Five types of cytolethal distending toxin (CDT-I to CDT-V) have been identified in Escherichia coli.In the present study we cloned and sequenced the cdt-IV operon and flanking region from a porcine extraintestinal pathogenic E. coli (ExPEC) strain belonging to serogroup O75. We confirmed that similar to other CDTs, CDT-IV induced phosphorylation of host histone H2AX, a sensitive marker of DNA double-strand breaks, and blocked the HeLa cell cycle at the G 2 -M transition. The cdt-IV genes were framed by lambdoid prophage genes. We cloned and sequenced the cdt-I operon and flanking regions from a human ExPEC O18:K1:H7 strain and observed that cdt-I genes were also flanked by lambdoid prophage genes. PCR studies indicated that a gene coding for a putative protease was always associated with the cdtC-IV gene but was not associated with cdtC genes in strains producing CDT-I, CDT-III, and CDT-V. Our results suggest that the cdt-I and cdt-IV genes might have been acquired from a common ancestor by phage transduction and evolved in their bacterial hosts. The lysogenic bacteriophages have the potential to carry nonessential "cargo" genes or "morons" and therefore play a crucial role in the generation of genetic diversity within ExPEC.Cytolethal distending toxins (CDTs) were the first bacterial toxins that block the eukaryotic cell cycle that were described, and they suppress cell proliferation and eventually lead to cell death. CDTs represent an emerging toxin family, which was initially described for Escherichia coli but is actually widely distributed among a variety of pathogenic bacteria, including Shigella dysenteriae, Salmonella enterica serovar Typhi, Campylobacter spp., Helicobacter spp., Aggregatibacter (formerly Actinobacillus) actinomycetemcomitans, and Haemophilus ducreyi (31,34).A CDT is a tripartite holotoxin (28) in which CdtB is the active subunit and CdtA and CdtC form a heterodimeric subunit apparatus required for delivery of CdtB into the cell (8,23,24). The toxin of S. enterica serovar Typhi is an exception. This organism does not encode CdtA or CdtC; instead, the enzymatic CdtB is delivered directly into host cells by a bacterial internalization pathway (14). Nuclear entry of CdtB, which relies on an atypical nuclear localization signal, is crucial for the cytotoxic activity (25,27,29). CdtB has DNase I-like activity (10,15,23). Once in the host cell nucleus, CdtB induces DNA double-strand breaks in both proliferating and nonproliferating cells (13,15,26). Although pathogenic roles of CDT have been shown for chronic infection in mouse models (12, 39), CDT has not played a significant role in acute infection models tested to date (25,40,48,49). Nevertheless, CDT appears to be a virulence factor; accordingly, studying its spread is important.So far, five different CDTs have been reported for E. coli, and they were designated in order of publication. CDT-I (44) and CDT-II (38) were identified in enteropathogenic E. coli (EPEC) serotype O86:H34 and O128:NM strains, respectively. CDT-III was cloned from an...