With heightened global concern of microbial drug resistance, advanced methods for early and accurate diagnosis of infection are urgently needed. Analysis of exhaled breath volatile organic compounds (VOCs) toward detecting microbial infection potentially allows a highly informative and noninvasive alternative to current genomics and culture-based methods. We performed a systematic review of research literature reporting human and animal exhaled breath VOCs related to microbial infections. In this Review, we find that a wide range of breath sampling and analysis methods are used by researchers, which significantly affects interstudy method comparability. Studies either perform targeted analysis of known VOCs relating to an infection, or non-targeted analysis to obtain a global profile of volatile metabolites. In general, the field of breath analysis is still relatively immature, and there is much to be understood about the metabolic production of breath VOCs, particularly in a host where both commensal microflora as well as pathogenic microorganisms may be manifested in the airways. We anticipate that measures to standardize high throughput sampling and analysis, together with an increase in large scale collaborative international trials, will bring routine breath VOC analysis to improve diagnosis of infection closer to reality.

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呼出的挥发性挥发性有机化合物：系统评价

随着全球对微生物耐药性的日益关注，迫切需要用于早期和准确诊断感染的先进方法。对呼出气中挥发性有机化合物（VOC）进行分析以检测微生物感染的方法，可能会为当前的基因组学和基于培养的方法提供高度有用且无创的替代方法。我们对报告涉及微生物感染的人和动物呼出气VOC进行了研究文献的系统综述。在这篇综述中，我们发现研究人员使用了各种各样的呼吸采样和分析方法，这极大地影响了研究间方法的可比性。研究要么对与感染有关的已知VOC进行目标分析，要么进行非目标分析以获得挥发性代谢物的总体概况。一般来说，呼吸分析的领域还相对不成熟，关于呼吸中挥发性有机化合物的代谢产生还有很多要理解的地方，尤其是在宿主中，共生微生物和致病微生物都可能在呼吸道中出现。我们预计标准化高通量采样和分析的措施，以及大规模国际合作试验的增加，将使常规呼气VOC分析提高感染诊断的准确性。