Foot ulceration is a serious complication of diabetes, with a reported incidence of 1–3.6% and a prevalence of up to 25% (Singh et al, 2005). The impact can be devastating and results in more hospital admissions than any other diabetes-related complication. It is the major contributing factor to lower extremity amputations (Pecoraro et al, 1990). Infection of diabetic foot wounds is a common and serious complication, which, if not managed effectively and quickly, can lead to extensive tissue destruction. Deep tissue samples are preferred, as they not only isolate surface dressingbacteria but also bacteria in the deeper tissues, and repeated sampling is important to verify isolates and target antimicrobial therapy. However, to avoid overuse of antimicrobial agents it is important to clinically differentiate between soft tissue infection and colonisation, although in patients with diabetes this can be extremely difficult due to dampened inflammatory responses.