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4_ Normal Flora

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31 views32 pages

4_ Normal Flora

Uploaded by

mohammad.salaymeh4
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPTX, PDF, TXT or read online on Scribd
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Microbiome

Normal Flora of Human Body


Normal Flora
Normal flora is the term used to describe the various
bacteria and fungi that are permanent residents of certain
body sites, especially the skin, oropharynx, colon, and
vagina.

Viruses and parasites are never considered members of


the normal flora.

Normal flora are (commensalism): organisms that derive


benefit from another host but do not damage that host.

Human microbiome is a term that refer to normal flora in


human body!!!.
Microbiome
• The microbiome is the genetic material (total
bacterial content) of all the microbes that live
on and inside the human body

3
Resident flora
– Species that live on or in nearly everyone almost all
the time
– These residents live in specific sites
- Staph. Epidermidis ( skin)
- E. coli (colon and small intestine
– When in their natural sites,
- Resident flora do not cause harm to
healthy tissue
- Some are beneficial to us
– May become pathogenic if introduced into
abnormal sites
- E. coli is considered an opportunist
Transient flora
• Species that are found periodically on or in the body

• They are not as well adapted to us as are the


resident flora
Streptococcus pneumoniae

• Transients may become pathogenic when the host’s


resistance is lowered

• Elderly person with influenza, S. pneumoniae may


invade the lower respiratory tract and cause a
serious or even fatal pneumonia
The term carrier implies that an individual harbors a potential
pathogen and therefore can be a source of infection of others
(not related to presence of normal flora).

There is also a distinction to be made between members of


the normal flora, which are the permanent residents, and
the colonization of the individual with a new organism.

The term colonization refers to the acquisition of a new


organism (on mucosal surfaces).
Normal flora play a role both in the maintenance of health and in
the causation of disease in three significant ways:

1 - Their presence in immunocompromised individuals.

2- They constitute a protective host defense mechanism. The


nonpathogenic resident bacteria occupy attachment sites on the skin
and mucosa that can interfere with colonization by pathogenic
bacteria. (colonization resistance).

3- Nutritional function. The intestinal bacteria produce several B


vitamins and vitamin K. Poorly nourished people who are treated
with oral antibiotics can have vitamin deficiencies.
THE HUMAN MICROBIOME:

The human microbiome is the term used to describe (“microbiota”)


located in/on different sites of human body. Many of these were
identified based on DNA analysis.

- The largest and most complex microbial population resides in the


colon.

- The intestinal microbiota also plays a role in certain autoimmune


diseases such as the inflammatory bowel diseases

- The gut microbiota influences the maturation and function of the


immune response.

- Colonization resistance is another function of the microbiota.


Role of normal flora (Advantages)

• Host nutrition

• Prevents colonization
- Competing for receptors or binding sites
- Competing for nutrients
- Producing antibiotics or bacteriocins
- Production of toxic products

• Stimulation of natural antibodies that cross react


with pathogenic organisms
Role of normal flora (Disadvantages)
• They become pathogenic when the host
resistance is lowered

• They may act as pathogens in tissue outside


their normal habitat
Role of normal flora (Disadvantages)
Examples :-
Intestinal flora may cause UTIs
Bacteroides fragilis: cause of peritonitis
associated with perforation of intestinal wall
following trauma, appendicitis or
diverticulitis
- Streptococci viridans (S.mutans) could be
introduced into the bloodstream following
tooth extraction or tonsillectomy-----
Infective endocarditis
Effect of Antibiotics on Normal Flora

• Resident flora may be diminished by the use of


antibiotics to treat bacterial infections

• An antibiotic does not distinguish between the


pathogen and the resident bacteria

• Without the usual competition, yeasts or pathogenic


bacteria may be able to overgrow and create new
infections.
Effect of Antibiotics on Normal Flora of intestine

• Clindamycin can suppress the predominant normal


flora allowing a rare toxin-producing Clostridium
difficile to overgrow and cause severe colitis

• Neomycin given prior to GI surgery to sterilize gut


leads to decrease bacterial levels but it return to
normal after several days
Localizations of the Normal Flora

– Skin
– Eyes (conjunctiva)
– Nose and throat ( upper respiratory tract )
– Mouth
– Large Intestine
– Urinary and reproductive systems
Relative density of the flora in the body
19
NORMAL FLORA OF THE SKIN

The predominant organism is Staphylococcus epidermidis, which is a


nonpathogen on the skin but can cause disease when it reaches
certain sites, such as artificial heart valves and prosthetic joints.

Some are found in the hair follicles and act as a reservoir to replenish
the superficial flora after hand washing.

Anaerobic organisms, such as Propionibacterium and Peptococcus,


are situated in the deeper follicles in the dermis. Propionibacterium
acnes is a common skin anaerobe that is implicated in the
pathogenesis of acne.

The yeast Candida albicans is also a member of the normal flora of


the skin.
NORMAL FLORA OF THE RESPIRATORY TRACT

They colonize the nose, throat, and mouth (mainly


streptococcal and staphylococcal), but not in the
lower bronchi and alveoli.

The throat contains a mixture of viridans streptococci,


Neisseria species, and S. epidermidis . These nonpathogens
inhibit the growth of the pathogens Streptococcus
pyogenes, Neisseria meningitidis, and S. aureus,
respectively.
viridans group in mouth (green colonies):
Streptococcus mutans, a member of the viridans group,
found in large numbers in dental plaque, the precursor of
caries.

The viridans streptococci, are also cause subacute bacterial


(infective) endocarditis. These organisms can enter the
bloodstream at the time of dental surgery and attach to
damaged heart valves.
NORMAL FLORA OF THE INTESTINAL TRACT:

The small intestine usually contains small numbers of streptococci,


lactobacilli, and yeasts, particularly C. albicans. Larger numbers of
these organisms are found in the terminal ileum.

The colon is the major location of bacteria in the body. Roughly


20% of the feces consists of bacteria, approximately 1011
organisms/g.

More than 90% of the fecal flora are anaerobes, the most
important of which is Bacteroides fragilis.

The most abundant facultative bacteria are the coliforms,


(Escherichia coli ).
The normal flora of the intestinal tract plays a significant role
in extra-intestinal disease. For example, E. coli is the leading
cause of urinary tract infections, and B. fragilis is an
important cause of peritonitis associated with perforation of
the intestinal wall following trauma, appendicitis, or
diverticulitis (inflammation in the large intestine).

Other important pathogens that could cause UTI and


endocarditis:

- Fusobacterium and Peptostreptococcus (anaerobic).


- Enterococcus faecalis, (facultative bacteria) cause
endocarditis.
- Pseudomonas aeruginosa, causing infection in hospitals (It is
present in 10% of normal stools, as well as in soil and water).
NORMAL FLORA OF THE GENITOURINARY TRACT

Lactobacillus species are normal flora of the vagina (in adults)


that produce acidic pH.

Lactobacilli could prevent the growth of potential pathogens,


since antibiotics treatment can lead to overgrowth by C.
albicans.
During urine passages through urethra it becomes contaminated with
S. epidermidis, coliforms, diphtheroids, and nonhemolytic
streptococci.

Mycobacterium smegmatis: mainly found in the secretions around


the urethral areas.
Staphylococcus saprophyticus: found on the skin surrounding the
genitourinary tract and it could be a cause of UTI in women.
Diseases caused by normal flora of
intestinal tract
• E. Coli  UTI

• Bacteroides fragilis  Peritonitis (perforation of


intestinal wall following trauma, appendicitis,
diverticulitis)

• Enterococcus feacalis  UTI & endocarditis

• Pseudomonas Aeruginosa  various infections in


patients with low host defenses
Diseases caused by NF of Genitourinary tract

• Suppression of Lactobacilli by antibiotics 


Overgrowth of the yeast-like fungi, Candida albicans

“Candida vaginitis”

• Recurrent UTI s due to E. Coli and Enterobacter


(anus close to vagina)

• 15-20% women of child bearing age carry


group B streptococci in the vagina
(sepsis and meningitis in the newborn)
Probiotics
• The use of normal flora of the GI tract to
treat diseases

• It stabilizes the composition of the Normal


flora

• 109-1010 organisms
Probiotics
• Classification of a Probiotic strain:
- Beneficial physiological effect
- Strain is of human origin
- Safe for human use
- Stable in acid and bile
- Adhere to intestinal mucosa
- Most common:
- Lactobacilus acidophilus
- Bifidobacterium bifidum
- Streptococcus thermophilus
Use of Probiotics in treatment of diseases
1) Treatment and prevention of diarrhea
- Rotavirus diarrhea in children
- Travelers’ diarrhea and enteritis
- Post-antibiotic diarrhea long-term use of
antibiotics
2) Alleviate symptoms of lactose intolerance
(lactic acid bacteria)

3) Food allergies: e.g. milk


Use of Probiotics in treatment of diseases
4) Treatment of GI inflammations associated
with disruption of the mucosal
barrier/permeability:
- Crohn’s disease
- Food allergies
- Atopic eczema
5) Reduction of recurrent respiratory infections
- Pneumonia in cystic fibrosis

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