Chapter 2 * NORMAL FLORA

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Miss Rashidah Hj Iberahim
MIC341 - Miss Rashidah Hj Iberahim
Content
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 Skin Flora
 Oral Cavity Flora
 Intestinal Flora
 Urogenital Flora
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Harmful
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 *microorganism in perianal area enter the urinary
tract (UT) causing infection in internal UT
Can prevent infection by:
 Medical asepsis – personnel and hospital
environment should be clean from pathogens
 Surgical asepsis – instrument used should be sterile
and including the surgical room
 What did you implement in daily life?
MIC341 - Miss Rashidah Hj Iberahim
Skin Flora
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Anatomy of the Skin
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Oils production
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 Different area consist of different microflora. Example
armpits vs forehead.
 Moisture area will support larger populations; nutrients
from oils and sweat
 Those normal flora might have capability to produce oils
that known as fatty acid providing an acidic condition of
particular area
 Initiating host defense against infection in the 1st line
stage
 But, excess of oils production might resulting an odour of
unpleasant smell to the body
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Sweating
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 Beside oils, the 2nd line of host defends is the sweat
that are salty
 However, in opposite situation, there are bacteria
that able to live in salty area such as Staphylococcus
sp.
 Majority of the skin flora – Gram +ve : Staphylococcus,
Micrococcus and Corynebacterium
 Hair follicles inhabitants – mite Demodex folliculorum
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Skin shedding
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 3rd line defends is regarding the keratin-degrading
fungi
 It helps in rapid and continuous shedding of skin
cells replacing layer by layer
 Removing of skin cell together with group of m/org
on the skin
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Closing the loop
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 Producing fatty acids that prevent growth of other
m/org
 Excretion of lysozyme by sweat glands
 Desquamation of epithelial
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Normal flora
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Gram positive org.
 Staphylococcus sp
 Micrococcus
 Coryneform bacteria
 Demodex folliculorum (opening glands – eyebrows)
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Oral Cavity Flora
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Anatomy of the oral
cavity
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Mouth
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 Basically the 1st area expose to m/org – the m/org
more than people on earth
 Affect the anatomy of mouth – teeth, tongue
 Contain saliva use to flush down food and bacteria
to the digestive systems below
 Level of efficacy of bacteria vary interms of
individual capability – physically and chemically
 Resulting a tooth decay which are differ between
individual
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Ecology of m/org
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 Currently, there are 400 species indentified
colonizing human mouth
 There are a lots more unknown m/org that need to
be discovered
 Colonization of m/org on cell lining cheek, tongue,
palate and floor of the mouth resulting bad breath
 Major effects on tooth appearance
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Intestinal Flora
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GI tract
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 In esophagus – no normal flora – pH of stomach
inhibit the colonization
 Until the 2/3 of small intestine rarely contain normal
flora – except lactobacili and streptococci (transient
microbes)
 The last 1/3 small intestine, the movement become
slower and leads to increasing of microbes
colonization
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1/3 small intestine
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The main flora in 1/3 last small intestine –
 Gram-negative
 Facultitative anaerobe such as enterobacteriaceae
(E.coli)
 obligate anaerobes (Bacteroides and Clostridium)
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Large intestine
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 Food remain as long as 60 hrs – long period leads to
high microbes colonization and replication
 50% of feces = microbes
 Mostly Bacteroides
 Eating foods of raw material derived from small
intestine
 By-product = vit K for clotting of blood
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Urogenital Flora
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Anatomy of female
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Anatomy of male
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Urogenital
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 All parts are sterile except urogenital opening
 Urine collection should have ‘clean catch’ technique
 E.coli and Lactobacillus are common flora = 100,000
bact/ml of urine
 Collection during direct puncture (suprapubic) = sterile
sample
 Acid pH, high salt and urea concentration leads to high
m/org growth
 Urine sample should be refrigerated during
transportation if delay – high multiplication if stir in RT
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Cont.
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 Mycobacterium smegmatis (acid fast staining bacili)
live in external genitalia of female and male
 Esp under penis of uncircumsized male – smegma
 If included in the sample, might leads to confusion
wt the tuberculosis patient which actually having M.
tuberculosis
 In male, 1/3 of deep are for genital area don’t have
normal flora
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In female..
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Due to hormonal changes..
 Child-bearing – lactobacili numerous in vagina
(eating glycogen)
 Glycogen in vaginal cell will be fermented become
lactic acid and pH decrease to 4.7
 Childhood and after menopause, lactobacili absent
coz no glycogen –replaced by streptococci and
staphylococci due to alkaline pH in vagina
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Normal flora
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 Mycobacterium smegmatis
 Lactobacillus
 E.coli
 Staphylococcus
 Streptococcus
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To be continue..
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Sorry..c u tomorrow nite..
MIC341 - Miss Rashidah Hj Iberahim
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