Colibactin is a genotoxic metabolite produced by Escherichia coli and other Enterobacteriaceae ("enteric bacteria") believed to cause mutations leading to colorectal cancer and the progression of colorectal cancer, especially in early-onset colorectal cancers. Colibactin is a polyketide peptide that can form interstrand crosslinks in DNA. Colibactin is only produced by bacterial strains containing a polyketide synthase genomic island (pks) or clb biosynthetic gene cluster. About 20% of humans in high-income countries are colonized with E. coli that harbor the pks island.
Colibactin forms DNA inter-strand cross-links by alkylation of adenine moieties on opposing DNA strands. It induces lytic development in certain bacteria that contain prophages. Colibactin has been previously demonstrated to have a characteristic mutational signature. The same mutational signature was discovered in several cohorts of colon cancer patients, and in smaller numbers of patients with urogenital and head and neck cancers. Colibactin exposure has been further linked to a proportion of APC driver indels.