Cervicovaginal flora. Comparison of conventional pap smears and a liquid-based thin-layer preparation.

We compared the effectiveness of SurePath (TriPath Imaging, Burlington, NC) with that of conventional Papanicolaou smears (CP) to demonstrate microorganisms in cervicovaginal smears. Samples from 904 randomly selected cases were examined at the Medical Center of Louisiana clinics for 2 years--the year before and the year after the implementation of SurePath. One observer reviewed the CP and SurePath preparations for detection of microorganisms. Comparison of the 2 systems was made, taking into accounting patient age, ethnicity, and previous hysterectomy and seasonal variation in prevalence. A seasonal variation was observed in the prevalence of candidiasis. Trichomonas and a shift in bacterial flora were detected more often with CP than with SurePath (13.4% vs 8.3% and 38.7% vs 30.2%, respectively). In contrast, candidiasis was detected more frequently with SurePath than with CP (13.7% vs 7.7%). At the Medical Center of Louisiana clinics, CP was more effective for detecting trichomoniasis and bacterial vaginosis; SurePath was more effective for detecting candidiasis.