Take a look at the information here.
http://www.ncbi.nlm.nih.gov/sites/entrez

Hi  Braecan:

Welcome to the twilight zone.

You might want to think about this abstract.
The parts that I would like to commend to your attention:
1. Biofilms are found on the tissue from sufferers of Chronic
Sinusitis.( This despite the fact that when makeing freeze facture
samples of tissue with biofilms attached, the desicated biofilm is
very fragile and can crumble into dust during the process, so a
positive is a positive, but a negative can be due to accident.)
A biofilm forms when bacteria get a foothold after an episode of flu
or cold which kills off the cilia.  You get about 1200 new bacteria in
each CC of air you breath, so over time you can get bacteria that
disburse the colony or bacteria that organize themselves and start
making toxins and enzymes that attack the tissue the colony is
attached to and create an ulcer which oozes plasma.

2. "The intraoperative cultures of the planktonic bacteria present in
the sinuses did not correlate with the biofilms identified."

This means that the organisms that form the biofilm do not necessarily
show up on sinus cultures.
Bacteria that form biofilms talk to each other with chemical
messengers called AHLs AcyetalHydroLactones.  It is kinda like the
whistle in a game of musical chairs. The message goes out, and the
bacteria swarm to one spot and settle down so that they are not
suspended in fluid anymore.

Also:

ENTs have difficulty differentiating the appearance of biofilm covered
tissue covered tissue from any other tissue.  Chemical engineers have
developed zinc based stains that tint only the bacteria, but the ENTs
still hardly know that biofilms exist, so they haven't
enthusiastically adopted in-vivo staining to look for them..

Look up "uncultureable bacteria" and you will find that 99% of the
bacteria out there can not be cultured. For a long time pseudomondas
could not be cultured. It was still quite capable of causing illness
and death.

Of the bacteria that CAN be cultured most pathogens have commensal
varients (non pathogenic varients) that look just like them. So
several bacteria that have nasty pathogenic varients have been
declared "normal flora" and are ignored.

Fungus is such a ubigutious contaminate of long term cultures that
when a fungal culture grows a fungus it is often ignored.  If it is a
speices that they are having a problem with in the lab, it will almost
always be thought to be a contaminate.  If the fungs looks different
from the normal lab pest then it will likely be sent to the CDC for
identification, which can take from weeks to months. In the meantime
they will report the fungal culture negative until the CDC tells them
what it is. So a negative culture for fungus does not rule out fungus
either. In fact a stain that is specific for the componants of fungal
cell walls will highlight fungal elements in almost everyone's mucus.
Carrying fungus does not necessarily make you sick.   Like bacteria,
they run the gamet from harmless to annoying, to deadly.

1: Laryngoscope. 2006 Jul;116(7):1121-6. Links
Bacterial biofilms on the sinus mucosa of human subjects with chronic
rhinosinusitis.Sanderson AR, Leid JG, Hunsaker D.
Department of Otolaryngology, Naval Medical Center San Diego, San
Diego, California 92134-2200, USA. arsanderson@nmcsd.med.navy.mil

INTRODUCTION: Chronic rhinosinusitis (CRS) is a common disease poorly
controlled by antibiotics. Postulated etiologies of CRS include
allergy, fungi, functional factors, and biofilm. OBJECTIVES: We
presented a preliminary study demonstrating bacterial biofilms'
presence on the sinus mucosa of patients with CRS using fluorescent in
situ hybridization (FISH). The advantage of FISH in biofilm
identification is that it is the only method that identifies the
specific bacteria creating the biofilm matrix. We now present the
results of a larger series of patients. METHODS: Patients with CRS
scheduled for sinus surgery were enrolled in the study. Biopsies of
the sinus mucosa and cultures were taken at the time of surgery.
Control samples were taken from patients undergoing septoplasty.
Specimens underwent FISH testing for Streptococcus pneumoniae,
Staphylococcus aureus, Haemophilus influenza, and Pseudomonas
aeruginosa. RESULTS: Bacterial biofilms were present on 14 of 18
specimens. The predominant species were H. influenzae, S. pneumoniae,
and S. aureus. P. aeruginosa biofilm was not identified on any
specimens. The intraoperative cultures of the planktonic bacteria
present in the sinuses did not correlate with the biofilms identified.
Two of the five control samples were positive for biofilm. CONCLUSION:
The presence of biofilms on the mucosa of patients with CRS offers a
possible cause of antimicrobial therapy failure and could change the
approach to treatment. However, the presence of biofilms on healthy
control samples implies that biofilms may simply be colonizers. The
precise role that biofilms play in CRS still remains to be determined.
Further studies with larger sample sizes are needed.

PMID: 16826045 [PubMed - indexed for MEDLINE]