Since the reform and opening up, STDs that were once eradicated in China have reappeared. Especially since the 1980s and 1990s, with the increase in migrant workers and changes in traditional sexual attitudes and behavior, there has been a significant increase in STD patients, including non-gonococcal urethritis caused by mycoplasma, which was previously rare. Since some mycoplasma is also associated with infertility, sterility, prostatitis, cervicitis and other diseases, it has been amplified and exaggerated by some money-oriented media in China, and in some departments of some hospitals it is used as a pillar of economic income. In fact, mycoplasma is a microorganism that can grow outside the cell and is smaller than bacteria. Among the mycoplasmas associated with STDs are Mycoplasma solium, Mycoplasma humanum, Mycoplasma genitalium, and Mycoplasma penetrans, among others. Due to their respective characteristics, the two types that are more frequently examined in clinical practice are the first two. While Ureaplasma pyogenes obtains energy by breaking down urea, Mycoplasma genitalium survives by breaking down arginine. In the culture medium, cholesterol is also a very important nutrient. Penicillin and actinomycin are added to the medium in order to inhibit the growth of bacteria and fungi that can lead to false positives or inaccurate results. Mycoplasma is cultured by both liquid and solid culture methods. The former method is simple and uses the decomposition of urea by Ureaplasma urealyticum and the decomposition of arginine by Mycoplasma humanum to produce ammonia, which eventually leads to an increase in the pH of the medium, causing the pH indicator phenol red in the medium to turn red and determine positive growth. It can only be used as an isolation culture, and not as a method of identification. Given that it is judged by using the change of pH, any microorganism that can cause an increase in the pH of the medium can be a positive result. In addition, the most suitable pH for growth of Ureaplasma urealyticum and Mycoplasma hominis is not the same. Solid culture is the use of mycoplasma in solid medium to form a certain form of colonies, there is a high specificity. On the basis of the colonies, further experiments such as biochemical reactions can be performed. Solid culture can be used as a preliminary identification method, but requires high conditions and techniques. The correct and ideal method of examination: isolation and culture of the specimen with liquid medium, followed by identification of the results of the liquid culture with solid medium or PCR. Due to the characteristics of mycoplasma, when solid culture or PCR is not possible, filtering the specimen with a filter and then culturing it is also an option. Serological examination of mycoplasma is not meaningful in the examination of STDs. Current actual screening methods and problems: Due to technical and cost issues, as well as lack of knowledge about mycoplasma, current hospital screening methods basically use liquid media instead of solid media for further identification. Given that the liquid medium is judged by pH change, any microorganism that can raise the pH of the medium can give a positive result, including contamination by bacteria and fungi, which is in fact a false positive result. False-positive mycoplasma tests are more common due to the nature of the female vagina. Irregular test methods. A proper specimen collection should involve collecting the patient’s urethral or cervical secretions including exfoliated cells, but in some places, specimens are collected by casually applying a few swipes to the vulva. There are even some conscience eaten by dogs, and blood is collected for mycoplasma antibody testing. In addition, almost no hospital is the result of a positive liquid culture and then transferred to a solid medium for colony identification. As far as I know, there are only a handful of hospitals with mycoplasma research programs that perform solid or bacterial filtration of positive suspect specimens before culturing. The quality of reagents varies. At present, the reagents used in the examination are imported and domestic. The imported ones are mainly from Mérieux in France. When used in China, there is no institution to seriously and specifically manage the sensitivity, specificity, false-positive rate and false-negative rate of imported products. Domestic reagents are even more varied. Although in recent years around the reagents have been tendered, some reagent factory has the official approval number of production, but the quality in the end, I believe that no competent department can say clearly. Bidding is mainly based on price as the main lever. In fact, the content of cholesterol and protein in mycoplasma media has a great influence on the culture results. Mycoplasma research experts found in their experiments that the culture results varied with different mediums prepared with different bovine hearts, not to mention what was produced on a large scale. In the culture medium, it is referred to foreign formulations with penicillin as a bacteriostatic agent, while in fact, penicillin has a very high resistance rate in China, and there is no authoritative body to identify whether it can be fully referred to. In addition, there is also no standard for the production of mycoplasma culture media at all. Drug sensitivity results are widely available, but in reality they are flowery. In the current test, there are a number of manufacturers’ reagents that can not only make qualitative judgments of mycoplasma, but also perform drug-sensitive experiments. In fact, even the NCCLS in the United States does not have a resistance standard for mycoplasma, and it is not known where the resistance standard for these reagents on the market comes from. Since there is no standard for drug resistance, what is the significance of the accuracy of the drug sensitivity results? In addition, the pH of the medium has a great influence on the minimum inhibitory concentration of the drug, and the in vitro results are not equivalent to the in vivo situation. The semi-quantitative mycoplasma count is another oddity. Another oddity in the test is the semi-quantification of mycoplasma to 104 to determine whether the culture results of mycoplasma are meaningful. And in fact, it is not quantified at the time of specimen collection, and it is not quantified at all simply by a swab of the collected specimen. What is the significance of quantification after culture when it is not quantified at the beginning? For these reasons, inconsistent test results occur among hospitals and even among multiple tests at the same hospital. The misuse of mycoplasma testing and the questionable accuracy of the results have had serious consequences for patients. Specifically, it leads to overtreatment. Since the accuracy of the results is already problematic, patients have to spend a lot of financial and human resources in order to cure mycoplasma “infection”, which increases their financial burden. Especially some of the so-called “STD experts”, using the tactics of deception, so that patients receive treatment, resulting in excessive treatment. Affects family harmony. Because mycoplasma infection and STDs may be related, when patients found “infected” with mycoplasma, will lead to a significant increase in the patient’s mental burden, especially patients who have had non-marital sex, this phenomenon is more obvious, and will even lead to family disputes. It is easy to lead to antibiotic resistance. China itself is a big country of antibiotic abuse. As mycoplasma infection requires antibiotic treatment, inaccurate results will lead to excessive use of antibiotics, which will further aggravate the development of drug resistance. Treatment of mycoplasma infection: Tetracycline or macrolide antibiotics are better, quinolones are also good, but they are prone to resistance. Other so-called laser, physical, targeted therapy and other new methods, is the emperor’s new clothes!