Normal Flora of the

Human Body
 Learning Objectives
At the end of the lecture, the student should be able to”
1.  Distinguish the three categories of symbiotic
relationships involving microorganisms.
2.  Define normal flora.
3.  Differentiate resident flora from transient flora.
4.  Describe the importance of normal flora in the body.
5.  Describe the normal flora inhabiting the upper
respiratory tract, the genitourinary tract, the
gastrointestinal tract and the skin of the human body.
 Introduction
•  Ecology is the systematic study of the interrelationships that
exist between organisms and their environment.
•  Microbial ecology is the study of the numerous
interrelationships between microbes with other microbes,
with non-microbial organisms, and with non-living world
around them
•  Symbiosis is defined as the living together or close
association of two dissimilar organisms
•  The organisms in the relationship are referred to as
symbionts.
•  Many microorganisms participate in symbiotic
relationships.
Symbiotic Relationships Involving
Microorganisms

•  Neutralism
–  Refers to a symbiotic relationship in which neither
symbiont is affected by the relationship.
•  Commensalism
–  A symbiotic relationship that is beneficial to one
symbiont and of no consequence to the other.
–  Many organisms in the indigenous microbiota of
humans are considered to be commensals.
•  Mutualism
–  A symbiotic relationship that is beneficial to both
symbionts;
Symbiotic Relationships Involving
Microorganisms

•  Parasitism
–  A symbiotic relationship that is beneficial to one
symbiont (the parasite) and detrimental to the other
symbiont (the host).
•  A host is a living organism that harbors another
living organism.
•  The parasite may or may not cause disease in the
host.
²  A change in conditions can cause one type of symbiotic
relationship to shift to another type.
 Overview: Normal Flora
•  Also referred to as Indigenous Microbiota

•  Includes all the microbes (bacteria, fungi, protozoa,

and viruses) that reside on and within a person;
sometimes referred to as the human microbiome.

•  Our indigenous microbiota is composed of between

500 and 1,000 different species (perhaps more)!

•  Blood, lymph, spinal fluid, and most internal tissues

and organs are normally free of microbes (i.e., they
are sterile).
 Overview: Normal Flora
There are two main types of normal flora:
1.  Resident flora
Ø  remain a part of the normal flora of a person
throughout life.
Ø  These organisms are found on the skin and on the
mucous membranes of the digestive tract, upper
respiratory tract, distal portion of the urethra, vagina.
Ø  Most of the resident microbiota are commensal; that
is, they feed on excreted cellular wastes and dead
cells without causing harm.
Ø  Destruction of the resident microbiota disturbs the
delicate balance between host and microorganisms.
 Overview: Normal Flora

There are two main types of normal flora:

2.  Transient flora
Ø  Transient microbiota remain in the body for only a
few hours, days, or months before disappearing.
Ø  They are found in the same locations as the
resident members of the normal microbiota but
cannot persist because of competition from other
microorganisms, elimination by the body’s
defense cells, or chemical and physical changes
in the body that dislodge them
 Overview: Normal Flora
Acquisition of Normal Microbiota
•  The fetus is devoid of microbiota being surrounded by an amniotic
membrane and fluid
•  Normal microbiome begins to develop when the amniotic membrane
ruptures and microorganisms come in contact with the newborn during
birth.
–  Microbes enter mouth and nose during passage through the birth canal
–  First breath is loaded with microorganisms that quickly establish
themselves in the upper respiratory tract.
–  First meals provide the progenitors of resident microbiota for the colon
–  Staphylococcus and other microbes are transferred from the skin of both
the medical staff and other people around
²  Most of the resident microbiota was initially established during the first
months of life.
 Microbiota of the skin

²  Skin is the most exposed to microorganisms

•  Factors that eliminate non-resident flora from the
skin
-  Lysozyme in the skin
-  Acidic pH of the skin due to sweat
-  Free fatty acids in sebaceous secretions
-  Constant sloughing of the skin
²  Primarily bacteria and fungi—about 30 different types;
most common = Staphylococcus spp.
 Microbiota of the skin

²  The skin may be divided in three regions

1.  Axilla, perineum, toe webs
-  With higher moisture levels
-  With higher body temperature
-  With higher levels of surface lipids
-  With relatively more microorganisms
2.  Hand, face and trunk 3. Upper arms and legs
-  Dry sites
-  With diverse flora because of their exposure to the
environment
 Microbiota of the skin

² Microbiota of the skin live on the outer dead layers of the

skin and in hair follicles and pores of the glands/
² The deeper layers (dermis and hypodermis) are axenic
(sterile)
² Tears wash most microbiota from the eyes, so there are
few compared to the skin.
² Tears contain lysozyme that may interfere with the cell
wall synthesis of the microorganisms.
Microbiota of the Respiratory Tract

•  Upper respiratory tract (nasal passages and throat) has

an abundance of microbes; many are harmless, some
are opportunistic pathogens.

•  Carriers harbor virulent pathogens in their nasal

passages or throats, but do not have the diseases
usually caused by these pathogens.

–  Example: people harboring the bacteria that cause

diphtheria, pneumonia, meningitis, and whooping
cough.

² Lower respiratory tract is usually free of microbes.

Information on blood agar:

Ø  Contains general nutrients with blood added to the agar

Ø  Certain Gram-positive bacteria produce exotoxins that
hemolyze (rupture) the RBC in the agar.
Ø  Hemolytic patterns:
o  Beta hemolysis – complete lysis of RBC
o  Alpha hemolysis – incomplete lysis of RBC
o  Gamma hemolysis – no hemolysis
Microbiota of the Respiratory Tract

² The nose is cooler than rest of the respiratory system

and has some unique microbiota
² The microbiota of the trachea and the bronchi arre
sparse compared to those of the nose and mouth.
² The alveoli of the lungs have no natural microbiota,
they are axenic.
² Microbiota of the upper respiratory tract include:
Fusibacterium, Haemophilus, Lactobacillus, Moraxella,
Staphylococcus, Streptococcus, Candida (fungi)
 Microbiota of the Oral Cavity

•  Oral cavity affords a shelter for numerous anaerobic and

aerobic bacteria; remaining food particles provide a rich
nutrient medium for bacteria.
•  Careless dental hygiene may cause
–  Dental caries (tooth decay)
–  Gingivitis (gum disease)
–  Periodontitis
•  The most common organisms within the indigenous
microbiota of the mouth are various species of α-
hemolytic streptococci.
 Microbiota of the
Gastrointestinal Tact
•  The GI tract is designed for digestion of food, absorption of
nutrients, and elimination of undigested materials.

•  The colon (large intestine) contains the largest number and

variety of microbes of any colonized area of the body: an
estimated 500 to 600 different species—primarily bacteria.

•  Colon is anaerobic; bacteria in colon are mostly obligate,

aerotolerant, and facultative anaerobes.

•  Many members of the colon microbiota are opportunists.

•  Include Bacteroides, Escherichia, Enterococcus,

Lactobacillus, Proteus, Shigella, Candida (fungus),
Entomeoba (protozoan), Trichomanas (protozoan)
 Microbiota of the
Genitourinary Tact

•  The GU tract consists of the kidneys, ureters,

urinary bladder, urethra, and parts of the female/
male reproductive systems.

•  Kidney, ureters, and urinary bladder are usually

sterile; the distal urethra and its external opening
harbor many microbes, including bacteria,
yeasts, and viruses.

•  Most frequent causes of urethral infections

include Chlamydia trachomatis, Neisseria
gonorrhoeae, and mycoplasmas.
 Microbiota of the
Genitourinary Tact

•  The male and female reproductive systems are

usually sterile, with the exception of the vagina

•  Microbiota change as acidity in the vagina

changes menstrual cycle.

•  The flow of urine prevents extensive colonization

of the urinary bladder and the urethra.
 Beneficial and Harmful Roles
of the Normal Flora
²  Humans derive many benefits from their indigenous
microbiota
•  Synthesis of vitamins K and B12
•  Microbial antagonism
–  This means “microbes versus microbes”
–  Many members of our indigenous microbiota are
beneficial, in that they prevent other microbes from
becoming established.
–  Other examples of microbial antagonism involve the
production of antibiotics and bacteriocins (antibacterial
proteins); an example is colicin, produced by E. coli.
 Beneficial and Harmful Roles
of the Normal Flora
•  Opportunistic pathogens and biotherapeutic agents
–  Opportunistic pathogens are those microbes that “hang
around,” waiting for the opportunity to cause infection.
•  Examples: E. coli, other members of the family
Enterobacteriaceae, S. aureus, and Enterococcus
spp.
–  The delicate balance of the indigenous microbiota can
be upset by antibiotics, other types of chemotherapy,
and changes in pH.
–  Bacteria and yeasts used to stabilize the microbial
balance are called biotherapeutic agents or probiotics.
 BIOFILMS
•  It is rare to find an ecologic niche in which only one type of
microbe is causing a particular effect.
•  Microbes are often organized into biofilms—complex
communities of assorted organisms. Biofilms are
everywhere (e.g., dental plaque).
•  Biofilms consist of a variety of different species of bacteria
plus a sticky polysaccharide that the bacteria secrete; the
bacteria grow in tiny clusters called microcolonies,
separated by water channels.
•  Biofilms have medical significance; they form on urinary
catheters and medical equipment and can cause diseases
like endocarditis.
 BIOFILMS
•  Microbes commonly associated with biofilms on medical
devices include the yeast, Candida albicans, and bacteria
such as Staphylococcus aureus, Enterococcus spp.,
Klebsiella pneumoniae, and Pseudomonas aeruginosa.
•  Biofilms are very resistant to antibiotics and disinfectants.
–  Antibiotics that are effective against pure cultures of
organisms have been found to be ineffective against
those same organisms within an actual biofilm.
•  Bacteria in biofilms produce different types of proteins that
may not be produced by the bacteria in pure culture.
 Synergistic Infections
•  When two or more organisms “team up” to produce a
disease that neither could cause by itself; it is referred to as
synergism.
•  The diseases are called synergistic infections, polymicrobial
infections, or mixed infections.
–  Examples:
• Acute necrotizing ulcerative gingivitis (ANUG, trench
mouth, or Vincent disease).
• Bacterial vaginosis (BV)
 Learning Objectives
At this point, the student should be able to”
1.  Distinguish the three categories of symbiotic
relationships involving microorganisms.
2.  Define normal flora.
3.  Differentiate resident flora from transient flora.
4.  Describe the importance of normal flora in the body.
5.  Describe the normal flora inhabiting the upper
respiratory tract, the genitourinary tract, the
gastrointestinal tract and the skin of the human body.