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

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Content
Skin Flora
Oral Cavity Flora
Intestinal Flora
Urogenital Flora
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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

4. MIC341 - Miss Rashidah Hj Iberahim
Skin Flora
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5. MIC341 - Miss Rashidah Hj Iberahim
Anatomy of the Skin
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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
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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
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8. 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

9. 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
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Normal flora
Gram positive org.
Staphylococcus sp
Micrococcus
Coryneform bacteria
Demodex folliculorum (opening glands – eyebrows)
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11. MIC341 - Miss Rashidah Hj Iberahim
Oral Cavity Flora
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12. Anatomy of the oral cavity
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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
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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
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Intestinal Flora
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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
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17. 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)
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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
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Urogenital Flora
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Anatomy of female
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Anatomy of male
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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
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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
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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
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Normal flora
Mycobacterium smegmatis
Lactobacillus
E.coli
Staphylococcus
Streptococcus
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To be continue..
Sorry..c u tomorrow nite..
MIC341 - Miss Rashidah Hj Iberahim