Infection is a complex interplay between the host, a potential pathogen and its virulence, and the environment (European Wound Management Association [EWMA], 2005). The diagnosis of infection is a clinical judgement decision (World
Union of Wound Healing Societies [WUWHS], 2008) often supported by laboratory analysis. While microbiology results potentially identify specific bacteria present, they cannot
predict whether the bacteria will remain colonised or proceed to infection. The important determinant is the host and his or her susceptibility, as well as the ability to mount a robust immune response. This article discusses the multifactorial, yet individual, nature of wound infection and the inherent difficulties in diagnosing infection in many patients’ wounds.