世界未来预测之超级细菌的攻击【经济学人精讲】第330期
文章导读
本文选自《经济学人》2019年7月6日文章。本期《经济学人》“The World If”专栏的几篇文章都非常有意思，有2020中美南海冲突，2024美国脱离NATO，2030人工智能，2020 Facebook退出欧洲等。今天要讲的这篇就是2030人工智能预测。
由于抗生素的滥用，40年后的病毒或细菌会进化成耐抗生素性，这意味着抗生素对人类已不再起作用，小小的一场细菌感染都可能让人类送命。糖尿病人不得不截肢以应对皮肤溃疡，很多新生儿也因败血症而截肢，病因通常是一次小小的擦伤、虫咬。这篇预测为我们敲响了警钟，抗生素曾拯救过千万生命，但我们不得不思考，一旦细菌产生耐药性，人类该怎么办。
由于篇幅较长，本文节选原文标题和全文重点段落进行精讲，
选文精讲
If antibiotics stop working 如果抗生素不起作用
Attack of the superbugs: July 2041 超级细菌的攻击:2041年7月
How the world belatedly responded to antimicrobial resistance. An imagined scenario from 2041
世界对抗菌素耐药性的迟钝反应，想象一下2041年的情景
belatedly: 迟了的、姗姗来迟的
antimicrobial: 抗菌剂
Jul 6th 2019 | GENEVA AND NEW YORK
AT THE CHAN ZUCKERBERG HOSPITAL in New York, Emma Jones beams a weak smile at her newborn son, cradled in her husband’s arms. Ms Jones is recovering from a severe bacterial infection that she contracted during her Caesarean section. The infection had begun to shut down her organs; doctors put her in a coma and hooked her up to a breathing machine. “We didn’t think she’d make it,” says Rosa Velasquez, an infectious-disease specialist at the hospital. Ms Jones is lucky. She is one of a handful of people to have been treated with parvomycin, the first new antibiotic to become available since 2024. The few older antibiotics that are still in use today work only rarely. In 2040 antibiotic-resistant bacteria killed nearly 400,000 people in Europe and America—more than seven times as many as in 2015. In Africa and Asia, drug-resistant tuberculosis alone now kills nearly 2m people a year, ten times more than in the 2010s.
cradle: 把...放在摇篮内、抚育，这里指“婴儿躺在...上”
tuberculosis: 肺结核
在纽约的陈-扎克伯格医院，艾玛-琼斯对着躺在他丈夫手臂中的刚出生的儿子微微一笑。琼斯女士在剖腹产手术中感染了严重的细菌，目前正在康复中。感染开始使她的器官衰竭，医生让她昏迷，并给她接上了呼吸机。医院的传染病专家Rosa Velasquez说:“我们没想到她能活下来。”琼斯女士很幸运。她是少数接受过parvomycin治疗的人之一，parvomycin是自2024年以来出现的第一种新型抗生素，是目前仍在使用的几种较老的抗生素，不过很少起作用。2040年，欧洲和美国有近40万人死于耐抗生素细菌，是2015年的7倍多。仅在非洲和亚洲，每年就有近200万人死于耐药结核病，是本世纪头十年的十倍。
In Western countries the rise in deadly infections has been primarily in hospitals. Back when antibiotics still worked, they were used preventively in almost all operations. In 2015 surgical-wound infections occurred in less than 5% of cases for most types of operations in Europe; by 2040 the rate had leapt to nearly 30% for some operations. Caesarean sections, which at their peak made up one-third of births in America in 2019, are now carried out only when there is no other option.
在西方国家，致命感染病例的增加主要发生在医院。在抗生素还有效的时候，几乎所有的手术都是预防性使用抗生素。2015年，欧洲大多数类型的手术的伤口感染病例不到5%，到2040年，这一比例已跃升至近30%。2019年，剖腹产在美国的分娩中所占比例达到顶峰，达到三分之一。如今，只有在别无选择的情况下，才会选择剖腹产。
Some hospitals no longer perform elective surgeries, such as hip and knee replacements, because so few patients are willing to take the risk of post-operative infection. But surgeons are busier with amputations, which have nearly doubled in Europe in the past decade. The lack of effective antibiotics means that amputating a limb is sometimes the only way to treat an infected skin ulcer in a diabetic patient. At the Chan Zuckerberg Hospital, most heartbreaking are the paediatric wards. They are full of children recovering from amputations, many as a result of sepsis. “It often starts with just a scrape, a bug bite or a strep throat,” says Dr Velasquez, “things that take-home antibiotics easily cleared up 20 years ago.”
amputation: 截肢
diabetic: 糖尿病
一些医院不再进行一些手术，比如髋关节和膝关节置换，因为很少有病人愿意承担术后感染的风险。但是外科医生更忙于截肢手术，在过去的十年里，欧洲的截肢手术几乎翻了一番。缺乏有效的抗生素意味着，截肢有时是治疗糖尿病患者感染的皮肤溃疡的唯一方法。在陈-扎克伯格医院，最令人心碎的是儿科病房。医院里到处都是截肢后处于康复的孩子，其中很多都是因败血症而截肢的。维拉斯克兹博士说:“通常一开始只是擦伤、虫咬或链球菌性咽喉炎，在20年前，通过抗生素这些疾病在家就可以治愈。”