Aetiology studies are therefore based on either insensitive or non-specific indirect methods such as blood culture, serology and microbiologic assessments of the upper airway.
We consider these associations with quantitative microbiologic assessments to be only suggestive.
Extrapulmonary dissemination of M. tuberculosis was not observed on gross pathology or microbiologic assessment.
In the primary care sub-cohort using culture and DFA, 271 patients completed the screening questionnaire but only 58 (21%) underwent microbiologic assessment.
Microbiologic assessments showed noteworthy elevations in counts of specific anaerobic components of the oral microflora, Streptococci, Neisseria, Lactobacilli and Enteric bacilli, which were believed to be diet related.
Based on available evidence, the presence of dampness, water damage, visible mold or mold odors or a history of water damage provides more reliable indicators of dampness- or mold-related health risks than do current quantitative microbiologic assessments.
Ideally, an epidemiologic investigation at both the hospital and nursing home would have been performed, but facilities for an investigation involving use of selective microbiologic media and assessment of gastrointestinal carriage of resistant organisms are not typically available in a rural setting.
In the future, our evaluation of new therapeutic approaches to nosocomial pneumonia will clearly focus on a measurement of improved outcomes, and not just on assessment of the microbiologic and clinical response to antibiotic therapy.
Other, long-term measures including establishing levels of contamination of raw materials and ready-to-eat pork products, assessment of production processes, and establishing reliable microbiologic methods were suggested.
