Cervicovaginal microbial flora in methenamine silver staining method

Noushin Afshar Moghaddam, Farahnaz Mardanian, Mojgan Mokhtari


BACKGROUND: Vagina like all other mucosal organs owns its especial bacterial/microbial flora. Though may be pathogen in other circumstances, members of vaginal normal flora do not cause disease on healthy vaginal mucosa. In this study, we tried to determine the relationship between microscopic findings on Methenamine silver stained cervicovaginal smears and clinical symptoms.
METHODS: A total of 389 cervicovaginal smears were examined cytologically from April to August 2005, among which 103 satisfactory smears of patients who were normally menstruating were subsequently selected. The originally Papanicolaou–stained smears were stained with Methenamine silver method. The cervicovaginal flora in symptomatic and asymptomatic patients was classified into four groups. The relationship between the type of genital flora and the presence of Candida or Actinomyces spp was also determined. Data were analyzed with SPSS software using Chi–square test.
RESULTS: In 103 evaluated patients, 46 (44.7%) were symptomatic and the rest were asymptomatic. The most prevalent genital microbial flora in both symptomatic (21.7%) and asymptomatic (37.9%) patients was type II (Lactobacilli). Microbial frequency differences were significant for types II (P = 0.034) and III (P = 0.039) in both groups. Coexistence of microbial flora of type I (P = 0.02) and type IV (P = 0.033) with Candida was statistically significant. Coexistence of all types of microbial flora with Actinomyces was not proved significant.
CONCLUSIONS: Symptomatic women, except those with potential pathogens, tend to have Lactobacillus flora. Therefore, it is advisable that all Lactobacilli types be investigated through microbiological methods in symptomatic patients. In silver stained slides, there was a clear relationship between the type of vaginal microbial flora and the presence of Candida spp.
KEY WORDS: Microbial flora, cervicovaginal smears, methenamine silver, symptomatic, asymptomatic.

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