Background. The significance of the possible presence of infection on the Pap smear of asymptomatic women based on cytological criteria is practically unknown. Materials and Methods. A total of 1117 asymptomatic nonpregnant women had Pap smear tests and vaginal as well as cervical cultures completed (622 with and 495 without inflammation on the Pap smear). Results. Out of the 622 women with inflammation on Pap test, 251 (40.4%) had negative cultures (normal flora present), while 371 (59.6%) women had positive cultures with different pathogens. In contrast, the group of women without inflammation on Pap test displayed significantly increased percentage of negative cultures (67.1%, ) and decreased percentage of positive cultures (32.9%, ). Bacterial vaginosis was diagnosed more frequently in both groups and significantly more in the group with inflammation on Pap smear compared to the group without inflammation ( ). Conclusions. A report of inflammatory changes on the cervical Pap smear cannot be used to reliably predict the presence of a genital tract infection, especially in asymptomatic women. Nevertheless, the isolation of different pathogens in about 60% of the women with inflammation on the Pap smear cannot be overlooked and must be regarded with concern. 1. Introduction The infections of the genital tract are common in reproductive-age women and the associated cost is substantial. It has been noted that many women remain asymptomatic in the presence of vaginitis or cervicitis [1, 2]. The Papanicolaou (Pap) test is a simple, quick, and painless procedure performed on cells from the uterine cervix and used as a screening test for the prevention of the cancer of uterine cervix [3, 4]. When reporting the results of cervical Pap smears tests usually a remark is made on the possible presence of infection based on cytological criteria [5]. The clinical significance of inflammation on the Pap smear of asymptomatic women is practically unknown since no guidelines exist on appropriate management. Thus clinicians are often faced with the dilemma on whether these women should be counselled to present for vaginal/cervical cultures in order to isolate possible pathogens [6, 7]. This study assessed the possible association between inflammation on Pap smears and the presence of cervical/vaginal pathogens as determined by cultures. 2. Materials and Methods The population studied consisted of asymptomatic nonpregnant women of reproductive age presenting to the Obstetrics and Gynaecology Outpatient Clinic of Aretaieio University Hospital for a routine Pap smear test
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