Microbiology – Lecture 2

Normal Flora
TEAM 437
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 Objectives
1. Define the terms: Normal Flora, Resident flora, Transient flora and carrier state
2. Know the origin of normal flora.
3. Know the importance of normal flora with examples, including importance as: Source of
opportunistic infection., Immunostimulation, Nutrition: Vitamins production, Production of
Carcinogens, Protection against external invaders.
4. Know areas of the body with normal flora (GIT, Urogenital tract, and skin) and most common
types of organism in these areas and relation to pathogenicity of these organism.
5. Know sites of the body with no normal flora e.g. sterile body sites and the importance of
this fact in relation to interpretation of culture results.
 What is Normal flora?
They are a population of microorganisms that are frequently
found on the skin ,mucous and other sites in a normal
healthy individual.
Some are found in association with humans and animals. The
Majority are bacteria.
• Has symbolic relationship with the host.
•Subject to constant changes.
• Altered by antimicrobial agents.
Normal flora
Beneficial Effects of Normal Flora
1- Immunostimulation (antibody production)
2- Exclusionary effect (vacuum effect ) and protection from
‫زي حرس الحدود‬external invaders.
3- Antagonize other bacteria through the production of
substances that inhibit or kill non-indigenous bacteria.
4-Production of essential nutrients (Vitamin K & B) by some
normal intestinal flora eg. Eschericia coli ( E.coli).
Origin of Normal Flora:
1) Newborn is sterile in uterus.
2) After birth , newborn is exposed to flora of mother’s
genital tract, skin, respiratory tract, flora of those handling
him , and the organisms in the environment.
Facts About Normal Flora
May be a source of opportunistic infections in patients with impaired
defense mechanisms. eg. Staphylococcus epidermidis & E.coli. Found
in skin
Some may cross react with normal tissue components ,eg. antibodies
to various ABO group arise because of cross reaction between
intestinal flora and the antigens of A & B blood substances.
Production of Carcinogens:
Especially to
Some normal flora may modify through their enzymes chemicals in those who use
our diets into carcinogens. eg. artificial sweeteners may be them often
enzymatically modified into bladder carcinogens.
Affected by antibiotics, tissue damage, mechanical procedures and
diet change.
 Note: they are
subject to constant
changes
Types of Normal Flora
Carrier flora
potentially pathogenic
and are present
without symptoms
because the person
caring it has immunity

Carrier state Transietes cont.

Transients
‫متعايشة‬ Residents Consist of Potentially Exist temporarily for the following reasons:
Commensals nonpathogenic or pathogenicthat • they are washed by hand wash or bathing
Consist of potential are carried by the • competition by resident flora
Microorganisms relatively fixed pathogenic individual without
that have types of microorganisms • killed by substances produced by resident flora
causing disease.
natural microorganisms . that inhabit the • may not survive in acidic or alkaline PH of the
However, it is the
relationship with Regularly found in skin or mucous source of body site
the host. Found in a given area at membrane for infection to other • may be flushed away by bodily secretions like
low number and invariable period. hours or days. susceptible (non- tears, sweat, oil urine,feces,..etc.
has no benefit or If disturbed Establish itself immune )
harm . promptly re- briefly , excluded individual. , eg.
Mainly associated establish itself . by host defense or Streptococcus
with the GIT. competition from pneumoniae,
residents flora. Neisseria
meningetidis in
throat of healthy
individual
Normal Flora vs Pathogenic Flora
Distribution& Body Sites With Normal Flora
All external body sites contain normal flora. Each site having a
predominant bacteria.

Team 436
Gastro intestinal tract (GIT): mouth & large colon.

Urogenital tract: vagina & distal one third of the urethra.

Skin: including external ear & conjunctiva.

Upper respiratory tract.

Internal organs are sterile at health “except the

Gastrointestinal (alimentary)tract”.

Sterility maintained by : ❑
Local defense mechanisms ✓
Chemical substances in serum & tissues e.g.: complement, ✓
antibodies. ً
‫المهم في الصورة هو نعرف توزي ع الفلورا في الجسم وكيف أنها تختلف كمية ونوعا في كل‬
Phagocytic activity of (PMN) Polymorphonuclear Monocytes ✓ ‫ واألمعاء تتواجد‬،‫ بينما المعدة شبه معقمة‬،‫ فمنطقة الفم والمرئ مليئة بالفلوريا‬،‫منطقة‬
.‫فيها الفلورا لكن بشكل أقل من الجزء العلوى من الجهاز الهضمي‬
.
Area Sites Normal Flora Sterile Site Information

Skin Anaerobic organisms Main skin flora: Potential pathogen: * Skin has rich resident
predominate in areas 1) Corynebacteria. Less common: bacterial
with sebaceous glands. 2) Propionibacterium acnes. 1) Staphylococcus flora(10^4/cm^2).
3) Anaerobic cocci. aureus. * Exist as microcolonies.
4) Staphylococcus epidermidis. * Fatty acid, lysozymes
5) Coliforms {gram negative, moist by sweat glands.
skin often colonized by it}.

Eye Conjunctival Sac. 1) Corynebacterium xerosis. Internal eye.

2) Staphylococcus epidrmidis.

Ear External auditory 1) S. epidermidis. Middle and

meatus. 2) Corynebacteria. inner ear.
3) Acid fast bacilli (AFB)
435 note
{occasionally in wax}. Note ;Its
Any skin has staph
normal non-pathogenic
epidermidis and
corynebacteria
 Area Site Normal Flora Sterile Site Information
Respiratory Upper respiratory tract colonized by Nose Flora: Lower respiratory
Tract normal flora as in: 1) Staphylococcus tract e.g.: lung.
1) mouth. epidermidis.
2) nasopharynx. 2) Staphylococcus aurues
3) Corynebacteria.

Oropharynx 1) Viridance streptococci. Potiential pathogen: Gram negative

2) Commensal neisseriae. Most common: bacteria in
3) Corynebacteria. 1) Heamophilus hospitalize patient.
4) Moraxella. inflenzea.
5) Bacteroides. 2) Pneumcoccus.
6) Fusobacteria. Less common:
7) Veillonella. 1) Streptococcus
8) Actinomyces. pyogenes.
9) Spirochaetes. 2) Niesseria meningitidis.

GIT Mouth: Empty stomach due Important:

* Saliva contains 108 bacteria/ml. to gastric acid. GIT contain mainly
* Gingival margin debris & dental Anaerobic, gram–ve
Plaque continually colonized by and enterococcus
bacteria. bacteria. (but it has 6
Oesophagus: types we need to
has normal flora similar to know).
pharyngeal flora. Note:
Small Intestine:
Duodenum, jejunum& upper ielium GIT has Mostly
have scanty flora. Anaerobic bacteria
Large intestine: (highest) because No
heavily colonized by bacteria. oxygen in GIT.
 Empty stomach is
sterile because of
low ph

Area Sites Normal Flora Sterile Site Information

Feces(stool) Anaerobics: * 1/3 of feces weight is

Site with most Bacteroides fragilis group is the dominant anaerobes. bacteria, mainly dead.
normal flora 2) Bifidobacteria. * Living bacteria about
3) Lactobacill. 1010/gm.
Aerobics: * 99% anaerobes.
1) E.coli. Anaerobic environment
2) Proteus. maintained by aerobic
bacteria utilizing free O2.
Less common aerobes.

Urinary tract Kidney & bladder.

 Area Sites Normal Flora Sterile Site Information

Genital Tract In both sexs Mycobacterium smegmatis in (AFB) secretions which

Distal urethra: contaminate urine and leads to confusion /misdiagnosis.
Distal urethra:
1) S.epidermidis.
2) Corynebacteria.
3) Mycoplasma species.

In Female: Vulva: Fallopian tube. * Female genital tract

Vulva 1) S. epidermidis. heavily colonized, Why?
Vagina 2) Corynebacteria. - {Because it is short
3) E.coli. compared to the male
4) coliforms. genital tract. Also, the
5) Enterococcus faecalis. bacteria from the colon will
Vagina: come to colonize it. This is
1) Lactobacillus (Doderlein’s bacilli). why we find that the flora
2) Bacteroides melaninogenicus. in the genital tract is the
3) Enterococcus faecalis. same as in the colon.}
4) Corynebacteria. * 108/ml flora in normal
5) Yeasts. vaginal secretion.
6) Mycoplasma.
 Team 436

GIT
Skin
Oral Cavity

Eye and ear

female Genital
Axilla, Groin and nose
GIT differ with Oral cavity by 4 different types •

Staphylococcus aurous

+++
Oral cavity differ then GIT with one type bacteria •

(Coagulase +)
GIT flora similar with the oral cavity with 2 types of bacteria

+++ Other Staph(Coagulase -)

+++
+++
•

+++ Alph Hemolytic Streptococci

+++

(viridians Streptococci and

strept pneumo
Enterococcus
+++

Neisseria ,Moraxella and

+++

Heaomophilus
Corynebacteria
+++
+++
+++

(diphtheroid) Only in
Popionibacterium skin!!
Lactobacillus note: found in
+++
+++

sexually active. i.e. 15 – 45 yrs

+
++

Gram Negative Bacteria

(coliform ie E.coli)
+++
GIT = most contaminated with 6 types of bacteria

Pseudomonas
Female genital = least contaminated (only one type)

Anaerobic bacteria
+++
+++

(Bactericides, fusobacterium
and clostridium )
 Quiz
1- Beneficial effects of normal flora includes: 2. A resident normal flora is:
a)iMicroorganisms that have natural relationship with the host
A)Immunostimulation b)Regularly found in a given area at invariable period.
B)Production of vitamins C and E by GI flora c)Consist of nonpathogenic or potential pathogenic microorganisms that inhabit
the skin
C)Production of inhibiting or killing substances against
foreign bacteria
D)A&C

4.Which one of the following is the most common bacteria in the skin?
3. The type of relationship between normal flora and host is:
a)complicated A)Staphylococcus epidermidis
b)parasitic B)Coliforms
c)symbolic
d)reversible C)Proteus
D)E.coli
Quiz
5.Which one of the following is sterile?
8. Among the normal flora found in the vagina is?
A)jejunum a)E.coli
B)skin
b)Lactobacillus
c)Enterococcus faecalis
C)vagina
D)peritoneum

6.Which of the following is not sterile? 7. which is sterile?

a)Heart a)Empty stomach
b)uterus b)Inner ear
b)Internal eye Answer key:
c) GI Tract 1.d
d) liver d)all of the above
2.b
3.c
4.a
5.d
6.c
7.d
8.b
 ‫ّ‬
‫اليقوى اإلنسان ف الحياة عىل هذه األرض من دون أن يعاونه الناس ويقفوا معه‪.‬‬

‫‪Team members:‬‬
‫الهام العالمي‬ ‫فهد الفايز‬ ‫داود إسماعيل‬
‫االء الصويغ‬ ‫سعد الهداب‬ ‫عمر الفوزان‬ ‫‪Team leaders:‬‬
‫رناد المقرن‬ ‫خالد الدوسري‬ ‫عبدهللا الزهراني‬
‫هديل عورتاني‬ ‫خالد المطيري‬ ‫معن شكر‬
‫اسراء النزاوي‬ ‫عبدالمجيد الوردي‬ ‫غادة الحيدري ‪ ،‬علي الشحادة‬
‫أنس السيف‬
‫لمياء القويز‬ ‫عبدالجبار اليماني‬ ‫محمد إبراهيم‬
‫شوق القحطاني‬ ‫عبدهللا السرجاني‬ ‫عمر السحيباني‬
‫نورة القاضي‬ ‫عبدالعزيز الدخيل‬ ‫سيف المشاري‬
‫افنان المصطفى‬ ‫عادل العريني‬ ‫سعد العقيلي‬
‫رهف الشمري‬ ‫محمد الدويغري‬ ‫فهد الشغيرثي‬
‫الهنوف الجلعود‬ ‫حسين عالمي‬

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