ABSTRACT
        Background and Objectives: Biofilm is a population of bacteria growing on a surface and enclosed in an exopolysaccharides matrix, which increases resistance to antimicrobial agents and immune response. Uropathogenic Escherichia coli (UPEC) are biofilm-forming bacteria and the most common cause of urinary tract infections (UTIs). This study evaluated the effect of different concentrations of glucose, NaCl, blood, serum and urine on biofilm formation and antigen 43 (Ag43) gene expression, as a main gene involved in biofilm formation.
        Methods: Among E. coli isolates from patients with UTI, four extended-spectrum beta-lactamase (ESBL) and non-ESBL strains, and a standard UPEC strain were selected. Biofilm formation of the strains in brain heart infusion (BHI) broth with different concentrations of glucose, NaCl, sheep blood, serum and human urine was evaluated using microplate method and crystal violet staining. Ag43 gene expression was investigated using Real-Time polymerase chain reaction, SYBR Green dye, and specific primers.
           Results: Presence of glucose at all concentrations reduced biofilm formation. Presence of 1% NaCl, 1% sheep blood, 10% bovine serum, and 5% urine significantly increased biofilm formation. Expression of Ag43 by the strains grown under 1% glucose, 1% NaCl, 1% sheep blood, 10% bovine serum and 5% urine decreased.
         Conclusion: All environmental factors other than glucose may increase biofilm formation of E. coli at different concentrations. This is not affected by factors such as isolation from inpatient or outpatients and type of strains (ESBL or non-ESBL). Contrary to our expectations, Ag43 expression is independent of environmental factors and decreases even under the most suitable concentrations.
          Keywords: Biofilms, Uropathogenic Escherichia coli, UTI, Antigen 43, Real-Time PCR.

ABSTRACT
             Background and objectives: Urinary tract infections (UTIs) are one of the most common infectious diseases caused by bacteria. The primary etiologic agent of UTIs is Escherichia coli. Uropathogenic E.coli (UPEC) strains have a number of specific virulence factors, which can worsen UTIs. This study was performed to detect fim, pap, sfa and afa genes among E.coli strains isolated from UTIs.
             Methods: A total of 100 E. coli isolates from patients with UTI was collected between June and December 2015 from Mosavi and Sayyad Shirazi hospitals in Gorgan, Iran. All bacterial isolates were identified via standard biochemical testing and Gram straining. Presence of the genes was assessed by polymerase chain reaction.
             Results: The frequency of the fim, pap, sfa and afa genes was 100%, 79%, 69% and 8%, respectively. All isolates contained at least one virulence gene. Prevalence of multiple adhesion genes was 6% for all genes and 65% for three genes (fim, pap and sfa) together. In addition, the frequency of the fim gene was significantly higher than that of the other genes (P<0.0001).
             Conclusion: The results of this study indicate the high prevalence of virulence factors that can enhance pathogenicity of E. coli. Therefore, these factors could be used as diagnostic markers or vaccine targets.
             Keywords: Virulence factors, Urinary tract infection, Uropathogenic Escherichia coli.