Determining the limits and confounders for the 2-pentyl furan breath test by gas chromatography/mass spectrometry

Aspergillus fumigatus produces 2-pentyl furan (2-PF), a volatile compound not produced by many other pathogens or normal human metabolism. 2-Pentyl furan has been detected in the breath of patients with invasive aspergillosis (IA) by SPME pre-concentration coupled with CG/MS providing the possibility of an attractive diagnostic test. The limit of detection (LOD) and quantification (LOQ) for peak integration were assessed both statistically and empirically respectively. 2-Pentyl furan was detected from 10 of 45 food stuffs tested. Levels were highest from soymilk (3 of 3 brands), lower from pumpkin, peanuts, rolled oats 2, Ensure Plus®, tinned asparagus, tinned beans and a vegetable exact (Marmite™). No 2-PF was detectable in anti-fungal medications used to treat IA or commonly used cosmetics tested. There was no difference in 2-PF breath levels between morning and afternoon or fasting and non fasting samples taken from healthy subjects eating a diet without 2-PF rich foods. 2-Pentyl furan levels were present in breath samples immediately after a mouth rinse with soy milk (P < 0.001), and in some subjects after ingesting soy milk and rinsing their mouth with water. The breath test for 2-PF can be conducted without an overnight fast or at a specified time provided the mouth has been rinsed 30 min or more from when 2-PF containing products have been ingested.