Consider the following medical report that includes the patient's historical health records. Use it to predict the disease that the patient is high likely exposed to. 

 Medical Report: allergies: niacin / lovastatin attending: chief complaint: dyspnea major surgical or invasive procedure: intubation arterial line placement history of present illness: 87 yo f wtih a history of copd on chronic steroids, dementia (nonverbal baseline), and recent admission for pneumonia requiring intubation, influenza and uti who was biba from rehab for worsening dyspnea and productive cough. duration is unclear, and patient unable to provide history. today she was found to be 87% on 4l at 10 pm, and came up to 98% on nrb. she was given atrovent neb, albuterol neb, and morphine 4 mg sl without much effect. prior to transfer vs were 99.8 (rectal), 118/76, 104, 42, 95% ra. . on arrival to the ed, patient was intubated. patient had a cxr consistent with interstitial edema versus infection, stable since prior study. she was treated with vancomycin, and ordered for zosyn but this was not given prior to transfer. she received propafol, etomidate 30 mg iv x1 and succinylcholine 120 mg iv x1 peri-intubation. after intubation she was started on fentanyl and versed drips. on transfer, vs were 98.4, 99, 99/61, with vent settings of tv 450 cc, rr 16, peep 5, 100% fio2. ekg showed sinus tachycardia with peaked t waves, but k was normal. wbc was elevated at 22. she received 1litres of fluid. prior to transfer, vs were 98.4, 101, 92/58, 14, 100%. . of note, patient was admitted to with influenza, hcap and uti. she required intubation in the icu and was treated with oseltamivir, azithro, vanco and meropenem. during this hospital stay family was reluctant to change code status because daughter/hcp was away on vacation. . in the micu, patient is intubated and sedated. . review of systems: limited by patient being on ventilator. appears comfortable past medical history: 1. end-stage alzheimers dementia, non-verbal 2. copd, fev1 81% in 3. pulmonary nodules 4. ?cad ?mi in ; normal dipyridamole thallium in . 5. osteoarthritis 6. cataracts. 7. chronic back pain and hip pain 8. hearing loss 9. varicose veins 10. heart murmur 11. breast cancer in the left breast back in treated with radiation and tamoxifen, which was later changed to arimidex. 12. osteopenia with history of atraumatic vertebral fracture. 13. abnormal endometrial, worked up by ob/gyn in the past. 14. hypercholesterolemia. 15. status post cholecystectomy in . 16. status post umbilical hernia repair. 17. rib fractures. 18. actinic keratoses. 19. posterior vitreous detachment. 20. hypertension. 21. history of vertigo. 22. headaches with negative workup in the past. social history: former criminal lawyer. 3 children. quit smoking 30 years ago; previously was heavy smoker. no alcohol, illicit drug use. family history: non-contributory physical exam: admission exam: t: 98.4 bp: 115/76 p: 100 450 cc rr 16 peep 5 fio2 100% general: sedated, not withdrawing to sternal rub : sclera anicteric, mmm, oropharynx clear, : macular on back bilaterally, extending to left flank neck: supple, jvp not elevated, no lad lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly gu: no foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema discharge exam: t 97.5, bp 105/58, hr 58, rr 22, 100%2l, 2 bm yesterday and 1 bm this am gen: nad, comortable, confused, dementia, alert cardiac: rrr< no mrg pulm: few scattered crackled in lower lung bases bilaterally, no wheezing or rhonchi abd: soft, non distended, non tender ext: no pedal edema, warm pertinent results: admission labs: 01:00am blood wbc-22.2*# rbc-3.85* hgb-10.0* hct-30.8* mcv-80* mch-25.9* mchc-32.4 rdw-17.6* plt ct-367# 01:00am blood neuts-87* bands-1 lymphs-4* monos-7 eos-1 baso-0 atyps-0 metas-0 myelos-0 01:00am blood hypochr-1+ anisocy-1+ poiklo-normal macrocy-normal microcy-1+ polychr-occasional 01:00am blood pt-12.1 ptt-20.0* inr(pt)-1.0 01:00am blood urean-19 creat-0.6 03:01am blood glucose-276* urean-20 creat-0.6 na-133 k-4.5 cl-99 hco3-27 angap-12 01:00am blood alt-22 ast-16 ld(ldh)-254* alkphos-78 03:01am blood ck(cpk)-43 01:00am blood lipase-36 03:01am blood ck-mb-2 ctropnt-0.03* 01:00am blood albumin-3.3* calcium-8.7 phos-2.8 mg-1.8 01:09am blood ph-7.34* comment-green top 01:09am blood glucose-258* lactate-3.0* na-137 k-4.5 cl-99* calhco3-28 01:09am blood hgb-10.4* calchct-31 o2 sat-96 cohgb-1.4 methgb-0 01:09am blood freeca-1.12 05:47am urine color-yellow appear-hazy sp -1.025 05:47am urine blood-neg nitrite-neg protein-tr glucose-300 ketone-neg bilirub-neg urobiln-neg ph-5.0 leuks-neg 05:47am urine rbc-2 wbc-6* bacteri-few yeast-none epi-<1 05:47am urine casthy-1* 05:47am urine mucous-rare micro: blood cx x2: pending urine cx x2: yeast sputum: sputum source: endotracheal. **final report ** gram stain (final ): >25 pmns and <10 epithelial cells/100x field. 1+ (<1 per 1000x field): yeast(s). 1+ (<1 per 1000x field): gram positive cocci. in pairs. respiratory culture (final ): rare growth commensal respiratory flora. due to mixed bacterial types ( >= 3 colony types) an abbreviated workup will be performed appropriate to the isolates recovered from this site. yeast. sparse growth. staph aureus coag +. sparse growth. staphylococcus species may develop resistance during prolonged therapy with quinolones. therefore, isolates that are initially susceptible may become resistant within three to four days after initiation of therapy. testing of repeat isolates may be warranted. gram negative rod(s). rare growth. sensitivities: mic expressed in mcg/ml _________________________________________________________ staph aureus coag + | clindamycin-----------<=0.25 s erythromycin----------<=0.25 s gentamicin------------ <=0.5 s levofloxacin----------<=0.12 s oxacillin-------------<=0.25 s trimethoprim/sulfa---- <=0.5 s imaging: cxr: impression: mild interstitial edema with a left lower lobe opacity, which could represent an underlying pneumonia. mitral annular calcifications. video swallow; penetration without aspiration of thin barium. no aspiration with any administered preparations. 09:37am blood wbc-7.0 rbc-3.19* hgb-8.4* hct-25.5* mcv-80* mch-26.4* mchc-33.0 rdw-18.4* plt ct-275 03:30am blood neuts-86.2* lymphs-8.6* monos-4.7 eos-0.2 baso-0.2 09:37am blood plt ct-275 09:37am blood glucose-198* urean-6 creat-0.3* na-138 k-3.5 cl-101 hco3-30 angap-11 03:30am blood ast-13 alkphos-63 totbili-0.3 05:59pm blood ck-mb-3 ctropnt-<0.01 09:37am blood phos-2.4* mg-1.7 03:01am blood caltibc-230* ferritn-85 trf-177* 06:11pm blood vanco-11.4 discharge labs: 05:36am blood wbc-6.1 rbc-3.24* hgb-8.4* hct-26.4* mcv-82 mch-26.0* mchc-31.8 rdw-17.9* plt ct-244 03:30am blood neuts-86.2* lymphs-8.6* monos-4.7 eos-0.2 baso-0.2 05:36am blood glucose-151* urean-6 creat-0.4 na-139 k-3.4 cl-99 hco3-33* angap-10 05:36am blood calcium-8.3* phos-3.1 mg-2.2 brief hospital course: 87 yo f wtih a history of copd on chronic steroids, dementia (nonverbal at baseline), and recent admission for pneumonia requiring intubation and influenza who was admitted from rehab for worsening dyspnea and productive cough secondary to new pneumonia. # respriratory failure: pt with lll opacity on cxr suggestive of pneumonia. given her recent influenza, she was was covered for mrsa with vancomycin. pt also with history of esbl and was started on meropenem (day 1=). pt was initialy closely monitored in the micu where she was intubated. her pulmonary status improved and she was extubated on . pt's fevers improved and her leukocytosis resolved (wbc 22->6). for possible copd exacerbation, she was continued on prednisone 20mg daily. she will taper down to 10mg daily in 3 days. cxr showed some signs of pulmonary edema, esp in the setting of getting ivf while in the micu, and she was diursed with iv lasix (10-20mg daily for 2 days). sputum culture notable for rare growth of coag positive aureus, mssa plus some rare gnr. she had a picc placed for antibiotic course of treatment for presumed hcap. vancomycin was stopped on (completed 5 day course) and she will continue meropenem for total 7 day course (through ). aspiration concern: pt had speech and swallow video study and passed. she was restarted on dysphagia diet of pureed solids and nectar think liquids. explained to pt's family that she is at risk for aspiration. : patient with in dependent areas on back (flank regions bilaterally) and part of stomach. crosses midline so unlikely zoster. likely to be contact dermatitis as existed prior to antibiotic administration. dementia: patient non-verbal at baseline. passed swallow evaluation and was restarted on dysphagia diet. anemia: patient??????s recent hct baseline around 28-31. during this hospitalization, her hct stable around 23-25 and was 26 at time of discharge. likely hemodilutional component in setting of ivf in addition to likely marrow suppresion in setting of acute illness. pending labs: -blood cultures from transition of care: -full code, verified by family -pneumonia: will need to complete course of meropenem -aspiration: family aware of pt's aspiration risk. -anemia: would trend hct while outpatient. hct stable and trending up while inpatient. reccoment cbc check on . if hct continues to decrease, would reccomend anemia workup. medications on admission: # prednisone 20 mg daily # morphine 4 mg q2 h prn # albuterol prn # vitamin d 1000 u # ipratropium neb q4h # dulcolax suppository # miralax 17 g daily # ativan 0.25 mg q4h prn # aspirin 81 mg daily # tylenol 650 mg suppository # albuterol neb q6h # ipratropium neb q6h # senna 17.2 mg daily # zinc oxide topical . per last d/c summary # albuterol sulfate prn # aspirin 81 mg daily # bisacodyl 10 mg pr # vitamin d 1,000 unit daily # ipratropium bromide 0.02 % solution q4h # polyethylene glycol 3350 17 gram daily # prednisone 40 mg x 3 days, 30 mg x 3 days, 20 mg x 3 days, 10 mg ongoing # acetaminophen 650 mg prn # docusate sodium 100 mg discharge medications: 1. prednisone 20 mg tablet sig: one (1) tablet po daily (daily): in the next 3 days, can taper to 10mg daily and continue 10mg. 2. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 3. bisacodyl 10 mg suppository sig: one (1) suppository rectal at bedtime as needed for constipation. 4. vitamin d 1,000 unit tablet sig: one (1) tablet po once a day. 5. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours). 6. polyethylene glycol 3350 17 gram/dose powder sig: one (1) po once a day. 7. tylenol 325 mg tablet sig: one (1) tablet po every six (6) hours as needed for pain: do not give more then 3g/day. 8. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day). 9. meropenem 500 mg recon soln sig: one (1) intravenous every six (6) hours for 3 days: take through for total 7 day course. 10. docusate sodium 50 mg/5 ml liquid sig: one (1) po bid (2 times a day) as needed for constipation. 11. albuterol sulfate 1.25 mg/3 ml solution for nebulization sig: one (1) inhalation every six (6) hours as needed for shortness of breath or wheezing: prn. discharge disposition: extended care facility: for the aged - macu discharge diagnosis: hospital acquired pneumonia chronic obstructive pulmonary disease- acute exacerbation contact dermatitis discharge condition: mental status: confused - always. level of consciousness: lethargic but arousable. activity status: bedbound. followup instructions: please make sure to see your primary care doctor within the week after leaving rehab. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified insertion of endotracheal tube enteral infusion of concentrated nutritional substances arterial catheterization central venous catheter placement with guidance diagnoses: coronary atherosclerosis of native coronary artery pure hypercholesterolemia unspecified essential hypertension long-term (current) use of steroids obstructive chronic bronchitis with (acute) exacerbation personal history of malignant neoplasm of breast personal history of tobacco use acute respiratory failure unspecified hearing loss old myocardial infarction methicillin susceptible pneumonia due to staphylococcus aureus iron deficiency anemia, unspecified alzheimer's disease dementia in conditions classified elsewhere without behavioral disturbance personal history of antineoplastic chemotherapy personal history of irradiation, presenting hazards to health other specified hypotension acute edema of lung, unspecified dysphagia, oropharyngeal phase contact dermatitis and other eczema, unspecified cause personal history of pathologic fracture 

Answer: The patient is high likely exposed to