Miss Rashidah Hj Iberahim Chapter 2 – NORMAL FLORA Miss Rashidah Hj Iberahim MIC341 - Miss Rashidah Hj Iberahim

MIC341 - Miss Rashidah Hj Iberahim Content Skin Flora Oral Cavity Flora Intestinal Flora Urogenital Flora MIC341 - Miss Rashidah Hj Iberahim

MIC341 - Miss Rashidah Hj Iberahim 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

MIC341 - Miss Rashidah Hj Iberahim Skin Flora MIC341 - Miss Rashidah Hj Iberahim

MIC341 - Miss Rashidah Hj Iberahim Anatomy of the Skin MIC341 - Miss Rashidah Hj Iberahim

MIC341 - 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

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

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

MIC341 - Miss Rashidah Hj Iberahim Closing the loop Producing fatty acids that prevent growth of other m/org Excretion of lysozyme by sweat glands Desquamation of epithelial MIC341 - Miss Rashidah Hj Iberahim

MIC341 - Miss Rashidah Hj Iberahim Normal flora Gram positive org. Staphylococcus sp Micrococcus Coryneform bacteria Demodex folliculorum (opening glands – eyebrows) MIC341 - Miss Rashidah Hj Iberahim

MIC341 - Miss Rashidah Hj Iberahim Oral Cavity Flora MIC341 - Miss Rashidah Hj Iberahim

Anatomy of the oral cavity MIC341 - Miss Rashidah Hj Iberahim

MIC341 - Miss Rashidah Hj Iberahim Mouth 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 MIC341 - Miss Rashidah Hj Iberahim

MIC341 - Miss Rashidah Hj Iberahim Ecology of m/org 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 MIC341 - Miss Rashidah Hj Iberahim

MIC341 - Miss Rashidah Hj Iberahim Intestinal Flora MIC341 - Miss Rashidah Hj Iberahim

MIC341 - Miss Rashidah Hj Iberahim GI tract 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 MIC341 - Miss Rashidah Hj Iberahim

MIC341 - Miss Rashidah Hj Iberahim 1/3 small intestine The main flora in 1/3 last small intestine – Gram-negative Facultitative anaerobe such as enterobacteriaceae (E.coli) obligate anaerobes (Bacteroides and Clostridium) MIC341 - Miss Rashidah Hj Iberahim

MIC341 - Miss Rashidah Hj Iberahim Large intestine 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 MIC341 - Miss Rashidah Hj Iberahim

MIC341 - Miss Rashidah Hj Iberahim Urogenital Flora MIC341 - Miss Rashidah Hj Iberahim

MIC341 - Miss Rashidah Hj Iberahim Anatomy of female MIC341 - Miss Rashidah Hj Iberahim

MIC341 - Miss Rashidah Hj Iberahim Anatomy of male MIC341 - Miss Rashidah Hj Iberahim

MIC341 - Miss Rashidah Hj Iberahim Urogenital 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 MIC341 - Miss Rashidah Hj Iberahim

MIC341 - Miss Rashidah Hj Iberahim 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

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

MIC341 - Miss Rashidah Hj Iberahim Normal flora Mycobacterium smegmatis Lactobacillus E.coli Staphylococcus Streptococcus MIC341 - Miss Rashidah Hj Iberahim

MIC341 - Miss Rashidah Hj Iberahim To be continue.. Sorry..c u tomorrow nite.. MIC341 - Miss Rashidah Hj Iberahim