Beruflich Dokumente
Kultur Dokumente
THE SKIN
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• Organism found in other tissues
e.g brain, heart, muscle, bone
– not normal flora
(Expected to cause disease)
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The relation ship between symbiotic
association
a. Commensalisms :
one species of organism uses the body of a
larger species (Staphylococcus growing on the skin
typically causes no measureable harm to a person )
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b. Mutualism :
relationship provide reciprocal benefits for
two organism involved (bacteria in
human colon)
c. Parasitism :
the symbiotic relation ship benefits only the
parasite (tuberculosis bacteria in human
lung)
Any parasite that can causes diseases is
called a pathogen
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Normal flora can be resident or transient
Resident :
– present invariably or for months in a
particular site
– Resident flora can be reduced by washing
but not eliminated
• Transient :
– present briefly, rest on body surface but do
not persist
– Transient flora can be eliminated by
washing
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• Hospital workers have large transient flora of
pathogens due to exposure
– e.g Staphylococcus aureus – harmless to
health workers but not to some patients
(open wounds, elderly)
• Carrier state
– A term used when potentially pathogenic
organisms are involved
– e.g Streptococcus pneumoniae, Neisseria
meningitidis
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• Normal flora is not static, constant change
• Depends on
– Age
– Nutritional status of the site
– Diseases states
– Drug or antibiotic effects
– pH
– oxidation-reduction potensials
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Disturbed balance
– may lead to infection
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• Opportunists
Cause disease when ‘opportunity’
arises
• breakdown in immune system
• Treatment with broad spectrum
antibiotics
• Implantation of devices e.g catheters,
prostheses
• Normal flora can be opportunistic
–e.g Candida albicans during antibiotic
therapy
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Distribution of some members of the normal flora of the human body
Skin :
Stap. epidermidis
Staph. aureus
Diphtheroids
Streptoccocci
P. aeruginosa
Anaerobes
Candida torulopsis
Pityrosporum
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Interaksi Host - Bakteri
VIRULENSI BAKTERI
Microbial Mucus
cells
Epithelial
cell
Hair
Epidermis
Dead
layer
Duct Dermis
Sebaceous
gland Apocrine
sweat gland
Subcutaneous
tissue
Hair follicle
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Several factor are responsible for
discouraging microbial growth on the skin :
1. Dryness
• the relatively dry surface of skin is to inhibitory
to microbial growth
• When allowed to dry, many bacteria enter a
dormant condition; some species die in a matter
of hours
• Moister areas (axillae, perineum, between toes,
scalp) have much larger populations e.g.
coagulase negative Staphylococci, S.aureus,
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• Gram-negative bacilli do not permanently
colonize few resident organisms (except
Acinetobacter sp.) because skin is too dry
2. Low pH
• Skin has normal pH : 3 – 5
• This low pH can inhibit the growth of many
kinds of microorganism
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3. Inhibitory substances
• Several bactericidal or bacteriostatic compound
occur on the skin.
• Such as :
• Sweat glands, secrete lysozyme, and enzyme
that destroys the peptidoglycan of bacterial cell
walls
• Secrete complex lipids, which may be partially
degraded by bacteria : Propionibacterium acnes
to produce long- chain fatty acid such as oleic acid,
that are highly inhibitory to other bacteria
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• Neither profuse sweating, nor washing and bathing
can eliminate or significantly modify the normal
resident flora.
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If the organism breach the stratum corneum
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Microbial disease of the skin may
result from any of three lines of
attack
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Slide preparation
From liquid media From solid media
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Gram stain
Gently stain with crystal violet Gently stain wash off the stain Gently apply Gram’s iodine for 45 –
For 5 minutes With tap water 60 seconds
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Counterstain with carbol fukhsin for Gently wash off the carbol fukhsin 42
1 – 2 minutes with tap water
Demonstration :
Vibrio sp.
Staphylococcus sp.
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Escherichia coli
B. subtilis
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Advantages
of the normal flora on the skin
• Desquamation of epithelium
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Disadvantages
of the normal flora on the skin
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Asepsis
• The exclusion of pathogenic and potentially
pathogenic microorganismsmto avoid infection:
• Aseptic technique:
practices designed to prevent contamination
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Hand Washing