CHAPTER 5
NORMAL FLORA OF THE HUMAN BODY
– Microbial Ecology- Is the study of the relationships
between microorganism and their environment.
– -Among these relationships is the relationships of
microbes with humans, and such include the normal
flora (or indigenous flora) of the human body.
2 TYPES OF FLORA
1. Resident flora- Are organisms that are relatively of fixed types and
are regularly found in a given area of the body at a given age.
2. Transient flora- Are those that inhabit the skin and mucous
membrane temporarily for hours, days or weeks and are derived
from the environment.
Normal flora
– Normal intestinal flora secrete vitamin K that is need for the
activity of some clotting factors.
– Also help in the metabolism of steroids.
– Can prevent pathogenic organisms from attaching to and
penetrating the skin and other tissues by producing mucin which
make it difficult for the pathogenic organisms to attach to the
tissues to produce disease.
Normal flora on different sites of the body
SKIN
The skin is part of the human body that is in constant
contact with the environment, making it the most
exposed to microorganisms.
There are certain factors that eliminate
non-resident flora from the skin; Namely:
– 1. Lysozyme in the skin;
– 2. Acidic pH of the skin due to sweat;
– 3. Free fatty acids in sebaceous secretions;
– 4. The constant sloughing off of the skin.
The normal flora of the skin consists mainly
of bacteria and fungi.
– The microorganisms vary depending on the region of
the skin.
The skin may be divided into three (3) regions.
1. Axilla, perineum, and toe webs.
2. Hand, face, and trunk.
3. Upper arms and legs.
NORMAL FLORA ON THE SKIN
Organism Remarks
Staphylococcus epidermidis Major skin inhabitant, comprising approximately 90% of resident
aerobic flora.
Staphylococcus aureus Most commonly found in nose and perineum; in the nose number varies
with age ( Greater in newborns than in adults)
Micrococci ( Micrococcus luteus ) Accounts for 20-80% of micrococci in the skin.
Diphtheroids ( Coryneforms ) Classified into; lipophilic (Common in axilla) or non-lipholic ( More
common on glabrous or hairless skin such as palms of hands)
Anaerobic diphtheroids ( Propionibacterium acnes )
-areas rich in sebaceous glands
Gram-negative bacilli (Enterobacter, Seen in most intertriginous areas such as toe webs and axilla
Klebsiella, Escherichia coli, and Proteus
spp.)
Nail Flora Similar to that of the skin
Fungi may also be present ( Aspergillus, Penicillium, Cladosporium,
Mucor )
Mouth and Respiratory Tract
– Tongue and buccal mucosa – Streptococcus virdans group (S. mutans, S. milleri,
S. salivarius, and S. sanguis).
– Although they are part of the normal flora of the mouth, Viridans streptococci
have been implicated in the pathogenesis of dental caries.
– The normal flora of the pharynx and trachea are similar to those found in the
oral cavity.
– In the upper respiratory tract, initial colonization by pathogenic organisms may
be seen.(Neissera meningitidis, Bordetella pertussis, and Corynebacterium
Diphtheriae)
– The lower respiratory tract is usually sterile and organisms that reach this
region are usually destroyed by the defense mechanism of the body such as the
alveolar macrophages.
CONJUNCTIVA
– The normal flora in the conjunctiva are very scanty because they are held in check by the flow of tears that
contain lysozyme.
– Some bacteria may transiently colonize the conjunctiva including Neisseria, Moraxella, and
Corynebacterium.
DIGESTIVE TRACT
– Esophagus contains transient mouth flora.
– Minimal bacteria may be found in the stomach due to the
relatively hostile environment in the stomach.
– Bacteria that may be found In the stomach are those that
may be swallowed with the food or those that are dislodged
from the mouth.
– The number of bacterial flora differs between the small and
large intestine. In the small intestine, scanty flora may be
found due to the constant peristaltic movement of the
intestines.
– Most bacteria cultured in the small intestine include
streptococci, lactobacilli, and bacteroides which are all
transient.
Important role of Intestinal Flora
– Synthesis of vitamin B complex and Vitamin K
– Conversion of bile into bile acids.
– Competition with transient flora for nutrients.
– Prevention of colonization of the intestines by transient flora.
– Production of potentially pathogenic end-products of metabolism that are toxic
to transient flora.
GENITOURINARY TRACT
– Urinary tract is sterile above the distal 1cm of the urethra.
– In both male and females, mycobacterium smegmatis may be found as normal commensals in
their secretions.
– Female urethra is either sterile or contains staphylococcus epidermidis.
– Vaginal flora varies depending on the age , hormonal level, and vaginal pH of the host.
– Predominant flora include Lactobacillus acidophilus, corynebacteria, peptostreptococci,
Bacteriodes, and staphylococci.
– Lactobacillus – prevents gonococcal infection by producing lactic acid that adds acidity of the
vagina.
