Prevalence of Abnormal Cervical Cytology in Women with and without Chlamydia trachomatis, Mycoplasma hominis, or Ureaplasma urealyticum infection

Abstract

Objectives: To determine the association of abnormal cervical cytology & Chlamydia trachomatis(CT), Mycoplasma hominis(MH), or Ureaplasma urealyticum(UU) infection in women with or without minor gynecologic symptoms.

Methods: Retrospective search carried out to identify the previous Pap smears & concomitant analyses for cervical CT, MH, or UU (April 2004 ~ December 2008).

Results: Results of PCR were available for 714, 123, and 124 patients of CT, MH and UU, respectively. The prevalence rate was 3% (19/714) for CT, 11% (14/123) for MH, and 23% (29/124) for UU. The CT (+) was younger than CT (-) (mean age 27.7 years vs. 39.2years). Patients with MH or UU were not different for mean age or prevalence of accompanied symptoms compared with their counterparts. On the other hand, patients with SLE, RA, and DM showed slightly higher infection rate of UU. In 714 patients underwent Pap smear and concurrent CT test, RCC cases accounted for 63% (12/19) in CT (+) and 25% (175/695) in CT (-) (p<0.001). In 123 patients taken MH test, number of RCC cases was not significantly different between MH (+) and MH (-). In 124 patients taken UU test, the CIN cases, specifically ASCUS, LSIL and HSIL, were more prevalent in UU (+) than in UU (-), which was accounted for 24% (7/29) and 8% (8/95)(P=0.054), respectively. However, number of RCC cases was not different between UU (+) and UU (-) (31% vs. 29%).

Conclusion: The results showed the correlation between CT infection and RCC. CT infection is not only responsible for inflammation in the upper genital tract and PID but also is probably one of the causes of cervical epithelial changes. On the other hand, UU may possibly have causal relationship in the development of CIN disease, although it was not statistically significant and needed further studies. We suggest that screening for CT and UU should be proposed to patients with RCC or CIN on routine Pap smear regardless of any presenting symptoms.