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: history of present illness: this is a 55 year-old male patient with known coronary artery disease, alcohol abuse, bipolar disorder who was admitted to on after approximately three day history of chest pain. the patient lives in a group home. he had previously been sober for fourteen months, however, recently began drinking again. approximately four days prior to admission the patient entered a detox facility. past medical history: significant for coronary artery disease as previously mentioned. he is status post stent to his left circumflex in . he has documented ejection fraction of 50%. the patient is positive for a myocardial infarction eight years ago. he has a history of bipolar disorder and alcohol abuse. medications on admission: lithium 300 mg po q.a.m., 600 mg po q.h.s., trazodone 300 mg po q.d., wellbutrin sr 150 mg po q.a.m., lipitor unknown dose, enteric coated aspirin 325 mg po q.d., atenolol unknown dose, seraquel 100 mg po q.d. hospital course: the patient was taken to the cardiac catheterization laboratory on , which revealed three vessel coronary artery disease including a 50% left main as well as a left ventricular ejection fraction of 45%. the patient was taken to the operating room on by dr. where the patient underwent a coronary artery bypass graft times four. postoperatively, the patient extubated himself on the night of surgery and was quite agitated upon waking from anesthesia. psychiatry service has been following him since his admission to the hospital. they recommended utilizing haldol for sedation and recommended holding other sedating medications as well as psychiatric medications at that time. on postoperative day one the patient was on neo-synephrine for some hypotension, propofol intravenous drip was converted to __________. the patient had been reintubated. he did not tolerate his self extubation on the night of surgery due to respiratory distress. the patient was placed on _________, however, that did not sedate the patient adequately and he was placed back on propofol. he received increasing doses of haldol, however, wound up with a prolonged qtc, therefore his haldol was converted to ativan and a morphine intravenous drip. again on postoperative day two the patient extubated himself and did not tolerate it and was reintubated a second time. the patient also discontinued his central intravenous line and a new stick right ij triple lumen catheter was placed. the patient spiked a fever and was fully cultured at that time. he remained on neo-synephrine for some hypotension and also remained on morphine and ativan drips for sedation. on the patient had a pulmonary artery catheter replaced due to fever and hypotension. however, his cardiac numbers were adequate. his tube feeds were resumed. he was placed on levaquin and vancomycin secondary to fever to 102, although his white blood cell count was between 10 and and he was fully cultured. the following day all of the psychiatric medications were discontinued at the recommendation of the psychiatry service. there had been worsening agitation and restlessness and it was their thought that these drugs could be contributing to them. it was there recommendation also to continue just haldol and follow his electrocardiogram daily to check his qt intervals. over the next couple of days the patient's pulmonary artery catheter was discontinued. he remained extremely agitated thrashing in the bed requiring large doses of sedation. morphine and ativan drips were continued. it was still the recommendation of the psychiatry service to not resume the rest of his psychiatric medication. infectious disease consultation was obtained on and it was their recommendation to discontinue all of his antibiotics. the vancomycin was discontinued at that time, but the levofloxacin was continued at the discretion of the cardiac surgery service due to large amounts of sputum production. the patient underwent bronchoscopy on the for increased secretions. on the patient was continued to progress with decreasing doses of neo-synephrine. over the next few days the infectious disease consult service had signed off the case. on the the patient underwent percutaneous tracheostomy and percutaneous endoscopic gastrostomy tube placed at the bedside by dr. . the patient tolerated this procedure well. on the patient was transferred from the cardiothoracic surgery service to the surgical intensive care unit/critical care service due to continued need for intensive care support. over the next few days the patient remained febrile. infectious disease service was reconsulted on the . it was their recommendation to discontinue the levofloxacin and to check for c-difficile in his stool, which was ultimately negative. the patient at that time had gram positive coxae in his blood, although it was not yet speciated and he was started on vancomycin due to the findings. this was subsequently discontinued on the since it was a line that was positive and not actually blood cultures at that time. the patient was started over the next few days on a clonidine patch. his morphine and ativan were slowly being weaned and he was begun on diuretics. the patient was also maintained on a propofol intravenous drip for sedating purposes. on the it was noted that the patient had enterobacter in his sputum. this was sensitive to levofloxacin so he was resumed on that. vancomycin was also restarted due to gram positive coxae in his blood. over the next few days the patient continued with slow pressure support ventilation wean. the patient underwent another bronchoscopy on for thick copious secretions. the patient underwent cat scans of his chest, abdomen and pelvis on the due to continued fevers without a definitive source and this revealed a left lower lobe pneumonia as well as no abdominal fever source. the patient began to wake up over the next few days and became more alert and less agitated. it was also ascertained around the that the patient had methacillin resistant staph aureus in his sputum and was on vancomycin at that time. it was the recommendation of the infectious disease service to continue a fourteen day course of vancomycin, which was started on for mrsa pneumonia. over the next few days the propofol was weaned to off and discontinued on . his intravenous ativan was converted to intermittent dosing and ultimately weaned off over the next few days. on the infectious disease service signed off. it was their recommendation to continue a fourteen day course of vancomycin as previously noted and to continue levofloxacin for his enterobacter in his sputum. repeat sputum culture, however, on , revealed that the enterobacter in his sputum is intermittently resistant to levofloxacin and this was changed to imipenem. on the patient was converted from his pressure support ventilation to a trach mask and he has remained off the ventilator since that time. he has tolerated a passy-muir valve at times for speaking purposes. physical therapy and occupational therapy consultations were obtained and they continued to follow the patient for treatment. the patient also underwent a swallow evaluation, which he failed. it was the recommendation of the speech therapy service to maintain a strict npo status and to continue tube feeds through his percutaneous endoscopic gastrostomy until he was able to swallow safely. the patient, however, has been witnessed to get himself up to the sink and drink water on his own. the patient continued to tolerate his tube feeds well through his percutaneous endoscopic gastrostomy tube. the patient remains hemodynamically stable and he is able to be transferred to rehabilitation facility at this time. most recent cultures revealed resistant enterobacter in the sputum as well as mrsa in the sputum from . the patient is on vancomycin, which is to continue through to give him a fourteen day course and imipenem, which is starting today and that is to continue through for a fourteen day course both for pneumonia. two sets of blood cultures on as well as two sets of blood cultures on were all negative. stool for c-difficile was negative on . right subclavian triple lumen catheter tip on was negative as was a urine culture on . the patient's condition today is as follows: temperature 98. pulse 86. normal sinus rhythm. respiratory rate 19. blood pressure 135/60. oxygen saturation on 35% oxygen via tracheostomy mask is 98%. the patient remains incontinent of large amounts of urine. generally the patient is awake and alert and responds appropriately to stimuli. he is agitated at times, but tempting to get up and ambulate on his own. cardiovascular examination is regular rate and rhythm. his breath sounds are coarse rhonchi bilaterally. his abdomen is soft. his extremities are warm and well perfuse. most recent laboratory values are from today , which revealed a white blood cell count of 17., this is down from 24,000 on . hematocrit 33.2, platelet count 295,000, sodium 138, potassium 4.0, chloride 98, co2 31, bun 26, creatinine 0.6, glucose 179. medications: aspirin 325 mg one per g tube q.d., albuterol meter dose inhaler four puffs q 4 hours and prn, atrovent four puffs q four hours and prn via trach. heparin 5000 units subcutaneously q 8 hours, multi vitamins one po q.d., clonidine patch 0.3 mg q monday, nystatin 5 milliliters swish and swallow t.i.d., colace 100 mg per g tube b.i.d., imipenem dose to be determined, tylenol 650 mg per g tube q 6 hours prn, glucotrol 5 mg per g tube q.d., nicotine patch 14 mg q.d., vancomycin 1 gram intravenous q 12 hours through , lopresor 50 mg q 6 hours per g tube, trazodone 100 mg q.h.s. per g tube, ativan 2 mg q.h.s. prn, ativan 0.25 mg q 8 hours around the clock per g tube, haldol 40 mg q 6 hours per g tube. the patient's current tube feeding, which he is tolerating well is promod with fiber at his goal rate of 75 cc per hour. discharge diagnoses: 1. coronary artery disease status post coronary artery bypass graft. 2. postoperative delirium/aggitation. 3. bipolar disorder. 4. alcohol abuse. 5. respiratory failure status post cardiac surgery. , m.d. dictated by: medquist36 procedure: (aorto)coronary bypass of three coronary arteries single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery coronary arteriography using two catheters angiocardiography of left heart structures injection or infusion of platelet inhibitor left heart cardiac catheterization temporary tracheostomy closed [endoscopic] biopsy of bronchus diagnoses: coronary atherosclerosis of native coronary artery pneumonia due to other gram-negative bacteria other pulmonary insufficiency, not elsewhere classified methicillin susceptible pneumonia due to staphylococcus aureus infection and inflammatory reaction due to other vascular device, implant, and graft bipolar i disorder, most recent episode (or current) unspecified urinary incontinence, unspecified alcohol abuse, episodic 

Answer: The patient is high likely exposed to