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: heparin agents attending: chief complaint: enterocutaneous fistula major surgical or invasive procedure: on he was taken to the operating room for (1) exploratory laparotomy, (2)lysis of adhesions (3.5 hours), (3) enterectomy, (4) enteroenterostomy, (5)colostomy, (6) closure of 2 enterotomies, (7) feeding jejunostomy, (8) component separation and (9) placement of vicryl mesh to reinforce the closure. history of present illness: patient is an 82 male who underwent a large bowel resection for a sigmoid vulvulous at the . his course was complciated by an enterocutaneous fistula and mrsa wound infection. on he was taken back to the operating room for lysis of adhesions, takedown of the enterocutaneous fistula, and a small bowel resction. post-operatively he had a wound dehisence. on the patient returned to the or for an abdominal exploration with debridement of abdominal wound and fascia and wound closure with insertion of sergisis. the exterocutaneous fistula evidentally recurred. on he was taken to the or for stsg of the abdominal wound. the fistula was closed with a chromic stitch with fibrin glue. a full thickness skin graft was laid over this. postoperatively the patient continued to have problems with drainage of the inferior protion of the wound in the location of the fistula. a fistula again developed. he was transfered to the care of dr. at on for definitive care of this fistula. past medical history: pacemaker loop colostomy small bowel resection take down of fisutla prior j-tube placeement fx ri shoulder appendectomy brief hospital course: mr. was admited to the general surgery service under dr. . he was made npo and tpn was started. his wound was dressed by the surgical team with the ostomy nurse. was used to keep the fistula contents away from the skin. from through this same routine was continued. his nutritional status was improved, and pt worked with him to improve his strength. however, given his deconditioning, he was not able to ambulate prior to surgery. on he was taken to the operating room for (1) exploratory laparotomy, (2)lysis of adhesions (3.5 hours), (3) enterectomy, (4) enteroenterostomy, (5)colostomy, (6) closure of 2 enterotomies, (7) feeding jejunostomy, (8) component separation and (9) placement of vicryl mesh to reinforce the closure. there were no complications but he was transfered to the sicu from the or for close monitoring. he was extubated prior to transfer. on pod 1 his respiratory status declined likely secondary to fluid shifts; he was re-intubated. he was able to be weaned from the vent the following day and was extubated with success. tf were started at 10cc on pod 1. over the next week his tube feeds were advanced daily, he was diuresed as needed, and he was placed on agressive pulmonary toliet. his tpn was decreased as tf were slowly advanced. on he proved to be positive for heparin-dependent antiboties; he was diagnosed with heparin induced throbocytopenia thus all heparin products were discontinued and prophylaxis was continued with venodynes on at all times. on he also spiked a temperature. blood cx later showed vancomycin resistant enterococcus. bronchoalveolar lavage showed mrsa. on he tested positive for cdiff and he was given appropriate antibiotics to treat all of these infections. gastrograffin study on demonstrated passage through small intestine and into colon easily, and the patient was begun on soft mechanical diet. he demonstrated questionable ability to eat without coughing and a swallow study was obtained that demonstrated overt aspiration signs with all consistencies. nutrition was therefore continued with tpn and tube feeds alone. the patient suddenly became confused with slurred speech while resting comfortably in bed moments before. while examining the patient he spiked temperature to 102, became tachycardic to 120s and was not able to follow commands. ekg showed no acute changes, stat head ct was normal and he proved to have blood cultures positive for pan-sensitive enterococcus for which he was appropriately treated and his clinical picture quickly improved. he remained stable for the next week before he developed some mild abdominal distension and serial abdominal plain films showed a persistent dilated loop of bowel in the luq. tube feeds were held and on a gatrograffin enema was obtained that showed no colonic stricture/obstruction however was not quite normal due to apparent mucosal and anastamotic abnormalities. tube feeds were re-initiated and a video swallow showed evidence that patient could tolerate thin liquids and pureed diet without significant aspiration risk. he tolerated this diet for several days with 1:1 feedings, however on he had an aspiration event and was transferred back to the intensive care unit after emergent intubation for respiratory distress. on his sputum grew acinetobacter baumannii sensitive to gent, imipenem and tobramycin and he was started on imipenem. he was weaned from the ventilator over several days and extubated on . however he was electively re-intubated later the same day for hypercarbia. antibiotics, tpn and tube feeds were continued and the patient was very gently diuresed over the next week. by he was felt to be euvolemic and he successfully extubated on . his family requested his transfer to a facility closer to home, and now that he is stable post-extubation this request can be more safely honored. he is being transferred afebrile, tolerating tube feeds (half strength impact with fiber at 40cc/hour) and has completed a 14 day course of imipenem for an acinetobacter pneumonia. he has a small open part of his abdominal incision that is nearly completely granulated but will continue to need wet to dry dressings until completely healed. he was transferred to hospital in stable condition and with instructions to remain npo with tf for nutrition. instructions were given to continue pulmonary toilet with nebulizer treatments. medications on admission: asa 81mg po daily protonix 40mg po daily reglan maalox tylenol albuterol ultram benadryl discharge medications: 1. insulin regular human 100 unit/ml solution sig: one (1) as direc injection asdir (as directed). 2. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid (2 times a day): pls give via j-tube. 3. miconazole nitrate 2 % powder sig: one (1) appl topical (2 times a day). 4. camphor-menthol 0.5-0.5 % lotion sig: one (1) appl topical qid (4 times a day) as needed. 5. acetaminophen 325 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed. 6. albuterol sulfate 0.083 % solution sig: one (1) inhal inhalation q2h (every 2 hours) as needed. 7. ipratropium bromide 0.02 % solution sig: one (1) inhal inhalation q6h (every 6 hours). 8. lansoprazole 30 mg susp,delayed release for recon sig: one (1) dose po daily (daily). 9. albuterol 90 mcg/actuation aerosol sig: 1-2 puffs inhalation q2h (every 2 hours) as needed. 10. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po daily (daily). disp:*100 ml(s)* refills:*2* discharge disposition: extended care facility: - discharge diagnosis: primary: admitted for care of enterocutaneous fistula, now repaired. secondary: emphysema/copd, cad/angina/mi, pacemaker, chf, paroxysmal a flutter, htn, anemia, h/o mrsa/vre, osteoporosis discharge condition: good discharge instructions: cont tf at 80cc/hr at 1/2 strength, then advance to 3/4 strength as tolerated. please use a wet to dry dressing on abdominal wound twice daily. absolutely nothing by mouth. followup instructions: please follow up with dr. . call for an appointment. any questions or concerns. procedure: venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more parenteral infusion of concentrated nutritional substances other enterostomy other partial resection of small intestine insertion of endotracheal tube fiber-optic bronchoscopy enteral infusion of concentrated nutritional substances closed [endoscopic] biopsy of bronchus other lysis of peritoneal adhesions other repair of abdominal wall transfusion of packed cells closure of fistula of small intestine, except duodenum other repair of intestine diagnoses: pneumonia due to other gram-negative bacteria congestive heart failure, unspecified chronic airway obstruction, not elsewhere classified infection with microorganisms resistant to penicillins other specified intestinal obstruction accidental puncture or laceration during a procedure, not elsewhere classified pneumonitis due to inhalation of food or vomitus bacteremia peritoneal adhesions (postoperative) (postinfection) intestinal infection due to clostridium difficile methicillin susceptible pneumonia due to staphylococcus aureus cardiac pacemaker in situ infection and inflammatory reaction due to other vascular device, implant, and graft anticoagulants causing adverse effects in therapeutic use other disorders of plasma protein metabolism hypovolemia fistula of intestine, excluding rectum and anus disruption of external operation (surgical) wound 

Answer: The patient is high likely exposed to