Cervical Cytology of Samples with Ureaplasma urealyticum, Ureaplasma parvum, Chlamydia trachomatis, Trichomonas vaginalis, Mycoplasma hominis, and Neisseria gonorrhoeae Detected by Multiplex PCR

• Published in: BioMed research international 2020, Vol.2020 (2020), p.1-10
• Main Authors: Sidou, Jéssica Meneses Othon, Pereira, Lívia Custódio, de Resende, Ceres Nunes, de Castro Moreira dos Santos, Agenor, Ferreira, Vânia Moraes, Motoyama, Andrea Barretto, da Costa Matsunaga, Michelle Egídio, Vilioni, Mariane Vieira, Fidelis, Cecília Ramos, de Vasconcelos Carneiro, Marcos, de Castro, Tércia Maria Mendes Lousa, Darós, Adriana Cysneiro Milhomem, Darós, Andersen Charles, Carneiro, Fabiana Pirani, Chaves, Mariana H.
• Format: Article
• Language: English
• Subjects: Adult; Biomedical research; Cellular biology; Cervicitis; Cervix Uteri - cytology; Cervix Uteri - microbiology; Chlamydia; Chlamydia trachomatis; Chlamydia trachomatis - genetics; Condoms; Cytology; Cytomegalovirus; Deoxyribonucleic acid; Diagnostic software; Diagnostic systems; DNA; Epithelial cells; Exudation; Female; Gram-Negative Bacteria - genetics; Gram-Negative Bacterial Infections - microbiology; Gram-Negative Bacterial Infections - pathology; Granulocytes; Health aspects; Herpes viruses; Humans; Infections; Inflammation; Leukocytes; Leukocytes (polymorphonuclear); Mass Screening; Microbial colonies; Microbiota; Middle Aged; Multiplex Polymerase Chain Reaction - methods; Multiplexing; Mycoplasma genitalium; Mycoplasma hominis; Mycoplasma hominis - genetics; Mycoplasma Infections - microbiology; Neisseria gonorrhoeae; Neisseria gonorrhoeae - genetics; Pap smear; Parasitic diseases; Pathogens; Sexually transmitted diseases; Statistical analysis; STD; Trichomonas vaginalis; Trichomonas vaginalis - genetics; Ureaplasma - genetics; Ureaplasma parvum; Ureaplasma urealyticum; Ureaplasma urealyticum - genetics; Uterine Cervicitis - microbiology; Uterine Cervicitis - pathology; Young Adult
• ISSN: 2314-6133; 2314-6141
• DOI: 10.1155/2020/7045217

Introduction. Despite increasing application of molecular diagnostic methods for the detection of sexually transmitted infections, the cytological findings in pap smears of patients with pathogens that can be identified only by PCR are not yet well described. The aim of this study was to describe the most common cytological features in cervical pap smears of patients with Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, Trichomonas vaginalis, Mycoplasma hominis, Ureaplasma urealyticum, and Ureaplasma parvum detected by multiplex PCR. Methods. Cervical samples for conventional and liquid-based cytology and for multiplex PCR were collected from women ranging from 23 to 54 years old, who underwent routine screening at a gynecological Unit. Results. Multiplex PCR was positive in 36.2% of the samples: Ureaplasma parvum 14.9%, Chlamydia trachomatis 10.6%, Trichomonas vaginalis 10.6%, Mycoplasma hominis 8.5%, Ureaplasma urealyticum 4.2%, Neisseria gonorrhoeae 2.1%, and Mycoplasma genitalium (0). Multiple pathogens were observed in 12.8% of samples. Microscopic cervicitis (≥10 polymorphonuclear leukocytes/epithelial cell) and normal (predominantly lactobacillary) microbiota were the most frequent findings in the samples in which the pathogens were detected alone or in multiple infections, except for samples with Trichomonas vaginalis in which the coccobacillary microbiota was the most common. In samples with microscopic cervicitis and normal microbiota, those with at least one pathogen identified by multiplex PCR were significantly more frequent than those with no pathogen, 66.6% versus 33.3%. Conclusion. Failure to identify an inflammatory agent in pap smear with intense neutrophil exudate may suggest the presence of Ureaplasma parvum, Ureaplasma urealyticum, Chlamydia trachomatis, or Trichomonas vaginalis. A remark on the intensity of inflammation should be made in the reports of cervical pap smears so that this cytological finding can be correlated with clinical and PCR results.