Microbiology

NORMAL FLORA, BACTERIA, AND DISEASE

Dr. Rebecca Sison | September 18, 2020 | Topic 3
- Transient flora: temporary
Overview present

I. Normal/ Indigenous Flora TYPES OF NORMAL FLORA

II. Human Microbiome
III. Types of Normal Flora 1) Resident flora
IV. Beneficial Effects of the Normal Flora Ø Consists of relatively fixed type
V. Harmful Effects of the Normal Flora of microorganism regularly
VI. Important terms in disease found in a given area, present
VII. Mechanism of Disease production for invariable period
VIII. Microbial Pathogenicity and Virulence Ø Exogenous colonization is
Factors
blocked by variety of
IX. Types of Host
mechanisms called “bacterial
X. Mode of Transmission
XI. Severity or Duration of a Disease
interference” which attributes to;
XII. Types of Infection § Production of
XIII. Stages of Clinical Infection bacteriocins
XIV. Factors affecting Communicability § Maintenance of an
XV. Occurrence of Disease inhospitable
XVI. Pathogens/ Products in Blood environment by
XVII. Prevention competing with the
pathogens for nutrients
or attachment sites
NORMAL/ INDIGENOUS FLORA § Generation of toxic
metabolic products by
the flora
Ø Microbial ecology: study of
§ Provide the acidic pH of
relationships between the
the skin
microorganism and its environment
Ø E.g. Lactobacillus: vagina
Ø Microorganisms that inhabit the skin and
Staphylococcus epidermidis: skin
mucus membranes of healthy normal
person provides;
2) Transient flora
§ First line of defense against
Ø Inhabit the skin and mucus
microbial pathogens
membrane temporarily (hours,
§ Assist in digestion
days, or weeks)
§ Plays a role in toxin degradation
Ø Establish itself briefly
§ Contribute to the maturation of
Ø Excluded by host defense or
immune system
competition from residents

HUMAN MICROBIOME FACTORS THAT MAY ELIMINATE NON-

RESIDENT MICROORGANISMS FROM THE
Ø Collection of microorganism species SKIN
routinely found in normal healthy • Acidic pH
individual usually consist of bacteria • Fatty acids in sebaceous secretions
Ø Types of organism-host • Presence of lysozyme
relationships/ symbiosis
§ Parasitism: one species is FACTORS INFLUENCING VARIETY OF
benefited at the expense of the ORGANISMS
other • Amount of moisture
§ Mutualism: host and organism • Temperature
benefit from one another • pH
§ Commensalism: organism • Presence of chemical wastes à urea
benefits but there are no and fatty acids
beneficial or harmful effects to • Other microbes producing toxic
the host substances
- Resident flora: normally
present

Irelia: The Blade Dancer 1

 Microbiology
NORMAL FLORA, BACTERIA, AND DISEASE
Dr. Rebecca Sison | September 18, 2020 | Topic 3

NORMAL FLORA OF THE EYES, 2) Mucus membrane of the mouth and

CONJUNCTIVA, EARS, AND NOSE pharynx
• Often sterile at birth but may be
contaminated by passage
1) Eyes through the birth canal
• Coagulase-negative • Streptococcus viridans
Staphylococcus § Found in the tongue
• Potential pathogens and buccal mucosa
§ Hemophilus spp. § Established within 4-12
§ Neisseria spp. hours after birth
§ Viridans streptococci § Most prominent
members
2) Conjunctiva § Remain for life
• Diphtheroid (Corynebacterium • Aerobic and anaerobic
xerosis) diplococci
• Staphylococcus epidermidis • Gam (-) diplococci (Neisseria,
• Non-hemolytic Streptococci Moraxella catarrhalis)
• Neisseria and Moraxella • Diphtheroids
• Occasional Lactobacilli
3) Ears
• Coagulase negative Table 1. Normal flora found on the mouth and
Staphylococcus upper respiratory tract
• Potential pathogens Location Flora
§ Streptococcus Tongue and - Viridans streptococci
pneumonia Buccal Mucosa - Neisseria spp.
§ Pseudomonas - Branhamella spp.
aeruginosa - Candida albicans
§ Enterobacteriaceae Tonsillar - Actinomyces species
Tissue and - Bacteroides
4) Nares Gingivae - Treponemes
• Only a few species - Fuscobacteria
• Usually transient - Clostria
- Peptostreptococcus
5) Nose Nasopharynx – - S. pneumonia
• Prominent Corynbacterium sp. transient - Haemophilus spp.
• Staphylococci (S. epidermidis, change - N. meningitides
S. aureus) Pharynx - Non-hemolytic and alpha-hemolytic
• Streptococci Streptococci
- Neisseria
- Staphylococci
NORMAL FLORA OF THE MOUTH AND
- Diptheroids
UPPER RESPIRATORY TRACT
- Haemophili
- Pneumococci
- Mycoplasmas
1) Oral cavity
- Prevotellae
• Highly variable complex
ecosystems
• Anaerobes dominate (100:1) NORMAL FLORA OF THE LOWER
• Diet and hygiene influence RESPIRATORY TRACT
composition
• Site of the most prevalent
infections of man (dental caries, • Larynx, trachea, bronchioles
gingivitis, plaque) and lower airways are generally
sterile

Irelia: The Blade Dancer 2

 Microbiology
NORMAL FLORA, BACTERIA, AND DISEASE
Dr. Rebecca Sison | September 18, 2020 | Topic 3

Table 2. Flora that cause respiratory illness Table 3. Continued

and manifestations Location Flora
Disease/ Flora Small - Scanty resident flora except in
Manifestation intestine the lower ileum, rapid peristalsis,
Acute Lower - S. pneumonia acidic pH
Airway Disease - S. aureus - Anaerobes (Bifidobacterium in
- H. influenza breastfed infants; Lactobacillus
- Members of acidophilus in formula-fed
Enterobacteriaceae (Klebsiella patients)
spp.) - Upper intestine (Lactobacilli
Chronic - Polymicrobial disease and Enterococci)
Aspiration - Anaerobes (Peptostreptoccus) Large - > 400 species
and gram (-) negative bacilli intestine
11
- 10 bacterial cells per gram
- Candida spp. demonstrated in feces
tissue - Anaerobes (1000:1)
- Dimorphic fungi (Histoplasma, - E. coli compromises only 1%
Coccidiodes, Blastomyces spp.) but is the dominant aerobe
- Predominantly anaerobes:
NORMAL FLORA OF THE INTESTINAL Bacteroides species, especially
TRACT B. fragilis
- Fusobacterium species
- Anaerobic Lactobacilli (e.g
Importance of intestinal bacteria Bifidobacteria)
3
Ø Synthesis of Vitamin K - Clostridia (C. perfringes: 10 –
5
Ø Conversion of bile pigments and bile 10 /g)
acids - Anaerobic gram-positive cocci
Ø Absorption of nutrients and breakdown (Peptostreptococcus species)
product
Ø Antagonism to microbial pathogens NORMAL FLORA OF THE GENITO-URINARY
Ø Produces ammonia and other TRACT
breakdown products that are absorbed
and can contribute to hepatic come
• Urinary tract: sterile above distal
Table 3. Normal flora in the intestinal tract 1 cm of the urethra
Location Flora • ONLY the anterior urethra and
Esophagus - Devoid of microflora due to the vagina are permanently
peristalsis of the organ colonized
Stomach - Highly acidic • Regularly appear in normal
- Only a few species present voided urine
- Interact tightly with the epithelial
cells for protection hence rapidly VAGINA
becomes sterile after meals Ø Before puberty and
- Acidity keeps the number of postmenopausal stage: flora of
3
microorganisms at a minimum (10 - skin and colon
5
10 g of contents) Ø At puberty: aerobic and anaerobic
- Obstruction at the pylorus favors the Lactobacilli reappear in large
proliferation of gram-positive cocci numbers and contribute to the
and bacilli maintenance of acid pH through the
- Cimetidine for peptic ulcer leads to a production of acid form
great increase in microbial flora of the carbohydrates, particularly glycogen
stomach Ø Childbearing age: Streptococci
- Lactobacillus sp. and Helicobacter and yeast
sp.

Irelia: The Blade Dancer 3

 Microbiology
NORMAL FLORA, BACTERIA, AND DISEASE
Dr. Rebecca Sison | September 18, 2020 | Topic 3
Ø Menopause: Lactobacilli again
diminish in number mixed flora FACTORS THAT DETERMINE
returns MICROBIAL FLORA IN AND ON THE
Ø Normal vagina flora HUMAN BODY
§ Alpha hemolytic species Ø Age: Older people exhibits
§ Anaerobic Streptococci diminished number of intestinal
(Peptostreptococcus) flora
§ Prevotella species Ø Diet: Vitamin and fiber rich diet
§ Clostridia propagates normal flora better.
§ Gardnerella vaginalis Ø Hormonal state
§ Ureuplasma urealyticum Ø Health
§ Sometimes Listeria spp. Ø Sanitary conditions
Ø Personal hygiene
BENEFICIAL EFFECTS OF NORMAL FLORA
IMPORTANT TERMS IN DISEASE
• Resident flora of intestinal tract:
produces Vitamin K and B • Pathogen: microorganism capable
• Defense the body against pathogens of causing disease
• Bacteria interference: interfering with • Pathogenicity: ability to cause
establishing bacterial populations or disease
colonization by exogenous bacteria (E.g • Virulence: degree of pathogenicity;
Bifidobacteria and Lactobacilli lowers measure by the ability to produce
pH) disease
• Production of bacteriocin • Pathogenesis: steps or
• Maintain inhospitable environment mechanisms involved in the
• Generation of toxic metabolic product by development of the disease
the flora • Pathology: study of the structural
• Priming the immune system of newborn and functional manifestations of the
• Immuno-stimulation (antibody disease
development) by stimulating nonspecific • Disease: undesirable host-parasite
human responsiveness relationship resulting in interruption
• Exclusionary effect (vacuum effect) and in normal function of a body
protection from external invaders structure
• Production of essential nutrients • Infection: invasion and
(Vitamin K and B complex) by some multiplication of microbes in an
normal intestinal flora (eg. E. coli) individual or population
• Infectious disease: occurs when
the infection causes damage to the
HARMFUL EFFECTS OF NORMAL FLORA
individual’s vital functions and
systems
• Occurs if the normal flora is displaced • Symptoms: evidence of disease
from their normal site of the body to an that is experienced or perceived
abnormal site or if the individual is - Subjective changes in
immunocompromised body function noted by
• Potential pathogens gain a competitive patient but not apparent to
advantage due to diminished an observer
populations of harmless competitors • Sign: objective evidence of a
• Harmless commonly ingested food disease the physician can observe
substances are converted into and measure
carcinogenic derivatives by bacterial • Syndrome: a specific group of signs
sulfatases of the sweetener cyclamate and symptoms that accompany a
into the bladder particular disease

Irelia: The Blade Dancer 4

 Microbiology
NORMAL FLORA, BACTERIA, AND DISEASE
Dr. Rebecca Sison | September 18, 2020 | Topic 3

KOCH’S POSTULATES ENDOTOXIN

Ø 4 criteria that identify the causative Ø A complex bacterial toxin that is
agent of a particular disease composed of protein, lipid, and
polysaccharide (LPS) which is
1) The microorganism must be present in release only upon lysis of the cell
all cases of the disease
2) The pathogen can be isolated from the EXOTOXIN
diseased host and grown in pure culture Ø Potent toxic substance formed and
3) The pathogen from the pure culture secreted by species of certain
must cause the same disease when bacteria
inoculated into a healthy, susceptible
laboratory animal Table 4. Differences of exotoxin and
4) The pathogen must be reisolated from endotoxin
the new host and shown to be the same Feature Exotoxin Endotoxin
as the originally inoculated pathogen Source Gm (-) and (+) Gram (-)
Location Extracellular Outer
MECHANISMS OF DISEASE PRODUCTION membrane
Toxicity Great Weak
Tissue Specific Non-specific
1) Mechanical affinity
Ø Involve invasion of tissues or Chemical Polypeptide LPS
surface (colonization) type
Ø Attributed to extracellular enzymes Stability Heat labile Heat stable
(eg. Coagulase)
Antigenicity High Weak
Ø Structure that promote adherence to
Convert to Yes No
susceptible cell like fimbria
toxoid
2) Chemical
PATHOPHYSIOLOGICAL EFFECTS
Ø Production substances that can
OF ENDOTOXINS
cause destruction of body toxin
Ø Fever
(toxin, haemolysin, lethal factor)
Ø Leukopenia
Ø Consequence of the chemicals and
Ø Metabolic effects: Hypotension,
toxins that they produce. For
hypoglycemia
examples, some bacteria produce;
Ø Impaired organ perfusion and
• Leukocidins: destroy white
acidosis
blood cells enabling them to
Ø Activation of C3 and complement
escape phagocytosis (E.g
cascade
Staphylococci and Streptococci)
Ø Cellular death
• Coagulase: coagulates the
• Septic shock
fibrinogen in blood, forming a
• Disseminated Intravascular
blood clot
Coagulation
Ø Toxin (endotoxin and exotoxin)
• Organ necrosis
• Exotoxin: Gm (+) bacteria and
Gm (-) bacteria
HOW ORGANISMS PRODUCE
• Endotoxin: Gm (-), not
DISEASE
converted to toxoid
Ø Immunologic: some organisms
produce disease not as
MICROBIAL PATHOGENICITY AND
consequence of the mechanical
VIRULENCE FACTORS
invasion or toxins production but as
a consequence of the immune
TOXIGENICITY
response of the host to the
§ ability of a microorganism to cause
microorganisms or its products
disease as determined by the toxin, it
produces which partly determines its
virulence

Irelia: The Blade Dancer 5

 Microbiology
NORMAL FLORA, BACTERIA, AND DISEASE
Dr. Rebecca Sison | September 18, 2020 | Topic 3

TYPES OF HOST 3) Vector Transmission

Ø Animals that carry disease from one
host to another
1) Reservoir host
Ø Arthropods are most important
Ø A supply of pathogen/ infection/
animal vectors
disease
Ø Example: A female Anopheles
a) Mechanical Transmission
mosquito is a reservoir of
Ø Passive transport of pathogen on
Plasmodium falciparum for malaria
insect’s body
Ø Fleas for bulbonic plaque
2) Susceptible host
Ø Likely or likeable to be influenced or
b) Biological Transmission
harmed by a pathogen
Ø Pathogen spends part of its life
cycle in the vector
*Reservoir and susceptible host both are equally
Ø Mosquitoes: Aedes aegypti for Zika
dangerous
and dengue
MODE OF TRANSMISSION TO BE A PATHOGEN TO CAUSE DISEASE
Ø Gain entry to the host
1) Contact Transmission Ø Colonized the host’s tissues
Ø Resist the host’s defenses
a) Direct Contact Transmission Ø Damage the host’s tissues
Ø Person to person transmission
Ø No intermediate object/ host is SEVERITY OR DURATION OF A DISEASE
involved
Ø Source: Auto-inoculation, sexual 1) Acute infection: last for a short period
contact, airborne of time
Ø Passing thru infected birth canal 2) Chronic infection: last for a long period
of time
b) Indirect Contact Transmission 3) Localized infection: microbes enter the
Ø Agent is transferred via a non-living body and remains confined to a specific
object tissue/ site of infection à severity
Ø Source or agent: towels, eating 4) Systemic infection/ generalized:
utensils, shared possessions etc. widespread infection spreads to several
sites and tissues, pathogens present in
c) Droplet Transmission the bloodstream
Ø Microbes are spread in nuclei 5) Focal infection: when infectious agent
droplets that travel short distance breaks loose from a local site of
(less than 1 meter) infection and is carried to other tissues
Ø Source or agent: coughing, talking, 6) Fulminating infection: infection very
and laughing severe will result to death of patient in/
over a short of time
2) Vehicle Transmission 7) Latent/ dormant/ subclinical infection:
Ø Transmission of disease via indicate mild infection or asymptomatic
medium such as water, food, air, 8) Nosocomial infection: acquired by a
blood, bodily fluids, and IV fluids person resulting from prolonged hospital
Ø stay
a) Water-borne transmission
Ø Usually caused by water
contaminated with fecal matter

b) Airborne transmission
Ø Spread of agents by droplets in dust
that travel more than 1 m to host

Irelia: The Blade Dancer 6

 Microbiology
NORMAL FLORA, BACTERIA, AND DISEASE
Dr. Rebecca Sison | September 18, 2020 | Topic 3

TYPES OF INFECTION D. Convalescence Period

Ø Manifestations decline
Ø Stage during which sign and
SOURCE OF INFECTION
symptoms decline
1) Exogenous infection: source of
microorganism is from outside the body E. Recovery Period
2) Endogenous infection: from within the Ø Person regains full strength
body Ø Stage when patient fully recovered
3) Specific infection: caused by a from the infection
microorganism that is known
4) Non-specific infection: unknown
microorganism FACTORS AFFECT COMMUNICABILITY
5) Community acquired infection:
obtained in the community 1) Ability to survive outside the body
6) Single infection: one infectious agent 2) Ability of the pathogen to survive the
7) Mixed infection: 2 or more pathogens host’s immune system
producing one or more disease 3) Ability of the pathogen to establish the
carrier state
STAGES OF CLINICAL INFECTION 4) Ability of the pathogen to survive in an
intermediate host/ vector
A. Incubation Period 5) Ability of the pathogen to survive in a
Ø First encounter with the pathogens reservoir host
Ø The time from initial contact with the
infectious agent to the appearance OCCURRENCE OF DISEASE
of first symptoms
Ø Time from which the pathogen was
INCIDENCE
introduced to the host up to the
Ø Number of people in a population who
time, when signs and symptoms
develop a disease during a particular
appear
period of time. It serves as an indicator
- May last from a few days to
of the spread of the disease.
many years
- Factors that influences the
PREVALENCE
length of the incubation
Ø Number of people in a population who
period
develop a disease at a specified time,
• Overall health and regardless of when it first appeared. It
immune status of the takes un to account both old and new
host cases and serves as an indicator of
• Virulence of the how seriously and how lung disease
pathogen affects population.
• Number of pathogens
that enter the body EPIDEMIC
Ø Involve a large number of individual in
B. Prodromal Stage a short period of time
Ø Period of onset of disease
Ø Vague feelings of discomfort; ENDEMIC
nonspecific complaints Ø Disease is constantly present in the
community
C. Period of Invasion/ Illness
Ø Period of maximum illness PANDEMIC
Ø Outcome of infection: acute, Ø Disease prevalent over the world
chronic, or carrier
Ø Multiplies at high levels; becomes SPORADIC
well-established Ø Disease occurs every now and then
Ø More specific signs and symptoms

Irelia: The Blade Dancer 7

 Microbiology
NORMAL FLORA, BACTERIA, AND DISEASE
Dr. Rebecca Sison | September 18, 2020 | Topic 3

EXOTIC
Ø Disease is strange to the community

EPIZOOTIC
Ø Epidemic in lower animal

ENZOOTIC
Ø Endemic in lower animal

ZOONOTIC
Ø Disease primarily occurring in lower
animal

PATHOGENS/ PRODUCTS IN BLOOD

Ø Bacterecemia: bacteria in the blood

stream
Ø Septicemia: presence of actively
multiplying bacteria in the blood
Ø Pyemia: presence of pus-producing
bacteria in the blood stream
Ø Septicopyemia: combination of
septicemia and pyemia
Ø Viremia: virus in the blood stream
Ø Sapremia: presence of saprophytes in
the blood stream
Ø Toxemia: presence of toxins in the
blood

PREVENTION

MEDICAL HYGIENE
Ø Includes a specific set of practices
associated with preservation of health

SANITATION
Ø Provision of facilities and services for
the safe disposal of human urine and
feces

REFERENCE
th
• Jawetz’ Medical Microbiology 28
Edition
• Dr. Sison’s PowerPoint presentation
• 2021 Transcript

Irelia: The Blade Dancer 8