Volatile Organic Compounds: Upcoming Role in Diagnosis of Invasive Mould Infections

Purpose of Review Breath testing for fungal respiratory infections has great promise as samples can be obtained by non-invasive, repeatable techniques that can be done on a wide range of patients including children, the confused and from those in the intensive care unit (ICU). We have reviewed progress toward development of test applicable to clinical practice. Recent Findings Many volatile organic compounds (VOCs) have been identified, especially from key pathogens such as Aspergillus fumigatus, but very few clinical trials have been performed. The most convincing of these demonstrated that Aspergillus species could be identified by gas chromatography with mass spectrometry in breath samples of at risk patients with high sensitivity (94%) and specificity (93%) compared with the European Organization for Research and Treatment of Cancer/Mycosis Study Group (EORTC/MSG) gold standard. Summary Significant progress has been made but further studies are needed to validate these recent findings and identify VOCs from other pathogenic fungi using GC-MS, and clinical trials performed using faster and less demanding analytic platforms that could be used in clinical laboratories.