Urinary tract infections (UTIs) are the most common type of nosocomial infection, and Candida albicans is the most frequent organism causing fungal UTIs. Presence of an indwelling urinary catheter represents a significant risk factor for UTIs. Furthermore, these infections are frequently associated with the formation of biofilms on the surface of these catheters. Here, we describe the characterization of C. albicans biofilms formed in vitro using synthetic urine (SU) medium and the frequently used RPMI medium and compare the results. Biofilms of C. albicans strain SC5314 were formed in 96-well microtiter plates and on silicon elastomer pieces using both SU and RPMI media. Biofilm formation was monitored by microscopy and a colorimetric XTT [2,3-bis(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide] reduction assay. As in biofilms grown in RPMI medium, time course studies revealed that biofilm formation using SU medium occurred after an initial adherence phase, followed by growth, proliferation, and maturation. However, microscopy techniques revealed that the architectural complexity of biofilms formed in SU medium was lower than that observed for those formed using RPMI medium. In particular, the level of filamentation of cells within the biofilms formed in SU medium was diminished compared to those in the biofilms grown in RPMI medium. This observation was also corroborated by expression profiling of five filamentation-associated genes using quantitative real-time reverse transcriptase PCR. Sessile C. albicans cells were resistant to fluconazole and amphotericin B, irrespective of the medium used to form the biofilms. However, caspofungin exhibited potent in vitro activity at therapeutic levels against C. albicans biofilms grown in both SU and RPMI media.Candida albicans is a nosocomial pathogen that has a predilection for the urinary tract, where it can cause infections with a broad spectrum of disease severity. It is thereby known to be the most frequent organism causing fungal urinary tract infections (UTIs) (26). Presence of an indwelling urethral catheter represents a significant risk factor for C. albicans UTI as these infections are frequently associated with the formation of biofilms on the surface of these catheters (8,19). C. albicans biofilms are highly organized communities of yeast, hyphae, and pseudohyphae attached to the surface of biomaterials and enclosed in a matrix of polysaccharides and are highly resistant to most major classes of antifungal drugs (21).C. albicans biofilms have been developed on several different model systems in vitro (4,14,24,30). Several experimental variables have been incorporated into these systems in order to mimic conditions in patients, such as flow to simulate blood flow, coating of substrate surfaces with various host blood and salivary proteins, variation in the nutrient medium employed, and use of common device materials (14,20). In the present study we grew C. albicans biofilms in synthetic urine (SU) medium-an in vitro model mimicking an in vivo...