HOST –MICROBE

INTERACTIONS AND FLORA

%90 of our body is made up
of microorganisms!!!
Human, animal and plants are constantly in a close
interaction with microorganisms found in nature

p In human body;
p -the skin
p -organs with outside opening
p -organs associated with external
environment,

p are in a constant interaction with

microorganisms
p This interaction rarely represents as
disease
HOST-MICROORGANISM INTERACTIONS

Mutualism
Association in which both partners
benefit
Commensalism
Association in which one partner
benefits and other is unharmed
Parasitism
Association in which the microbe
benefits at expense of host
NORMAL FLORA OF THE HUMAN BODY

Normal flora is defined as populations of

microorganisms routinely found growing on the body of
healthy individuals

•Resident flora
typically inhabits body sites for extended periods
•Transient flora
are temporary. ie they form associations for a short
time and are replaced
NORMAL FLORA OF THE HUMAN BODY

p Microorganisms choose a body site suitable for their

growth and survive there. Survival depends on
physiologic factors such as:
p -pH in different parts of the body
p -Moisture
p -Temperature
p -Nutrients
p -Natural inhibitory substances
PERMANENT (RESIDENT) FLORA

Resident flora consists of relatively fixed type

of microorganisms regularly found in a given
area at a given age; if disturbed, it promptly
reestablished itself
PERSISTENT FLORA:
p Members of the normal flora may become
pathogenic if:
p -Removed from the restrictions of that environment
and introduced into the bloodstream or tissues
p -The balance between the microorganisms is lost
p -The host immune systems is weakened
PERMANENT (RESIDENT) FLORA

q Opportunism: happens when some members of the

normal flora cause disease taking advantage of an
opportunity such as disrupted barriers or weakend
immune response.
p These microbes are called opportunistic pathogens
p Many infectious diseases are caused by opportunistic
pathogens. eg. Staphylococcus aureus, C. albicans

p Strict pathogens are true pathogens – are always

associated with disease
TRANSIENT FLORA

Transient flora consists of microorganisms that

inhabit the body surface or mucous membranes for a
limited period. They establish themselved briefly for
colonization without disease
TRANSIENT FLORA

q If the transient flora is removed by various factors,

it does not reform. A new flora is replenished
p The type of microorganisms in a certain body site
depends on the conditions of that body site
p Transient flora usually exists together with the
permanent flora
p If the permanent flora is removed, transient flora
may cause disease
p Most members of the transient flora are
nonpathogenic or opportunistic pathogens
ROLE OF FLORA IN THE ORGANISMS

p Most are commensal

n Use body temperature, moisture, remainder
materials and are not harmful to host

p Some are found as mutualistic with host

n Some bacteria in the digestive tract help in the
synthesis of vitamins
p Some bacteria prevent colonization by pathogenic
bacteria via competition
p eg. Lactobacilli in adult female vagina change the pH of
the vagina. By making it more acidic prevents
colonization by gonococci
FLORA OF OUTER ENVIRONMENT
p Microorganisms found temporarily or permanently
in certain environments
p Air, soil, water
FLORA OF OUTER ENVIRONMENT

p Air is not suitable for the growth and survival of the

microorganisms
p Microorganisms diffuse into the environment via air
flow
-The survival of the microorganisms on dust particles
or water droplets depends on:
-Resistance to dryness
-Existance of organic material
-Moisture levels
-Temperature of the environment
p Microorganisms that cause diease via the
respiratory tract:

p Mycobacterium tuberculosis
SOIL MICROBIAL FLORA
p Soil is an environment where organic material
and water constantly exist
p There are numerous microorganisms in the soil
p These organisms play an important role in
biotransformation
p Nitrogen, sulphur, carbon transformation happens
via soil microorganisms
Pathogenic microorganisms transmitted via soil:
p Clostridium’s
(C.tetani, C.botulinum, gas gangren formers)
p Bacillus anthracis
p Coccidioides immitis
p Histoplasma capsulatum
p Cryptococcus neoformans

C.botulinum Bacillus anthracis

WATER MICROBIAL FLORA

p Microorganisms may even exist in water from

purified sources
p The most important organisms are the ones
which pass from human or animal faeces into the
water
Pathogenic microorganisms transmitted via water

Bacteria
•Salmonella typhi
•Vibrio cholera
•Shigella
•Escherichiae
•Enterobacteriaceae and Leptospirae
Salmonella
Viruses
•Polio virus
•Hepatitis A virus
•Other enteroviruses

Protozooa
•Entomoeba histolytica

Shigella
RESPIRATORY TRACT FLORA

p Pharynx
p Contains a rich flora similar to oral flora
p •Nonhemolytic and alpha hemolytic streptococci
p •Neisseria, Haemophilus
p •Staphylococci, Corynebacteria
p •Peptostreptococci!!!

p Esophagus
p •Low levels of normal flora
p •Microorganism in food and saliva
(transient flora)
RESPIRATORY TRACT FLORA
Nose and Upper Resp. Tract
p Streptococci (alpha hemolytic
and non hemolytic)
p Staphylococci (S. epidermidis
and S. aureus)
p Corynebacteria
p Neisseriae
Lower Resp. Tract
p From larynx to trachea the number
of bacteria decrease
p Lower resp. tract is sterile, no
bacteria exist
ORAL FLORA
Newborn
p The newborn contains the vaginal flora of mother
p Streptococcus salivarus (high in numbers)
p S. agalactiae (is lost after 4.th month)
p Veillonella, Neisseria, coagulase (-) staphylococci
p E. coli, Lactobacillus, Bifidobacterium
p Actinomyces, Peptostreptococcus, Bacteroides
p Yeast

-Fusiform 4-8. months

-S. Sanguis 6. month
-S. Mutants 12. months
p Important: Streptococci make up %98 of newborn oral
flora
ORAL FLORA
Child
p Most important changes start on the 6. month with the arrival
of the teeth
p In areas without O2 supply, oral flora appears (aproximal
surfaces of teeth and gums)
p Increase in the number of anaerobic bacteria

p Important: S. sanguis and S. mutans make up the

majority of the permanent flora after the 1. year of life
ORAL FLORA
Adult
p The most important increase in the no. of oral microbial
population starts with the appearance of permanent teeth
p Increase in suitable growth area for anaerobes
p Appearance of bacteria not seen in childhood

p Superficial plaque: S. sanguis, S. mitis and S. mutans

p Important: ~300 types of bacteria, ~10,000 variants

ORAL FLORA
p IMPORTANT!!
p Half of the mo.s in saliva and 2/3 of
mo.s in gum pockets are anaerobes
p
p %90-94 of mo.s that cause root
canal inflammation are anaerobes

p Total no. of mo.s in saliva is 43

million-5.5 billion/ml

p 750 million bacteria in 1 ml of

saliva

p 200 billion bacteria/gr in gingival

sulcus and teeth plaque
ORAL FLORA – Ecological factors
p The factors that determine which mo.s will colonize and be a
part of the flora are termed ecological determinants.

These include:
p Host selectivity
p Acidity
p Nutrition
p Smoking
p Saliva, gingival crevicular fluid
p Bad habits
ORAL FLORA – Ecological factors
Host selectivity
p Bacilli bacteria are present in the oral flora – because
they need high levels of O2
p Similarly Brucella, Francisella and Pseudomonas
p Proteus – cause URT as well as UTI

p pH
p Some mo.s prefer a slightly alkaline pH
p Some others prefer low pH

p Eg. Lactobacilli, streptococci and bacteroides

ORAL FLORA – Ecological factors
Temperature
p Some mo.s have selectivity for for certain temperatures
• Bacteroides pneumosintes prefers URT which has a low
temperature
• Most lactobacilli cannot grow at low temperatures

Nutrition
p Individuals with a diet high in carbohydrates
• more Lactobacillus and Streptococcus
ORAL FLORA – Ecological factors
Smoking
p Research indicates that compared with nonsmokers, smokers
have:
p More gingivitis, periodontitis and oral cancers
p Inhibition of Neisseria and Lactobacilli
p An important risk factor for periodontal diseases
ORAL FLORA – Ecological factors
Saliva
p has washing, dilution, antibacterial and immune defense effects
p Stabilizes the number and variety of bacteria in mouth
p Antimicrobial (inhibitory) substances :

Ø Lysozyme: In particular against Gram positive

Ø Lactobacidin: inhibits lactobacilli
Ø Immunoglobulins – particularly IgA, and in less amounts
IgG, and some IgM
ORAL FLORA – Ecological factors

Gingival crevicular fluid (GCF)

p responds to inflammation
p presence, lower or higher levels indicates degree of infection
p Content similar to plasma
p During inflammation also contains lysozyme, antibodies,
leukocytes and lymphocytes
p Antibodies are mainly IgA

Bad habits
p Biting pencils, putting foreign objects in mouth, thumb sucking
Flora of different parts of the mouth
Lips
p Mainly S. epidermidis, skin micrococci and oral
streptococci

Cheeks
p S. mitis, S. sanguis, S, salivarus. Rarely Haemophilus and
Neisseia species

Palate
p mainly Streptococci, Haemophilus, Actinomyces,
Lactobacillus
p Individuals with prosthesis – increase in yeast and
Lactobacillus
Flora of Different Regions’s of Mouth
Tongue
p %20-50 S. salivarus, S. mitis and Haemophilus are
dominantly present
p %15 anaerobes
p C. albicans

Gingival canal
p Part of the mouth with the highest number of mo.s – 1010-
1011 bacteria/gr

p In an order: facultative Gram positive cocci, anaerobic Gram

negative bacilli, anaerobic Gram positive bacilli, facultative
Gram positive bacilli, anaerobic Gram positive cocci, anaerobic
Gram negative cocci
Flora of different parts of the mouth
Teeth
p All teeth has dental plaque – microorganism building up
on teeth
p Variation in bacterial species in dental plaques
p Gram positive bacilli and Gram negative anaerobes are
always present