candidosis”. London: Baillière Tindall(W. B. Saunders), 1988.
[8] Sobel J.D., Faro S., Force R.W., Foxman B., Ledger W.J., Nyirjesy P.R. et al.: “Vulvovaginal candidiasis: epidemiologic, diagnostic, and therapeutic considerations”. Am. J. Obstet. Gynecol., 1998, 178, 203.
doi: 10.1016/s0002-9378(98)80001-x pmid: 9500475
[9] Spinillo A., Capuzzo E., Egbe T.O., Baltaro F., Nicola S., Piazzi G.: “Torulopsis glabrata vaginitis”. Obstet. Gynecol., 1995, 85, 993.
doi: 10.1016/0029-7844(95)00047-U pmid: 7770272
[10] Monod M., Hube B., Hess D., Sanglard D.: “Differential regulation of SAP8 and SAP9, which encode two new members of the secreted aspartic proteinase family in Candida albicans”. Microbiology. 1998, 144, 2731.
doi: 10.1099/00221287-144-10-2731 pmid: 9802014
[11] Cassone A., De Bernardis F., Mondello F., Ceddia T., Agatensi L.: “Evidence for a correlation between proteinase secretion and vulvovaginal candidosis”. J. Infect. Dis., 1987, 156, 777.
doi: 10.1093/infdis/156.5.777 pmid: 3309073
[12] Staib P., Kretschmar M, Nichterlein T, Hof H., Morschha J.: “Differential activation of a Candida albicans virulence gene family during infection”. PNAS, 2000, 97, 6102.
doi: 10.1073/pnas.110031497 pmid: 10811913
[13] Hube B.: “Possible role of secreted proteinases in Candida albicans infection”. Rev. Iberoam. Micol., 1998, 15, 65.
pmid: 17655411
[14] Calderone R.A.: “Recognition between Candida albicans and host cells ”. Trends. Microbiol., 1993, 1, 55.
doi: 10.1016/0966-842x(93)90033-n pmid: 8044462
[15] Papanicolaou G.N.: “A new procedure for staining vaginal smears”. Science, 1942, 95, 438.
doi: 10.1126/science.95.2469.438 pmid: 17842594
[16] Avwioro O.G., Olabiyi Oe., Avwioro To.: “Sensitivity of a Papanicolaou smear in the diagnosis of Candida albicans infection of the cervix”. N. Am. J. Med. Sci., 2010, 2, 97.
doi: 10.4297/najms.2010.297 pmid: 22624121
[17] Sivaranjini R., Jaisankar T., Thappa D.M., Kumari R., Chandrasekhar L., Malathi M., et al.: “Spectrum of vaginal discharge in a tertiary care setting”. Trop. Parasitol., 2013, 3, 135.
[18] Foxman B.: “The epidemiology of vulvovaginal candidiasis: risk factors”. Am. J. Public. Health, 1990, 80, 329.
doi: 10.2105/ajph.80.3.329 pmid: 2305918
[19] Spinillo A., Capuzzo E., Nicola S., Baltaro F., Ferrari A., Monaco A.: “The impact of oral contraception on vulvovaginal candidiasis”. Contraception, 1995, 51, 293.
doi: 10.1016/0010-7824(95)00079-p pmid: 7628203
[20] Hooton T.M., Roberts P.L., Stamm W.E.: “Effects of recent sexual activity and use of a diaphragm on the vaginal microflora”. Clin. Infect. Dis., 1994, 19, 274.
doi: 10.1093/clinids/19.2.274 pmid: 7986899
[21] Chassot F., Negri M.F.N., Svidzinski A.E., Donatti L., Peralta R.M., Svidzinski T.I., Consolaro M.E.: “Can intrauterine contraceptive devices be a Candida albicans reservoir?” Contraception, 2008, 77, 355.
doi: 10.1016/j.contraception.2008.01.007
[22] Malkawi S.R., Abu Hazeem R.M., Hajjat B.M., Hajjiri F.K., : “Evaluation of cervical smears at King Hussein Medical Centre, Jordan, over three and a half years. East. Mediterr. Health. J., 2004, 10, 676.
pmid: 16335662
[23] Lessa P.R., Ribeiro S.G., Lima D.J., Nicolau A.I., Damasceno A.K., Pinheiro AK.: “ Presence of high-grade intraepithelial lesions among women deprived of their liberty: a documental study”. Rev. Lat. Am. Enfermagem., 2012, 20, 354.
doi: 10.1590/s0104-11692012000200019 pmid: 22699737
[24] Adad S.J., de Lima R.V., Sawan Z.T., Silva M.L., de Souza M.A., Saldanha J.C., et al.: “Frequency Of Trichomonas Vaginalis, Candida spp. and Gardnerella vaginalis in cervical-vaginal smears in four different decades”. Sӑo. Paulo. Med. J., 2001, 119, 200.
[25] Roeters A.M., Boon M.E., van Haaften M., Vernooij F., Bonteoe T.R., Heintz A.P.: “Inflammatory events as detected in cervical smears and squamous intraepithelial lesions”. Diagn. Cytopathol., 2010, 38, 85.
doi: 10.1002/dc.21169 pmid: 19795485
[26] Kalantari N., Ghaffari S., Bayani M.: “Trichomonas, Candida, and Gardnerella in cervical smears of Iranian women for cancer screening”. N. Am. J. Med. Sci., 2014, 6, 25.
doi: 10.4103/1947-2714.125861 pmid: 24678473
[27] Zdolsek B., Hellberg D., Frόman G., Nilsson S., Mȧrdh P.A.: “Culture and wet smear microscopy in the diagnosis of low-symptomatic vulvovaginal candidosis”. Eur. J. Obstet. Gynecol. Reprod. Biol., 1995, 58, 47.
doi: 10.1016/0028-2243(94)01981-c pmid: 7758645
[28] Siapco B.J., Kaplan B.J., Bernstein G.S., Moyer D.L.: “Cytodiagnosis of Candida organisms in cervical smears”. Acta. Cytol., 1986, 30, 477.
pmid: 3465137
[1] M. Durmuscan, S. Yildirmak, V. Mihmanli, Y. Gulen Cicek, M. Vardar, F. Sezgin, O. Dikker, B. Basat. A disintegrin and metalloproteinase domain-containing protein-12 levels in first-trimester pregnant women[J]. Clinical and Experimental Obstetrics & Gynecology, 2018, 45(4): 517-522.
[2] E.N. Yeniceri, B. Kasap, E. Akbaba, M.N. Akın, B. Sarıyıldız, M. Küçük, N. Turhan. Knowledge and attitude changes of pregnant women regarding prenatal screening and diagnostic tests after counselling[J]. Clinical and Experimental Obstetrics & Gynecology, 2017, 44(1): 48-55.
[3] S. Hacivelioglu, A. Uysal, A.N. Cakir Gungor, M. Gencer, D.U. Cakir, E. Cosar. The effect of maternal polycystic ovary morphology on first-trimester maternal serum biochemical markers of aneuploidy and fetal nuchal translucency thickness[J]. Clinical and Experimental Obstetrics & Gynecology, 2015, 42(1): 32-35.
[4] N. Güdücü, G. Gönenç, H. İşçi, A. Başgül Yig˘iter, N. Başsüllü, İ. Dünder. Clinical importance of detection of bacterial vaginosis, trichomonas vaginalis, candida albicans and actinomyces in Papanicolaou smears[J]. Clinical and Experimental Obstetrics & Gynecology, 2012, 39(3): 333-336.
[5] M. Varras. Benefits and limitations of ultrasonographic evaluation of uterine adnexal lesions in early detection of ovarian cancer[J]. Clinical and Experimental Obstetrics & Gynecology, 2004, 31(2): 85-98.
[6] N. Vitoratos, E. Salamalekis, P. Bettas, D. Kalabokis, A. Chrisikopoulos. Which is the threshold glycose value for further investigation in pregnancy?[J]. Clinical and Experimental Obstetrics & Gynecology, 1997, 24(3): 171-173.
[7] N. L. Aziz, S. Abdelwahab, M. Moussa, M. Georgy. Maternal fructosamine and glycosolated haemoglobin in the prediction of gestational glucose intolerance[J]. Clinical and Experimental Obstetrics & Gynecology, 1992, 19(4): 235-241.
No Suggested Reading articles found!