Chapter 2 – NORMAL FLORA
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Transcript Chapter 2 – NORMAL FLORA
Miss Rashidah Hj Iberahim
MIC342 - Miss Rashidah Hj Iberahim
Types of Pathogens
Primary Pathogens
Cause disease upon infection, not normally associated with
host
1.
2.
Plague (Yersinia pestis),
influenza virus
Opportunistic Pathogens
Cause disease under some circumstances, sometime members
of normal flora
1.
2.
Pseudomonas,
Candida albicans
Progression of Disease
Transmission: infectious dose from 10-10 organisms
6
Incubation period: few days (common cold)-weeks
(hepatitis A)-months (rabies)
Convalescence:
Clearing (Strep throat, S. pyogenes)
Latency (Chicken pox, tuberculosis, cold sores)
Koch’s Postulates
Proposed by Robert Koch
Conclude that a microbe causes a particular
disease
Must fulfill four postulates
1. Microorganism must be present in every case of
the disease
2. Organism must be grown in pure culture from
disease hosts
3. Produce the same disease from the pure culture
4. Organism recovered from experimentally infected
hosts
Molecular Postulates
Describe virulence factors
Four postulates
1. Virulence gene or its product must be present
2. Virulence gene must transform a non-pathogen
into a pathogen
3. Virulence gene must be expressed during disease
process
4. Antibodies against gene products are protective
Establishing an Infection
1. Encounter:
fecal-oral (cholera)
human-human (tuberculosis)
animal-human (rabies)
vector-borne (plague, lyme disease)
environmental contact (anthrax)
Establishing an Infection
2. Adherence
Prevents early clearance
Often bind host tissues via pili
Specificity can determine host range of pathogen
Establishing an Infection
3. Colonization: multiplication and maintainance
Competition with normal
flora
Resist:
1.
2.
3.
4.
5.
6.
bile
stomach acid
peristalsis
skin secretions
IgA (mucosal antibodies)
compete with host for iron
4.
Establishing an Infection
Molecule Delivery
Affects target cell
structure and host
response
Invasion:Breaching
Anatomical Barriers
Find new niche with few competitors
Gain access to rich nutrient supply
1. Skin: tough barrier, rely on wounds or insect vectors
2. Crossing mucous membrane (e.g.
intestinal epithelial cells)
Definition of normal
flora
m/org that normally found in particular area that do
not cause harm to host cell and body system
Also known as microflora
Harmful
*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
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)
Normal flora of body
system
Skin
Gram positive org:
1. Staphylococcus sp,
2. Micrococcus,
3. Coryneform bacteria/Demodex folliculorum (opening glands –
eyebrows)
Urogenital
1.
2.
3.
4.
5.
M. smegmatis,
Lactobacili,
Streptococci,
Staphylococcus,
E.coli
Body system w/out
normal flora
Lower respiratory tract
Systemic and cardiovascular
Nervous system
Skin Flora
MIC342 - Miss Rashidah Hj Iberahim
Oils production
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
MIC341 - Miss Rashidah Hj Iberahim
Sweating
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
MIC341 - Miss Rashidah Hj Iberahim
Skin shedding
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
MIC341 - Miss Rashidah Hj Iberahim
Normal flora
Gram positive org.
1. Staphylococcus sp
2. Micrococcus
3. Coryneform bacteria
Demodex folliculorum (opening glands – eyebrows)
MIC341 - Miss Rashidah Hj Iberahim
Urogenital Flora
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Urogenital
Al 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.
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
MIC341 - Miss Rashidah Hj Iberahim
In female..
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
MIC341 - Miss Rashidah Hj Iberahim