Editor's Note: Since its inception in 2005, the Shanghai International Forum for Infection Control (SIFIC) has grown over the past two decades. Known for its professionalism and forward-thinking approach, SIFIC has become a significant academic platform in China for the fields of hospital infection, major infectious diseases, and the prevention and control of multidrug-resistant organisms. Each year's academic conference not only boasts a large scale but also serves as a grand academic gathering for infection control experts and scholars from both domestic and international arenas. In the recently concluded SIFIC 2024 conference, one of the founders and current Chairman of SIFIC, Dr. Bijie Hu from Zhongshan Hospital, Fudan University, shared with Infectious Disease Frontier the development and achievements of SIFIC, as well as his profound insights into the future of infection control in China. Through his perspective, we gain a glimpse into the evolution of the field, the challenges it currently faces, and the direction it is likely to take in the future.

Overview of SIFIC’s 20-Year Journey and Achievements

As a key advocate for infection control in China, Dr. Bijie Hu has witnessed the journey from the early stages to the maturation of China’s infection control efforts. Since the first hospital infection training course co-hosted by China’s Ministry of Health and the Danish National Serum Institute in 1986, China’s infection control system has transitioned from nonexistence to a fully developed framework. However, compared to international standards, the early infection control work in China focused more on epidemiological surveys and monitoring, with fewer interventions in infection prevention and control.

In 2005, Dr. Hu began contemplating the direction of China’s infection control development. Inspired by international experiences, he realized that infection control should shift from monitoring to prevention and control. This idea led to the creation of the Shanghai International Forum on Infection Control (SIFIC), with the inaugural conference theme focusing on “The Urgent Need for Hospital Infection Monitoring in China: Doing the Right Thing.” This marked the transition of China’s infection control efforts from mere monitoring to a more proactive approach focused on prevention and control.

Over the past 20 years, the themes of the SIFIC conference have continuously evolved. From “Process Monitoring Is More Important Than Outcome Monitoring” in 2006, to “Global Thinking, Local Action” in 2010, to “Scientific Cognition, Evidence-Based Practice” in 2014, and “Building an Infection Defense Line Together, Creating a Better Future” in 2023, each theme has reflected the needs of the time and provided crucial guidance for China’s infection control efforts. Simultaneously, SIFIC has grown from a basic infection control platform to one that emphasizes evidence-based infection control, and now to a stage where precision infection control is the focus.

SIFIC’s influence has steadily increased, evolving from a single forum into a comprehensive academic exchange and service platform that integrates websites, WeChat, Weibo, and mini-programs. This transformation has not only diversified the means of information dissemination but also greatly enhanced the breadth and depth of infection control knowledge dissemination. Today, SIFIC has become a landmark platform in China’s infection control field, bringing together experts and scholars from across the country to share knowledge, exchange experiences, and collectively contribute to the progress of infection control in China.

In 2024, SIFIC’s theme, “Precision Diagnosis and Control,” is not only a proactive response to the challenges faced by the healthcare industry but also a long-term plan for the future of medical safety and quality. Under this theme, SIFIC will gather elites and pioneers from related fields, both domestic and international, to explore new pathways in precision medicine through cutting-edge academic discussions, in-depth case sharing, and innovative technology demonstrations. The ultimate goal is to ensure that every patient can enjoy safer, more effective, and personalized medical services, thus realizing true patient benefit.

The 40-Year Trajectory of China’s Infection Control Efforts and Key Breakthroughs

Dr. Bijie Hu noted that China’s infection control efforts have made significant progress over the past 38 years, especially in the last 20. He believes that the most substantial change lies in the correct establishment of infection control concepts and innovations in practice. The core goal of infection control is to reduce the risk of hospital infections during medical activities, a concept that has now been widely recognized and emphasized.

As infection control concepts have become more deeply ingrained, Chinese infection control workers, guided by evidence-based medicine, have implemented targeted and effective control measures for various types of infections. Bundled interventions, a key method among them, significantly reduce hospital infection rates by combining multiple evidence-based measures. For example, in preventing ventilator-associated pneumonia, the implementation of enhanced oral hygiene and head-of-bed elevation measures has effectively reduced the incidence of such infections.

Meanwhile, the scope of infection control has continuously expanded, from traditional monitoring of surgical site infections and catheter-related infections to broader areas such as infection control in immunocompromised hosts and the prevention and control of infectious diseases. Dr. Hu emphasized that major public health events like the SARS epidemic have profoundly shown that infection control is not just a matter for hospitals but a shared responsibility of the entire society. Therefore, the prevention and control of infectious diseases have been integrated into the infection control system, becoming an indispensable part of it.

In terms of infectious disease prevention, China has not only strengthened the control of blood-borne infectious diseases such as HIV, hepatitis B, and hepatitis C but has also actively responded to respiratory infectious disease challenges like the COVID-19 pandemic. Through scientifically precise control measures, the spread of these epidemics has been effectively curbed. Additionally, the prevention and control of drug-resistant bacteria have become a new focus, particularly the emergence of “superbugs” like carbapenem-resistant gram-negative bacteria (CRO), which pose new challenges to infection control efforts.

Dr. Hu also mentioned that the continued advancement of infection control requires corresponding cost investments, and how to scientifically and reasonably compensate these costs has become an urgent issue. In the future, establishing an efficient and fair medical system and social environment that positively incentivizes medical institutions to intensify infection control efforts will be key to promoting the development of infection control. Furthermore, strengthening the culture of infection control needs to not only be deeply rooted within medical institutions but also involve increasing patient participation and awareness, forming a good doctor-patient collaboration in infection control. These aspects present challenges for professionals in infection control and related fields and are critical issues for advancing the public health system as a whole, requiring multidisciplinary and cross-departmental collaboration and continuous exploration and innovation.

Building Microbiology Competencies for Infection Control Personnel

With rapid advancements in the field of microbiology, infection control professionals are facing new challenges in enhancing their professional competencies. Dr. Bijie Hu emphasized the urgency and importance of capacity building for infection control professionals. He pointed out that the World Health Organization (WHO) released the Core Competencies for Infection Prevention and Control Professionals in 2020, outlining 16 core competency areas covering various aspects from standard prevention to education and training. However, Dr. Hu believes that the most challenging aspect lies in developing foundational microbiology competencies.

Addressing the current relative weakness in microbiology knowledge among infection control personnel, Dr. Hu suggested that they should continually deepen their understanding of microbiology and keep pace with the latest developments in the field. This includes understanding the main characteristics and transmission mechanisms of different pathogenic microorganisms and mastering their pathogenic properties and control strategies. For instance, when dealing with hospital infections caused by environmental microorganisms such as non-tuberculous mycobacteria, infection control personnel need to be familiar with their presence in environments like water sources, and through environmental monitoring and interventions, effectively block their transmission.

At the same time, Dr. Hu emphasized that infection control work should not be limited to traditional physical isolation measures such as masks, caps, gowns, and zonal divisions. These measures may have limited effectiveness against airborne pathogens and endogenous infections, thus requiring stronger microbiological knowledge to achieve scientific and precise control.

To further strengthen the capacity building of infection control personnel, Dr. Hu called for an increased emphasis on microbiology knowledge in education and training and advocated for the construction of a continuous learning ecosystem. Providing appropriate learning platforms and pathways for infection control personnel will help comprehensively enhance their microbiology literacy and infection control practice capabilities, ensuring that they can accurately assess and scientifically strategize, steadily progressing on the path of “precision diagnosis and control.”