Lec 17 Flashcards

1
Q

Three ways microbes and a human host can interact

A
  1. Commensal = unaffected
  2. Mutualistic = benefit for both
  3. Pathogenic = benefit microbe harm human

1,2 = normal flora

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2
Q

Normal Flora

A

Total microbial pop. associated with healthy human (mainly bacteria)

one human = 10^13human cells + 10^14 bacteria cells

Found all external body sites (internal site exposed to external = inner lumen of intestinal tract)

Highly variable and changeable

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3
Q

Where do you not find normal flora

A

Internal tissues/organs and the fluids within those organs

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4
Q

Conization
infection
Disease

A

Colonization = Microbe grows on external body surface

Infection = Multiplies within body tissue triggers immune response

Disease= infection causes dmg to body

NF = 1,

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5
Q

Types of Normal flora (defined by length of time they are associated with host)

2

A
  1. Transient Normal Flora
    - short term (hours to days)
    - Highly variable in types and numbers of species present
    - influenced by external factors (hygiene)
  2. Resident Normal Flora
    - Long term association with host (months to life)
    - more stable in types and numbers
    - less influenced by external factors
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6
Q

Origin of Normal flora in Humans

A

Fetus in uterus is sterile

At birth exposed to microbes (vaginal tract, medical personnel, environment) most are transient flora

  • oral, nasopharyngeal, skin flora established within hours of birth
  • gastrointestinal tract flora established within 1-2 days

stable pop. take weeks

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7
Q

What factors determine composition (types of species) of a persons normal flora

A

Varies

Site to site differences:

  • Types and amounts of nutrients, pH, oxygen concentration
  • Presence/absence of anti-microbial substances (lysozyme in tears)

Person to person differences:
-Age, sex, diet, hygiene, living conditions

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8
Q

Normal flora of different body sites

Skin

A
  • Less species diversity (mostly species that survive dry salty condition eg Staphylococcus)
  • Transient pop. on exposed surfaces; Resident pop. in protected areas (pores)
  • Mostly commensal interactions (some mutualism)
    e. g. Metabolize lipids for nutrition - acidic waste that lower ph and prevent pathogen growth

-cause disease if introduced to underlying tissue

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9
Q

The “skin flora” problem in diagnostic microbiology

A

Blood culture” = patient’s blood inoculated into broth media to test for the presence of bacterial pathogens (“bacteremia”)

Normal flora contaminate blood culture

Collect 2 or 3 blood samples from different sites

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10
Q

Normal flora of different body sites

Respiratory Tract

A

Mouth, tongue, teeth, saliva

  • often present as biofilm communities (plaque on teeth)
  • free bacteria in saliva

Nasal Area/ Upper respiratory tract

  • similar flora to skin & mouth
  • staph. aureus part of normal flora in 10-15% (Food borne diseases)

Lower Respiratory Tract (eg. Trachea into lungs)
-No normal flora (occasional transient microbes)

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11
Q

Normal flora of different body sites

Genito-urinary

A
  • Urine in bladder is sterile in healthy video (no normal flora)
  • First 1 cm of urethra transiently colonized (flushing action)
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12
Q

Normal flora of different body sites

Intestinal Tract (stomach, small intestine, colon)

A

Stomach = too acidic for most bacteria, only acid tolerant survive

Small intestine = Fewer bacteria at Ant. end vs Post. end

Colon = 25% of fecal mass is normal flora
99% anaerobes or facultative anaerobes
Coliforms (E.coli and co)

Intestinal tract: Greatest total number flora/ greatest diversity of species

Composition of gut flora influenced by diet:

Site of Mutualistic microbe host interactions (Gut E. coli)

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13
Q

Intestinal Tract

Lactose-intolerance related to intestinal flora

A

Lactose (lactase) = Glucose + galactose

-reduced lactase production, lactose not broken down and passes un-digested into large bowel - lactose used as nutrient by lactic acid bacteria - release gas and acidic waste

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14
Q

Important contributor to human nutrition

A
  • Intestinal bacteria add metabolic abilities that humans don’t have:
  • synthesize essential vitamins (B and K)
  • Salvage nutrient that would escape digestions (carbs into short chain fatty acids)

But some metabolic activities of intestinal flora may be harmful
(over abundance of bacteria causes excess release of acid, gas metabolic wastes as they grow)

Maintaining proper balance of intestinal flora important

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15
Q

A defense against infection by pathogens

A

Priming (or training) of immune system

-early age exposure of IS required
(germ free has poor immune systems)

Exclusion of pathogens from body sites

  • pathogens compete with normal flora
  • pathogens inhibited by chemical produced by normal flora
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16
Q

Fecal Microbiota Transplantation (FMT) to treat C. difficile colitis

A
  • restore intestinal normal flora by introducing feces (test for pathogens)
  • More effective than antibiotics at eliminating C.Difficile and creating normal flora

Not intended to kill but restore balance

17
Q

Normal flora sometimes can be harmful

A

Any species of bacteria has potential to cause disease = opportunistic infections

Ruptured colon releases gut bacteria in peritoneum (peritonitis)

18
Q

Unintentional Alterations

A

Long term antibiotic use disrupts balance

gastrointestinal discomfort, C. Difficile superinfections

19
Q

Intentional Alterations 4

A

Fecal transplants

Prophylactic Antibiotics
(given to immunocompromised pts before surgery to remove normal flora)

Probiotics (live microorganisms, health benefit)

Lactobacillus and Bifidobacteria are the most common probiotics

  • gram positive, lactic acid producing species of bacteria
  • don’t cause disease
  • Companies have their own strains
20
Q

Probiotics vs Prebiotics

A

Probiotics = living bacteria

Prebiotic = nutrients (fiber, carb) support growth of pre existing bacteria

Fructo-oligosaccharides: used as nutrient by lacto/bifido

21
Q

How do probiotics work?

A

Competitive exclusion
-use up nutrients, produce toxic metabolites, occupy space on host tissue

Stimulate mucus production by intestinal cells and strength the intestinal epithelial barrier

22
Q

Use of Probiotics in clinical practice

A

Prevention of necrotizing enterocolitis (NEC) in premature, very low birth weight infants*

-GI tissue is dmged and dies off in infants