normal flora of the human body
TRANSCRIPT
NORMAL FLORA NORMAL FLORA OF THE HUMAN OF THE HUMAN
BODYBODYJANUARY 30, 2008JANUARY 30, 2008
MUTUALISTIC MUTUALISTIC RELATIONSHIPRELATIONSHIP
HOSTHOSTNUTRITIONAL NUTRITIONAL BENEFITSBENEFITS
STIMULATION OF STIMULATION OF THE IMMUNE THE IMMUNE SYSTEMSYSTEM
COLONIZATION COLONIZATION STRATEGIESSTRATEGIES
ORGANISMORGANISMNUTRIENT NUTRIENT SUPPLYSUPPLY
STABLE STABLE ENVIRONMENTENVIRONMENT
REASON FOR THEIR REASON FOR THEIR PREFERRED SITESPREFERRED SITES
TISSUE TROPISMTISSUE TROPISM
TISSUE TISSUE PREVALENCE/PREDILECTIONPREVALENCE/PREDILECTION
PRESENCE OF AN ESSENTIAL PRESENCE OF AN ESSENTIAL GROWTH GROWTH FACTORFACTOR
INHOSPITABLE ENVIRONMENTINHOSPITABLE ENVIRONMENT NORMAL FLORA’S SURFACE NORMAL FLORA’S SURFACE
COMPONENTSCOMPONENTS
FIMBRIAE, CAPSULES, PILIFIMBRIAE, CAPSULES, PILI
REASONS FOR REASONS FOR COLONIZATIONCOLONIZATION
BACTERIAL BACTERIAL BIOFILMSBIOFILMS
TISSUE TROPISM OF TISSUE TROPISM OF LACTOBACILLUS IN THE LACTOBACILLUS IN THE
G.U.T.G.U.T.
N.gonorrhoeae: piliN.gonorrhoeae: pili
SKINSKIN
HIGHEST NUMBER IN THE MOIST HIGHEST NUMBER IN THE MOIST AREASAREAS
MOST SUPERFICIAL LAYERS, MOST SUPERFICIAL LAYERS, UPPER HAIR FOLLICLESUPPER HAIR FOLLICLES
S.epidermidisS.epidermidis Micrococcus spp.Micrococcus spp. CorynebacteriumCorynebacterium
NONPATHOGENICNONPATHOGENIC COMMENSAL/MUTUALISTIC/COMMENSAL/MUTUALISTIC/
PARASITICPARASITIC MAY PROTECT AGAINST FUNGAL MAY PROTECT AGAINST FUNGAL
COLONIZATIONCOLONIZATION
Micrococcus spp.Micrococcus spp.
S.epidermidisS.epidermidis
RESPIRATORY TRACTRESPIRATORY TRACT
NOSTRILNOSTRIL
S.epidermidisS.epidermidis
S.aureus**S.aureus**
CorynebacteriumCorynebacterium SINUSESSINUSES
STERILESTERILE
URTURT
STREPTOCOCCUSSTREPTOCOCCUS
H.influenzaeH.influenzae
LRTLRT
STERILESTERILE
LOWER RESPIRATORY LOWER RESPIRATORY TRACTTRACT
LRT EPITHELIUMLRT EPITHELIUM
RESP.TRACT CILIARESP.TRACT CILIA
ORAL CAVITYORAL CAVITY
NUTRIENTS, DEBRIS, NUTRIENTS, DEBRIS, SECRETIONS:IDEAL ENVIRONMENTSECRETIONS:IDEAL ENVIRONMENT
AT BIRTH - STERILEAT BIRTH - STERILE
S.salivarius – UP TO 9 MONTHS S.salivarius – UP TO 9 MONTHS OF AGEOF AGE
S.mutans, S.sanguis – AFTER S.mutans, S.sanguis – AFTER TEETH TEETH ERUPTIONERUPTION
Bacteroides – PUBERTYBacteroides – PUBERTY
ANAEROBES - GINGIVAANAEROBES - GINGIVA
ORAL CAVITYORAL CAVITY
PREVENT GROWTH OF PATHOGENSPREVENT GROWTH OF PATHOGENS
NUTRIENT DEPLETIONNUTRIENT DEPLETION
PRODUCE FATTY ACIDS, PEROXIDESPRODUCE FATTY ACIDS, PEROXIDES STIMULATE LOW LEVELS OF IG, CROSS STIMULATE LOW LEVELS OF IG, CROSS
REACTREACT CAUSE HARM IF THEY ENTER TISSUESCAUSE HARM IF THEY ENTER TISSUES
B.melanogenicus - WOUNDSB.melanogenicus - WOUNDS
STREPTOCOCCUS – HEART VALVES, STREPTOCOCCUS – HEART VALVES, SUBACUTE BACTERIAL SUBACUTE BACTERIAL
ENDOCARDITISENDOCARDITIS
DENTAL PLAQUEDENTAL PLAQUE
LEADS TO CARIES, PERIODONTAL LEADS TO CARIES, PERIODONTAL DISEASEDISEASE
BIOFILM – 300 TO 500 CELL BIOFILM – 300 TO 500 CELL THICKNESSTHICKNESS
60-70%PLAQUE VOLUME: 60-70%PLAQUE VOLUME: BACTERIABACTERIA
MOST COMMON ORGANISMMOST COMMON ORGANISM
S. sanguis, S.mutansS. sanguis, S.mutans
S.mutans PRODUCE LACTIC ACID S.mutans PRODUCE LACTIC ACID FROM DIETARY CARBOHYDRATESFROM DIETARY CARBOHYDRATES
DEMINERALIZES TEETH ENAMELDEMINERALIZES TEETH ENAMEL LACTOBACILLI,ACTINOMYCES:LACTOBACILLI,ACTINOMYCES:
SECONDARY INVADERSSECONDARY INVADERS PERIODONTAL DISEASE: PERIODONTAL DISEASE:
ACTINOMYCESACTINOMYCES
GINGIVA, ALVEOLAR BONEGINGIVA, ALVEOLAR BONE
CONJUNCTIVACONJUNCTIVA
MOST DOMINANTMOST DOMINANT
S. epidermidisS. epidermidis
PROPRIONIBACTERIUM sppPROPRIONIBACTERIUM spp MECHANICAL WASHING OF MECHANICAL WASHING OF
TEARSTEARS LYZOZYME LYZOZYME LITTLE/NO OPPORTUNITY FOR LITTLE/NO OPPORTUNITY FOR
COLONIZATIONCOLONIZATION
N.gonorrhoeaeN.gonorrhoeae C.trachomatisC.trachomatis PRESENCE OF PRESENCE OF
SIALIC ACID SIALIC ACID RECEPTORSRECEPTORS
NEWBORN MAY NEWBORN MAY BE INFECTEDBE INFECTED
PROPHYLACTIC PROPHYLACTIC ANTIBIOTIC AT ANTIBIOTIC AT BIRTHBIRTH
NYC PROTOCOLNYC PROTOCOL
TETRACYCLINETETRACYCLINE ERYTHROMYCINERYTHROMYCIN 1%SILVER NITRATE1%SILVER NITRATE
UROGENITAL TRACTUROGENITAL TRACT
URINE- STERILEURINE- STERILE FLUSHING OF URINEFLUSHING OF URINE ANTERIOR URETHRAANTERIOR URETHRA
S.epidermidisS.epidermidis
ENTERIC BACTERIAENTERIC BACTERIA CONTAMINANTSCONTAMINANTS
VAGINAVAGINA
Lactobacillus acidophilusLactobacillus acidophilus
(Doderlein’s bacillus)(Doderlein’s bacillus)
METABOLIZES GLYCOGEN TO METABOLIZES GLYCOGEN TO LACTIC ACIDLACTIC ACID
LOW pHLOW pH
PREVENTS GROWTH OF MOST PREVENTS GROWTH OF MOST BACTERIA, YEAST (CANDIDA)BACTERIA, YEAST (CANDIDA)
GITGIT INFLUENCED BY THE AGE, DIET, INFLUENCED BY THE AGE, DIET,
SPECIFIC SITESPECIFIC SITE ESOPHAGUSESOPHAGUS
BACTERIA IN FOOD, SALIVABACTERIA IN FOOD, SALIVA STOMACHSTOMACH
RARERARELACTOBACILLILACTOBACILLIHELICOBACTER PYLORIHELICOBACTER PYLORI
Helicobacter pyloriHelicobacter pylori RELATED TO RELATED TO
GASTRIC ULCERS, GASTRIC ULCERS, CANCERCANCER
CLASS I CLASS I CARCINOGEN CARCINOGEN (WHO)(WHO)
20-30 YEARS 20-30 YEARS INFECTION---CAINFECTION---CA
MOST COMMON MOST COMMON BACTERIAL BACTERIAL INFECTIONINFECTION
H.PYLORIH.PYLORI
DETECTED BY THE C-13 OR C-14 DETECTED BY THE C-13 OR C-14 BREATH TESTBREATH TEST
ANTIBODY DETERMINATION TESTANTIBODY DETERMINATION TEST ENDOSCOPYENDOSCOPY
GIT NORMAL FLORAGIT NORMAL FLORA
PROXIMAL SMALL INTESTINEPROXIMAL SMALL INTESTINE
SPARSE GR(+) FLORASPARSE GR(+) FLORA
LactobacilliLactobacilli
S.faecalisS.faecalis DISTAL SMALL INTESTINEDISTAL SMALL INTESTINE
Coliforms (gram – bacilli)Coliforms (gram – bacilli)
BacteroidesBacteroides
LARGE INTESTINELARGE INTESTINE
+++COLIFORMS+++COLIFORMS
ANAEROBIC BACTEROIDESANAEROBIC BACTEROIDES
ANAEROBIC LACTOBACILLIANAEROBIC LACTOBACILLI
METHANOGENIC BACTERIAMETHANOGENIC BACTERIA
OUTNUMBER E.COLI 1,000:1 OUTNUMBER E.COLI 1,000:1 UP TOUP TO
10000:110000:1
GIT IN INFANTSGIT IN INFANTS
BIRTH – STERILE GITBIRTH – STERILE GIT BREASTFED INFANTS BREASTFED INFANTS
90% BIFIDOBACTERIA90% BIFIDOBACTERIA COW’SMILK, SOLID FOODCOW’SMILK, SOLID FOOD
BACTEROIDESBACTEROIDES
STREPSTREP
ENTERICSENTERICS
GIT TROPISMGIT TROPISM
GRAM (+)GRAM (+)
CAPSULESCAPSULES
LIPOTECHOIC ACIDS IN THEIR LIPOTECHOIC ACIDS IN THEIR WALLSWALLS
GRAM (-)GRAM (-)
FIMBRIAE BINDS TO THE FIMBRIAE BINDS TO THE GLYCOPROTEINS ON THE CELL GLYCOPROTEINS ON THE CELL SURFACESURFACE
BENEFITS OF THE BENEFITS OF THE INTESTINAL FLORAINTESTINAL FLORA
E.COLI SYNTHESIZES VITAMIN KE.COLI SYNTHESIZES VITAMIN K COMPETE FOR ATTACHMENT SITE COMPETE FOR ATTACHMENT SITE
OF PATHOGENIC SPECIESOF PATHOGENIC SPECIES STIMULATES GROWTH OF STIMULATES GROWTH OF
LYMPHOID TISSUESLYMPHOID TISSUES PRODUCTION OF CROSS PRODUCTION OF CROSS
REACTIVE ANTIBODIESREACTIVE ANTIBODIES
Predominant bacteria at various anatomical locations in adults.Predominant bacteria at various anatomical locations in adults.
SkinSkinstaphylococci and corynebacteria staphylococci and corynebacteria
ConjunctivaConjunctivasparse, Gram-positive cocci and Gram-negative rodSsparse, Gram-positive cocci and Gram-negative rodS
Oral cavityOral cavity
teeth teeth streptococci, lactobacilli streptococci, lactobacilli mucous membranesmucous membranes Streptococci and lactic acid Streptococci and lactic acid
bacteriabacteria
Upper respiratory tractUpper respiratory tract
nares (nasal membranes)staphylococci and nares (nasal membranes)staphylococci and corynebacteria corynebacteria
pharynx (throat) streptococci, neisseria, Gram-pharynx (throat) streptococci, neisseria, Gram-negative rods and coccinegative rods and cocci
Lower respiratory tractLower respiratory tract none none
GasTrointestinal tractGasTrointestinal tract
stomach stomachHelicobacter pyloriHelicobacter pylori (up to (up to 50%)50%)
small intestinesmall intestine lactics, enterics, lactics, enterics, enterococci, bifidobacteriaenterococci, bifidobacteria
coloncolon bacteroides, lactics, enterics, bacteroides, lactics, enterics, enterococci, clostridia, enterococci, clostridia, methanogensmethanogens
Urogenital tractUrogenital tract
anteriOR urethra anteriOR urethra sparse, sparse, staphylococci, corynebacteria, entericsstaphylococci, corynebacteria, enterics
vaginavagina lactic acid bacteria during lactic acid bacteria during child-bearing years; otherwise mixedchild-bearing years; otherwise mixed
Streptococcus pyogenes
Cell-bound protein (M-protein)
Pharyngeal epithelium
Streptococcus mutans
Cell- bound protein (Glycosyl transferase) Pellicle of tooth
Streptococcus salivarius
Lipoteichoic acidBuccal epithelium of tongue
Streptococcus pneumoniae
Cell-bound protein (choline-binding protein)
Mucosal epithelium
Staphylococcus aureus
Cell-bound proteinMucosal epithelium
Neisseria gonorrhoeae
N-methylphenyl- alanine piliUrethral/cervical epithelium
Enterotoxigenic E. coli
Type-1 fimbriae Intestinal epithelium
Uropathogenic E. coli
P-pili (pap) Upper urinary tract
Bordetella pertussis
Fimbriae ("filamentous hemagglutinin")
Respiratory epithelium
Vibrio cholerae
N-methylphenylalanine pili
Intestinal epithelium
Treponema pallidum
Peptide in outer membrane
Mucosal epithelium
Mycoplasma Membrane proteinRespiratory epithelium
Chlamydia UnknownConjunctival or urethral epithelium