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IOSR Journal Of Pharmacy
(e)-ISSN: 2250-3013, (p)-ISSN: 2319-4219
www.iosrphr.org Volume 5, Issue 4 (April 2015), PP. 35-39
35
Isolation and Identification of Coliform Bacteria’s from Drinking
Water Sources of Hazara Division, Pakistan
Ehsan Humayun*
, Aqsa Bibi, Sajjad Ahmad, Nodia Shujaat
Department of Biochemistry, Hazara University Garden Campus Manshera, KPK, Pakistan
ABSTRACT: In Pakistan there is not a good awareness about water borne diseases. It is just due to lack of
knowledge and infrastructure and it is not a hidden thing that in Pakistan water borne diseases are not different
from world. In this study determination of coliforms specially E.coli, P.aeruginosa, Salmonella and H. pylori
were isolated and identified by using 100 ml of drinking water sample from common sources. WHO
recommendation tells us that any 100 ml water sample used for deinking must not contain any coliforms in it. In
this study a total of 90 samples were collected from 3 different cities of Hazara Division (Mansehra, Abbottabad
and Haripur). To find out pathogenic bacteria culturing technique was used followed by staining for
identification of bacterial specie. In Mansehra 15 samples (16.66%) were found pathogenic, 18 samples (20%)
from Abbottabad and 16 samples (17.77%) from Haripur respectively. Four Different bacterial species were
found i-e E.coli, P. aeruginosa, Salmonella and H. pylori. Ecoli was mostly isolated specie that was identified in
24 samples (26.66%) followed by P. aeruginosa 11 samples (12.22%), H. pylori 8 samples (8.88%) and
Salmonella 6 samples (6.66%). This study concludes that disinfection of water should be implemented to reduce
water borne diseases, water supplying departments have to follow WHO standards for better public health and
to control disease outbreak by coliforms.
KEYWORDS: E.coli, P. aeruginosa, Salmonella, H. pylori, Contamination,
I. INTRODUCTION
Earth consist of approximately 70% surface area covered with water and remaining is land which have
only 2% water which is drinkable [1]. Water is an important chemical molecule containing feature of life it can
be dissolved into organic compounds, salts, inorganic compounds and gases that are involved in metabolic
processes because it is universal solvent and due to that it provides stability to membrane system, macro
molecules, hemostatis, transportation and thermal regulation of body [2,3,4,5]. All cells of body contain water as
an important component. Water content of a single cell is 45% to 95% and microorganism contains 80% of body
weight as water and human contains water i-e 70% of their body weight. It is thermal regulator of human body
and normal human body contains 42 liters of water in them [6]. Whenever 2.7 liters of water loss from body it
can leads to headache, dehydration and weakness. Water is equally important and critical for both humans and
environment and it is a key issue in form of drinking water [7]. Dams, canals and wells show importance of
water and the impact of human beings on water cycle. Environmental effects like migration of peoples and
animals, land losses, change of environmental factors, depletion of biological resources shows that these
activities are noticeable [8]. Pathogenic contamination of water is also important threat for living organisms. In
Asian regions peoples those are living near to rivers are at high risk of their lives because of sewage pollution
which is directly disposed off from chemical factories and septic tanks that are the main reservoir of pathogens
involves in water borne diseases [9]. Developing regions lack in provision of safe drinking water to their
peoples and in Africa and Asia almost 800 billion individuals using unsafe drinking water which results in
suffering of individual from water borne diseases [10].
II. OBJECTIVES OF STUDY
1. To find out the presence of coliforms in drinking water of Hazara Division (Mansehra, Abbottabad, and
Haripur cities).
2. To find out the storage effect in households on the presence of coliforms.
3. To find out the prevalence of bacterial pathogens in drinking water of Hazara Division.
4. To find out the quality of water used for the purpose of drinking of Hazara Division.
III. METHODOLOGY
SAMPLING SITES
Current study was carried out to examine the quality of drinking water of Hazara Division, Pakistan. In
Hazara division Municipal Corporation store water and supplied it to local population through pipe lines.
Knowing the public health risk from unsafe drinking water three cities i.e Mansehra, Abbottabad and Haripur
were chosen to study the quality of daily used drinking water.
Isolation And Identification Of Coliform…
36
SAMPLE COLLECTION
A total of 90 samples were collected from different demographic location of Mansehra, Abbottabad
and Haripur including Rural and Urban areas (30 from each city). 100 ml water sample was collected and
transferred it into disposable sterilized test tubes. Also pH of water was tested by using combi 3 dipsticks.
After collection of sample test tubes were tightly closed to avoid any contamination and protection to make it
protected from environmental pathogen contamination.
STERILIZATION
At first Petri plates, test tubes and other instruments like flasks etc were sterilized using spirit and
allowed to cool down after that they were autoclaved at 1210
C. After that Petri plates were dried in laminar flow
hood in presence of UV light.
PREPRATION OF CULTURING MEDIA
Ingredients of media were taken in conical flasks and mixed using international criteria for Media
preparation [11]. The samples were autoclaved to remove suspension and bacteria at 110°C by plugging them
with cotton and covering them with aluminum foils. After sterilization media was transferred to Petri plates and
incubate at 30°C for 24 hours,
CULTURING
With the help of streaking water samples were streaked on prepared culture and incubate it for 24 hours
at 30°C. Placed petri plated upside down to prevent any environmental contamination.
GRAM STAINING
Bacterial growth appeared were obtained and fixed on glass slide and stained using crystal violet for 30
seconds and then washed using distilled water. After that Gram Iodine was applied for 10 sec and used 95%
Acetone alcohol as decolorizing agent and finally safranin were applied and wash slide with water dried and
observed using microscope.
OXIDASE TEST
Oxidase regent was prepared using manufacturer instructions and then drop 2-3 drops of it on filter
paper placed in petri plate. Then by moving some bacteria to regent showed those bacteria which changes color
to deep purple on treated filter paper within 10 seconds were report as oxidase +ive.
IV. RESULTS & DISCUSSION
A total of 90 samples were collected from different demographic locations of Hazara division from 1st
May 2014 to 30th
August 2014. Rural and urban areas of three major cities of Hazara division were selected i-e
Mansehra, Abbottabad, Haripur and samples were collected. 30 samples were collected from each city to
achieve a good comparison as shown in Fig 1. After a careful experimental work Abbottabad stand top for
having most number of coliforms found in drinking water samples with 18 samples (20%) followed by Haripur
city were total no of coliform identified were in 16 samples (17.77%) and in Mansehra bacterial species were
found in 15 samples (16.66%) as shown in Fig 2. Four Bacterial species were found i-e E.coli, P. aeruginosa,
Salmonella and H. pylori. Ecoli was mostly present specie and it was identified in 24 samples (26.66%)
followed by P. aeruginosa in 11 samples (12.22%), H. pylori in 8 samples (8.88%) and Salmonella in 6 samples
(6.66%) as shown in Fig 3. In Mansehra most prevailing pathogen found was E.coli in 8 samples (8.88%) > P.
aeruginosa in 3 samples (3.33%) > Salmonella in 2 samples (2.22%) > H. pylori in 1 samples (1.11%). In
Abbottabad E.coli were found in 6 samples (6.66%) > H. pylori in 4 samples (4.44%) > P. aeruginosa in 2
samples (2.22%) > Salmonella in 0 samples (0%). In Haripur city E.coli were found in 10 samples (11.11%) >
P. aeruginosa in 6 samples (6.66%) > Salmonella in 4 samples (4.44%) > H. pylori in 3 samples (3.33%) as
shown in Fig 4. pH of samples recorded for every sample and it shows the mean ph in month of June 7.9 > July
7.8 > August 7.6 > May 7.4 respectively as shown in Table 1. Temperature of Hazara division recorded per
month and mean temps shows that month of July 33 0
C > June 32 0
C > August 26 0
C > 22.05 0
C respectively as
shown in Table 2.It has beeen the goal to achive diagnostics for target coliforms in clinical labs and from the last
decade successful efforts have been made [12]. According to Stevens et al., E.coli is main indicator for fecal
contamination [13]. Jay stated that E.coli presence is indication of enteric patrhogens [14]. According to Baudart
et al., Water quality is directly proportional to presence of coliforms in water [15]. Bej et al., and Petit et al.,
studies showed that E. coli is mostly concerned with fecal pollution [16,17]. According to Baudizsova E. coli
should be used as a prime bacteria as indicator for pathogenic contamination of water [18]. Kudryavtseva and
Edberg et al., reported that E. coli survival depends upon environmental factors and type of water they mostly
survived 4 to 12 weeks at moderate temperature [19,20]. In a study by Havelaar et al., P. aeruginosa was most
prevalent possibly because of its mesophilic nature [21]. According to Jarvis and Martine nosocomial
pneumonia respiratory tract infections are because of Pseudomonas [22]. In developed countries there are very
rare cases to isolate Salmonellae because of management of system [23,24].
Isolation And Identification Of Coliform…
37
Okonko et al., stated that pH value of samples were within range which is mostly confirmed by other authors
[25]. Sautour et al., study presented that Bacterial survival greatly depend upon incubation temperature [26].
According to W.H.O bacterial growth increases when temperature increases and it will lowers down when
temperature drops [27]. Kirchman and Rich stated that bacterial species respond quickly to higher temperature
when there is avalibilty of dissolved organic matter [28].
V. CONCLUSIONS
Water used for drinking is highly contaminated in Hazara Division (Mansehra, Abbottabad and Haripur
cities). As summer progressed no of pathogenic bacteria increased isolation of four different bacterial species
indicate high no of water borne diseases in Hazara division. So water authorities should have to take steps to
control coliforms in drinking water in order to prevent population from water borne diseases.
Fig 1: Total no of samples collected monthly
Fig 2: Total no of infected samples reported monthly
May June July August
Mansehra 9 3 7 11
Abbottabad 4 12 6 8
Haripur 9 5 9 7
0
2
4
6
8
10
12
14
May June July August
Total
Samples
Mansehra 5 1 3 6 15
Abbottabad 1 8 4 5 18
Haripur 5 3 5 3 16
0
2
4
6
8
10
12
14
16
18
20
Isolation And Identification Of Coliform…
38
Fig 3: Total no of microorganisms found per month
Fig 4: Total no of microorganisms found according to demography
Table 1: pH of Water Samples,
Month Minimum Maximum Mean
May 7 7.8 7.4
June 7.2 8.6 7.9
July 7.5 8.1 7.8
August 7.2 8 7.6
Table 2: Temp of Hazara Division
MONTH
MINIMUM
O
C
MAXIMUM
O
C MEAN O
C
May 17.6 26.5 22.05
June 26 38 32
July 30 36 33
August 22 30 26
May June July August
Total
Samples
Total Samples collected 22 20 22 26 90
Total Infected samples 11 12 12 14 49
SALMONELLA 0 2 3 1 6
E. coli 6 7 5 6 24
PSEUDOMONAS 4 1 3 3 11
H. Pylori 1 2 1 4 8
0
10
20
30
40
50
60
70
80
90
100
Mansehra Abbottabad Haripur
Total Infected samples 15 18 16
SALMONELLA 2 0 4
E. coli 8 6 10
PSEUDOMONAS 3 2 6
H. pylori 1 4 3
0
2
4
6
8
10
12
14
16
18
20
Isolation And Identification Of Coliform…
39
REFRENCES
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[5]. M. Sawka, S.N. Cheuvront, and R. Carter, 2005, Human water needs. Nutr. Rev. 63(6) pp 30-39.
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Company pp 2 and 667.
[7]. W.B. Solley, R.R. Pierce, and H.A. Peralman, 1998 “Estimated use of water in United States in 1995” U.S. Geological Survey
Circular 1200.
[8]. D.B. Botkin, and E.A. Keller 2005 Water supply use and management In. Environmental Science 5th
ed. John Willey & sons pp
406-415
[9]. S. R. Huttly, 1990 the impact of inadequate sanitary condition on health. In developing countries. World Health Stat. 43 pp 118-
126.
[10]. F. Tanwir, A. saboor and M.H. Shan 2003, Water contamination Health hazard and Public awrness: a case of the urban Punjab,
Pakistan. Inter. J Agri. Bio l(5) pp 460-462.
[11]. M. Farooq, 2006, Aeromycofloar of thinly populated areas of Lahore. Pak. J. Bot., 6(3) pp 27-36.
[12]. G. Cengi, A.De. Bartolomia, G. Caldiri 1993, Comparasion of flouogenicand conventional membrane filter media for the
enumeration of coliform bacteria. Micrbios. 76 pp 47-54.
[13]. M. Stevens, N. Ashbolt, D. Cunliffe, 2003, Recommendation to change the colifrom as microbial indicators of drinking water
quality. Australia Government National Health and Med. Res. Coun. ISBN 1864961651
[14]. J.M. Jay, 1996 Modren food microbiology 5th
edition Van Nostrand Reinhold. New Yark. pp 661.
[15]. J. Baudart, J. Coallier, P. Laurant, and M. Prevost, 2002, Rapid and sensitive Enumeration of viable Diluted Cells of members of
Family Enterobacteriaceae in freshwater and drinking water Appl.Envirn. Microbiol. 68 pp 5057-5063
[16]. A.K. Bej, M.H. Mahbubani, and R.M. Atlas, 1990. Detection of viable Legionella pneumophila in water by Polymerase Chain
Reaction and gene probe methods. Appl. Environ. Microbiol. 57(2), pp 597-600.
[17]. M. Petit, I. George, and P. Servais, 2001. Removal of indicator bacteria, human enteric viruses, Glucoronidase activity
measurements and characterization of cellular states’, Can. J. Microbiol. 46 pp 679-684.
[18]. D. Baudizsova, 1997, Evaluation of Escherichia coli as the main indicator of faecal pollution. Wat. Sci. Tech. 35 pp 333-336.
[19]. B.M. Kudryavtseva, 1972. An experimental approach to the establishment of zones of hygienic protection of underground water
sources on the basis of sanitary-bacteriological indices. J. Hyg. Epidemiol. Microbiol. Immunol 18 pp 503-511.
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from patients with diarrhoea and from drinking water. J. Appl. Bacteriol., 72, pp 435-444.
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pp 1176-1193.
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Equatorial Pacific Ocean Microbial Ecol 33 (1) pp 11-20.

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Isolation and Identification of Coliform Bacteria from Drinking Water Sources

  • 1. IOSR Journal Of Pharmacy (e)-ISSN: 2250-3013, (p)-ISSN: 2319-4219 www.iosrphr.org Volume 5, Issue 4 (April 2015), PP. 35-39 35 Isolation and Identification of Coliform Bacteria’s from Drinking Water Sources of Hazara Division, Pakistan Ehsan Humayun* , Aqsa Bibi, Sajjad Ahmad, Nodia Shujaat Department of Biochemistry, Hazara University Garden Campus Manshera, KPK, Pakistan ABSTRACT: In Pakistan there is not a good awareness about water borne diseases. It is just due to lack of knowledge and infrastructure and it is not a hidden thing that in Pakistan water borne diseases are not different from world. In this study determination of coliforms specially E.coli, P.aeruginosa, Salmonella and H. pylori were isolated and identified by using 100 ml of drinking water sample from common sources. WHO recommendation tells us that any 100 ml water sample used for deinking must not contain any coliforms in it. In this study a total of 90 samples were collected from 3 different cities of Hazara Division (Mansehra, Abbottabad and Haripur). To find out pathogenic bacteria culturing technique was used followed by staining for identification of bacterial specie. In Mansehra 15 samples (16.66%) were found pathogenic, 18 samples (20%) from Abbottabad and 16 samples (17.77%) from Haripur respectively. Four Different bacterial species were found i-e E.coli, P. aeruginosa, Salmonella and H. pylori. Ecoli was mostly isolated specie that was identified in 24 samples (26.66%) followed by P. aeruginosa 11 samples (12.22%), H. pylori 8 samples (8.88%) and Salmonella 6 samples (6.66%). This study concludes that disinfection of water should be implemented to reduce water borne diseases, water supplying departments have to follow WHO standards for better public health and to control disease outbreak by coliforms. KEYWORDS: E.coli, P. aeruginosa, Salmonella, H. pylori, Contamination, I. INTRODUCTION Earth consist of approximately 70% surface area covered with water and remaining is land which have only 2% water which is drinkable [1]. Water is an important chemical molecule containing feature of life it can be dissolved into organic compounds, salts, inorganic compounds and gases that are involved in metabolic processes because it is universal solvent and due to that it provides stability to membrane system, macro molecules, hemostatis, transportation and thermal regulation of body [2,3,4,5]. All cells of body contain water as an important component. Water content of a single cell is 45% to 95% and microorganism contains 80% of body weight as water and human contains water i-e 70% of their body weight. It is thermal regulator of human body and normal human body contains 42 liters of water in them [6]. Whenever 2.7 liters of water loss from body it can leads to headache, dehydration and weakness. Water is equally important and critical for both humans and environment and it is a key issue in form of drinking water [7]. Dams, canals and wells show importance of water and the impact of human beings on water cycle. Environmental effects like migration of peoples and animals, land losses, change of environmental factors, depletion of biological resources shows that these activities are noticeable [8]. Pathogenic contamination of water is also important threat for living organisms. In Asian regions peoples those are living near to rivers are at high risk of their lives because of sewage pollution which is directly disposed off from chemical factories and septic tanks that are the main reservoir of pathogens involves in water borne diseases [9]. Developing regions lack in provision of safe drinking water to their peoples and in Africa and Asia almost 800 billion individuals using unsafe drinking water which results in suffering of individual from water borne diseases [10]. II. OBJECTIVES OF STUDY 1. To find out the presence of coliforms in drinking water of Hazara Division (Mansehra, Abbottabad, and Haripur cities). 2. To find out the storage effect in households on the presence of coliforms. 3. To find out the prevalence of bacterial pathogens in drinking water of Hazara Division. 4. To find out the quality of water used for the purpose of drinking of Hazara Division. III. METHODOLOGY SAMPLING SITES Current study was carried out to examine the quality of drinking water of Hazara Division, Pakistan. In Hazara division Municipal Corporation store water and supplied it to local population through pipe lines. Knowing the public health risk from unsafe drinking water three cities i.e Mansehra, Abbottabad and Haripur were chosen to study the quality of daily used drinking water.
  • 2. Isolation And Identification Of Coliform… 36 SAMPLE COLLECTION A total of 90 samples were collected from different demographic location of Mansehra, Abbottabad and Haripur including Rural and Urban areas (30 from each city). 100 ml water sample was collected and transferred it into disposable sterilized test tubes. Also pH of water was tested by using combi 3 dipsticks. After collection of sample test tubes were tightly closed to avoid any contamination and protection to make it protected from environmental pathogen contamination. STERILIZATION At first Petri plates, test tubes and other instruments like flasks etc were sterilized using spirit and allowed to cool down after that they were autoclaved at 1210 C. After that Petri plates were dried in laminar flow hood in presence of UV light. PREPRATION OF CULTURING MEDIA Ingredients of media were taken in conical flasks and mixed using international criteria for Media preparation [11]. The samples were autoclaved to remove suspension and bacteria at 110°C by plugging them with cotton and covering them with aluminum foils. After sterilization media was transferred to Petri plates and incubate at 30°C for 24 hours, CULTURING With the help of streaking water samples were streaked on prepared culture and incubate it for 24 hours at 30°C. Placed petri plated upside down to prevent any environmental contamination. GRAM STAINING Bacterial growth appeared were obtained and fixed on glass slide and stained using crystal violet for 30 seconds and then washed using distilled water. After that Gram Iodine was applied for 10 sec and used 95% Acetone alcohol as decolorizing agent and finally safranin were applied and wash slide with water dried and observed using microscope. OXIDASE TEST Oxidase regent was prepared using manufacturer instructions and then drop 2-3 drops of it on filter paper placed in petri plate. Then by moving some bacteria to regent showed those bacteria which changes color to deep purple on treated filter paper within 10 seconds were report as oxidase +ive. IV. RESULTS & DISCUSSION A total of 90 samples were collected from different demographic locations of Hazara division from 1st May 2014 to 30th August 2014. Rural and urban areas of three major cities of Hazara division were selected i-e Mansehra, Abbottabad, Haripur and samples were collected. 30 samples were collected from each city to achieve a good comparison as shown in Fig 1. After a careful experimental work Abbottabad stand top for having most number of coliforms found in drinking water samples with 18 samples (20%) followed by Haripur city were total no of coliform identified were in 16 samples (17.77%) and in Mansehra bacterial species were found in 15 samples (16.66%) as shown in Fig 2. Four Bacterial species were found i-e E.coli, P. aeruginosa, Salmonella and H. pylori. Ecoli was mostly present specie and it was identified in 24 samples (26.66%) followed by P. aeruginosa in 11 samples (12.22%), H. pylori in 8 samples (8.88%) and Salmonella in 6 samples (6.66%) as shown in Fig 3. In Mansehra most prevailing pathogen found was E.coli in 8 samples (8.88%) > P. aeruginosa in 3 samples (3.33%) > Salmonella in 2 samples (2.22%) > H. pylori in 1 samples (1.11%). In Abbottabad E.coli were found in 6 samples (6.66%) > H. pylori in 4 samples (4.44%) > P. aeruginosa in 2 samples (2.22%) > Salmonella in 0 samples (0%). In Haripur city E.coli were found in 10 samples (11.11%) > P. aeruginosa in 6 samples (6.66%) > Salmonella in 4 samples (4.44%) > H. pylori in 3 samples (3.33%) as shown in Fig 4. pH of samples recorded for every sample and it shows the mean ph in month of June 7.9 > July 7.8 > August 7.6 > May 7.4 respectively as shown in Table 1. Temperature of Hazara division recorded per month and mean temps shows that month of July 33 0 C > June 32 0 C > August 26 0 C > 22.05 0 C respectively as shown in Table 2.It has beeen the goal to achive diagnostics for target coliforms in clinical labs and from the last decade successful efforts have been made [12]. According to Stevens et al., E.coli is main indicator for fecal contamination [13]. Jay stated that E.coli presence is indication of enteric patrhogens [14]. According to Baudart et al., Water quality is directly proportional to presence of coliforms in water [15]. Bej et al., and Petit et al., studies showed that E. coli is mostly concerned with fecal pollution [16,17]. According to Baudizsova E. coli should be used as a prime bacteria as indicator for pathogenic contamination of water [18]. Kudryavtseva and Edberg et al., reported that E. coli survival depends upon environmental factors and type of water they mostly survived 4 to 12 weeks at moderate temperature [19,20]. In a study by Havelaar et al., P. aeruginosa was most prevalent possibly because of its mesophilic nature [21]. According to Jarvis and Martine nosocomial pneumonia respiratory tract infections are because of Pseudomonas [22]. In developed countries there are very rare cases to isolate Salmonellae because of management of system [23,24].
  • 3. Isolation And Identification Of Coliform… 37 Okonko et al., stated that pH value of samples were within range which is mostly confirmed by other authors [25]. Sautour et al., study presented that Bacterial survival greatly depend upon incubation temperature [26]. According to W.H.O bacterial growth increases when temperature increases and it will lowers down when temperature drops [27]. Kirchman and Rich stated that bacterial species respond quickly to higher temperature when there is avalibilty of dissolved organic matter [28]. V. CONCLUSIONS Water used for drinking is highly contaminated in Hazara Division (Mansehra, Abbottabad and Haripur cities). As summer progressed no of pathogenic bacteria increased isolation of four different bacterial species indicate high no of water borne diseases in Hazara division. So water authorities should have to take steps to control coliforms in drinking water in order to prevent population from water borne diseases. Fig 1: Total no of samples collected monthly Fig 2: Total no of infected samples reported monthly May June July August Mansehra 9 3 7 11 Abbottabad 4 12 6 8 Haripur 9 5 9 7 0 2 4 6 8 10 12 14 May June July August Total Samples Mansehra 5 1 3 6 15 Abbottabad 1 8 4 5 18 Haripur 5 3 5 3 16 0 2 4 6 8 10 12 14 16 18 20
  • 4. Isolation And Identification Of Coliform… 38 Fig 3: Total no of microorganisms found per month Fig 4: Total no of microorganisms found according to demography Table 1: pH of Water Samples, Month Minimum Maximum Mean May 7 7.8 7.4 June 7.2 8.6 7.9 July 7.5 8.1 7.8 August 7.2 8 7.6 Table 2: Temp of Hazara Division MONTH MINIMUM O C MAXIMUM O C MEAN O C May 17.6 26.5 22.05 June 26 38 32 July 30 36 33 August 22 30 26 May June July August Total Samples Total Samples collected 22 20 22 26 90 Total Infected samples 11 12 12 14 49 SALMONELLA 0 2 3 1 6 E. coli 6 7 5 6 24 PSEUDOMONAS 4 1 3 3 11 H. Pylori 1 2 1 4 8 0 10 20 30 40 50 60 70 80 90 100 Mansehra Abbottabad Haripur Total Infected samples 15 18 16 SALMONELLA 2 0 4 E. coli 8 6 10 PSEUDOMONAS 3 2 6 H. pylori 1 4 3 0 2 4 6 8 10 12 14 16 18 20
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