UNIT-VI

HUMAN AND MICROBIAL

INTERACTION
AD Bheel
 OBJECTIVES
1. Define normal flora of the body.
2. Differentiate between resident and transient normal flora.
3. List at least three beneficial roles of normal flora.
4. Define nosocomial infections.
5. List at least three measures to control nosocomial
infections.
6. Describe some pathogenic microbes and diseases i.e.
tetanus, typhoid, cholera, diphtheria, tuberculosis, pertussis,
mumps, measles, polio, influenza ascariasis, taeniasis and
dermatomycosis.
 Human Microbiome/ Normal
flora of microorganisms like
The human microbiome consists
bacteria and fungi that reside on the skin, oral cavity,
conjunctiva, and gastrointestinal tracts.

Some microorganisms benefit the host, while most have no

known positive or negative effects.

Microorganisms that help maintain health and do not cause

disease under normal conditions are called normal flora.

• More bacterial than human cells in the body

Provide some nutrients (vitamin K)
Stimulate immune system, immunity can be cross-
reactive against certain pathogens
Prevent colonization by potential pathogens
(antibiotic-associated colitis, Clostridium difficile)
 Human Microbiome/
Normal flora
 Our bodies host around 100 trillion bacteria as
normal flora, which help prevent colonization
by harmful bacteria that could cause
infections.

 Normal flora changes after hospital admission,

typically starting on day 4, leading to an
increased risk of hospital-acquired infections.

 Antibiotics for hospital-acquired infections

change after 4 days of admission due to shifts
in the patient’s normal flora, not the severity
of illness.
 Human Microbiome/ Normal
flora
• Healthy people live in harmony with most of the
microorganisms that establish themselves on or in
(colonize) nonsterile parts of the body, such as
the skin, nose, mouth, throat, large intestine, and
vagina.

• The skin and mucous membranes always harbor a

variety of microorganisms that can be arranged
into two groups:

1. Resident flora

2.Transient flora
 Resident flora
 Resident flora are microorganisms that regularly
inhabit specific body sites, outnumbering
human cells 10 to 1 and varying by age and
environment.
 These flora consist of numerous microorganism
types, influenced by factors like diet, antibiotics,
hygiene, and pollution.
 Resident flora usually reestablishes quickly after
temporary disturbances, such as washing or
antibiotic use.
 While generally protective, resident flora can
sometimes cause disease under specific
conditions.
 Transient flora
1. Transient flora are microorganisms that temporarily colonize
the skin or mucous membranes for hours to weeks.
2. They are non-pathogenic or potentially pathogenic, derived
from the environment, and do not permanently establish
themselves.
3. These microorganisms usually cause no harm if the normal
resident flora is intact.
4. If the resident flora is disturbed, transient flora may colonize,
multiply, and cause disease.
 Host Flora
Interactions
Members of the normal flora form part of the host and
include:
• Saprophytes
• Commensals
• Facultative pathogens
• True pathogens
Classification – Based on
taxonomy
 Sterile organs in human body
Internal organs except alimentary tract are STERILE

Sterility maintained by:

1. Local defense mechanisms

2. Chemical substances in serum & tissues. Ex:
Antibodies.
3. Phagocytic activity of polymorphomononucleocytes
(PMN)

Areas of the body with normal flora:

• Respiratory tract
• Gastrointestinal tract
• Genital tract
• Skin
• External auditory meatus
Inhabitation of normal microflora
Normal microflora - Skin
Normal microflora - Skin
Normal microflora - Conjunctiva
Normal microflora – Nose & Nasopharynx
Normal microflora – Respiratory Tract
Normal microflora – Oral Cavity
Normal microflora – Gastrointestinal Trac
Normal microflora – Genitourinary Tract
 Normal flora may act as
opportunistic pathogens
Especially in hosts rendered susceptible by;

1. Immuno-suppression (AIDS & SCID)

2. Radiation therapy and chemotherapy
3. Perforated mucous membranes
4. Rheumatic heart diseases
5. Change their usual anatomic location

Normal flora is absent in

• Blood
• Muscle
• Cerebrospinal fluid
Are normally free of microorganisms
 Advantages of normal flora
The bacteria living in and on us are not invaders but beneficial
colonizers

Digestion of substrates and synthesis of

essential nutrients like vitamins and
carbohydrates.
Protection by occupying niches and
preventing pathogen growth.
Contribution to immunity through
antibodies and immune system
development.
Support for intestinal health by enzyme
production, cell turnover, and transit
stimulation.
Microbiome dysfunction linked to
autoimmune diseases like diabetes and
 Nosocomial
Infections
1. Nosocomial infections are contracted
from infections or toxins present in
hospitals.
2. The terms healthcare-associated
infections (HAIs) and hospital-acquired
infections are often used interchangeably.
3. HAIs must not be present before
receiving medical care.
4. ICUs are common areas for HAIs due to
critical patient care.
5. About 1 in 10 hospital patients contract
HAIs, leading to high morbidity, mortality,
and costs.
Symptoms of Nosocomial Infection
 Discharge From A Wound
 Fever
 Cough, Shortness Of Breathing
 Burning With Urination Or Difficulty Urinating
 Headache
 Nausea, Vomiting, Diarrhea
For a HAI, the infection must occur:
• up to 48 hours after hospital admission
• up to 3 days after discharge
• up to 30 days after an operation
 Sources of Infection
Endogenous:

• Patients own flora may invade patient’s tissue during

some surgical operations or instrumental manipulations

• Normal commensals of the skin, respiratory, GI, UG tract

Exogenous:

• From another patient / staff member / environment in the

hospital

• Environmental sources: Inanimate objects, air, water, food

• Cross infection from: other patients, hospital staff

(suffering from infections or asymptomatic carriers)
 Factors Responsible for
Nosocomial Infections
• Susceptible immune system of the host (patient)
• Increased variations of modifications in medical
techniques and procedures
• Prevalence of infectious microorganisms
• Poor health care practices resulting in the facilitation of
transmission of drug-resistant bacteria
Causes of Nosocomial Infections
Bacteria, fungus, and viruses can cause HAIs.
Bacteria alone cause about 90 percent of these
cases. Some of the common bacteria that are
responsible for HAIs are:
Bacteria Infection type
Wound, respiratory and gastro-intestinal
Staphylococcus
infections
Streptococci Throat and urinary tract infections
Escherichia coli (E. coli) UTI
Salmonella Food poisoning
Enterococci blood, UTI, wound
Pseudomonas aeruginosa (P. aeruginosa) kidney, UTI, respiratory
Proteus wound, UTI
Viruses Infection type
Hepatitis A Infectious hepatitis
Hepatitis B Serum hepatitis
Acquired immunodeficiency syndrome
Human immunodeficiency virus (HIV)
(AIDS)
 Types of Infections
• Urinary tract infections (UTI)

• Surgical wound infections (SWI)

• Lower respiratory infections

• Traumatic wounds and burns infections

• Bloodstream infections

• Skin and soft tissue infections

• Other nosocomial infections

 Urinary tract infections (UTI)
• It is the most common cause of nosocomial infections
(40%)

• Usually associated with catheterization or

instrumentation of urethra, bladder or kidneys

• Eg: E. coli, Klebsiella, Proteus, Serratia, Pseudomonas,

Candida albicans
Pneumonia (Respiratory Infections)
• Leading cause of mortality in patients suffering from HAI

• During aspiration in unconscious patients & pulmonary

ventilation

• Eg: Staph. aureus, Klebsiella, Enterobacter, Serratia,

Proteus, Pseudomonas, Acinetobacter, Legionella, E. coli
Surgical wound infections (SWI)
• Follow surgical procedure where causative agents are introduced into
the tissue during operations

• Higher in elderly patients

• Manifest within a week of surgery

• Non-surgical wounds due to burns, bed sores.

• Eg: Staph aureus, Pseudomonas aeruginosa, E. coli, Proteus,

Enterococci

Gastrointestinal infections
• Food poisoning due to Salmonella, Shigella sonnei

• Enterotoxic manifestation due to Staphylococcal

contamination of cooked food

• Diarrhea due to E. coli

 Bacteremia & Septicemia
• Bacterial invasion of bloodstream in various HAIs

• Mostly caused by infected intravenous cannulae

• Gram negative bacilli: common pathogens

Tetanus

• Inadequate attention to aseptic precautions during surgery

• Use of contaminated dressings or improperly sterilized

dressings

• Improper disinfection of site of intramuscular injection

• Inadequate care while cutting umbilical cord of new-born

 Infection controlling
responsibilities
1. Hospital Management:
Provide leadership, infrastructure, and resources to support
infection control programs.
2. Physicians:
Prevent and control infections through proper patient care
and hygiene practices.
3. Microbiologists:
Manage specimens for diagnosis, develop specimen
handling guidelines, ensure safe lab practices, and perform
antimicrobial tests.
4. Hospital Pharmacist:
Prevent infection through safe medication handling and
assist in sterilization practices.
5. Nursing Staff:
Ensure hygiene and infection control during patient care.
 Infection controlling
responsibilities
6. Central Sterilization Service:
Clean, sterilize, and store hospital equipment.
7. Food Service:
Ensure food safety, staff training, and proper food
handling.
8. Housekeeping:
Perform regular cleaning to maintain hygiene.
9. Maintenance:
Collaborate for equipment safety and timely repairs.
10. Infection Control Professionals:
Oversee infection control programs, supervise drug
use, ensure cleanliness, and provide outbreak
management.
 REFERENCES
1. https://chatgpt.com/