The gastrointestinal

microflora

F. Meque, MD- Clinic Infections Disease Specialist

Presented by Santos A. Jossene
June/2022
Contents
 Introduction
 Concepts
 Normal flora
 Oral
 Gastric
 Small intestine
 Colonic
 Function of the microflora
 Factors that affect the normal flora
 Consequences being germ-free
 Supporting normal flora
 References.
Introduction

 Many billions of beneficial bacterial that live in

our Gl tract help keep it functioning properly to
help us avoid disease. These colonies of GI
bacteria are often referred to as our normal flora.

 Eachperson has a unique mix of flora,

potentially containing as many as 400 different
species. Most belong to the genera streptococcus
or bacteroides.
Concepts

Pathogen: an organism that can cause infection in individuals
with normal host defences.
e.g.: Salmonella.


Commensal
 an organism that is found normally on those parts of the
body that communicate with the external environment.
e.g.: Staphylococcus epidermidis;


Opportunistic pathogen
 an organism that can cause infection in individuals with
abnormal host defences. Commensals may be
opportunistic pathogens.
 Sterileareas: no microorganism is found
normally
E.g. Blood, brain, synnovia, liquor, deep
tissues.

 Microbial transit areas: respiratory tract

 Permanently colonized areas: intestines.

Normal flora

• Oral Flora
• Gastric Flora
• Small Intestine Flora
• Colonic Flora
Oral flora

• Habitats
- Gingival surface, tooth surfaces, bucal
mucosa, surface of tongue and pharynx.

- Bacteroides (intermedius, oralis, gingivalis…

- Streptococci(sanguis, salivarius, mitis,
viridans...
Gastric flora

• H. pylory ↑
• Lactobacillus, candidas, streptococcus
viridans, neisseria, S. coagulase-negative
peptostreptococcus
Small intestine flora

• Proximal: Duodenum, jejunum and Ileum

- Facultative anaerobe, streptococci,
lactobacilli, yeast and staphilococcus.
• Distal ileum: Colonic flora
Colonic flora

Most of them are anaerobes.

• Staphylococcus aureus
• C. difficile
• Enterobacteriaceae sp., E. coli
• Candida albicans
• Enterrococci
Function of microflora

• Metabolism
• Immunomodulatory
• Protective barrier function
Metabolism

 Ferment indigestible fiber in our food,

breaking it down into smaller molecules that
are eliminated in stool.

 They synthesize vitamin K and also produce

other vitamins such as vitamin B12, folic acid
and thiamin.
Metabolism

• Nitrogen metabolism
- Anaerobic metabolism of protein and
peptides putrefacion

• Bile metabolism
- Desconjugation of bile acids.
Metabolism

• Drug metabolism
- Decrease activity of Penicillins
- Activaction of some drugs, eg: Metronidazole
Protective function


Barrier effect by competition;

Exogenous bacteria cannot establish because
suitable ecological conditions are missing;

Active protection of the host and the existing
microbial community.
Factors that affect normal flora

• Buccal hygiene
• Decreased salivary flow
• Achlorhydria
• Stasis
• Impaired cell-mediated immunity
• Use of antibiotics
Consequences of being germ-free

• Vitamin deficiency
• Immune system underdevelopment
• Susceptibility to enteric pathogens
• Increased risk of allergies, inflammatory
bowel diseases.
Supporting normal flora

 Probiotic foods: are foods that contain living

bacteria or identical to those that live in our GI
tract.

Consuming these foods regularly can help build up

our intestinal flora by adding new colonies and
replacing any lost during an illness.

E.g.: yourgurt containing live cultures, natto, goat or

sheep’s milk, fermented cabbage dishes…
References

 HarvardMedical School Family Health

Guide: Health Benefits of Taking Probotics.

 Gut, AnInternational Journal of

Gastroenterology and Hepatology: Ecological
Control of GI tract. The role of probiotic flora.

 Medical
Microbiology; Sherwood L.
Goarbach.
Thank you