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: patient recorded as having no known allergies to drugs attending: chief complaint: bleeding from tracheostomy major surgical or invasive procedure: ent cautery with silver nitrate of trach site trach down-sized from size 8 to size 7 history of present illness: mr is a 65 year old man with als since who has been at after a complex medical stay at which resulted in him being trached; prior to that he had been a long-time bipap user. at he had been having some leaks around his trach so doctors attempted to change out the trach tube for a larger bore size. however he then had copious bleeding as well as some shortness of breath. . when he came to the he was seen by ent who did a fiberoptic exam and removed a large clot from inside the trach tube. his prior feeling of difficulty breathing resolved with this. they saw no evidence of tracheoinnominate fistula or large bleed and the bleeding resolved. when he arrived on the floor of the micu he was once again having some fresh bleeding but this resolved after suction and no further intervention. past medical history: als diagnosed in ; stopped working in ; had been power wheelchair user in past but very difficult now due to almost no hand strength hypercholesterolemia social history: occupation: retired economic consultant drugs: denies tobacco: denies alcohol: denies family history: nc physical exam: tmax: 35.8 ??????c (96.5 ??????f) tcurrent: 35.8 ??????c (96.5 ??????f) hr: 69 (69 - 91) bpm bp: 114/68(79) {114/68(79) - 147/81(99)} mmhg rr: 14 (14 - 20) insp/min spo2: 99% heart rhythm: sr (sinus rhythm) respiratory o2 delivery device: tracheostomy tube ventilator mode: cmv/assist/autoflow vt (set): 400 (400 - 400) ml rr (set): 14 rr (spontaneous): 7 peep: 5 cmh2o fio2: 50% pip: 18 cmh2o plateau: 16 cmh2o compliance: 36.4 cmh2o/ml spo2: 99% ve: 6.1 l/min physical examination general appearance: thin eyes / conjunctiva: perrl head, ears, nose, throat: trach tube; fresh blood visualized through op without any source of bleeding visualized cardiovascular: (pmi normal), (s1: normal), (s2: normal) peripheral vascular: (right radial pulse: present), (left radial pulse: present), (right dp pulse: present), (left dp pulse: present) abdominal: soft, non-tender, bowel sounds present extremities: right: absent, left: absent musculoskeletal: muscle wasting, unable to stand skin: warm, no(t) rash: neurologic: attentive, responds to: not assessed, movement: not assessed, paralyzed, tone: decreased pertinent results: on admission: 10:00pm blood wbc-10.2 rbc-3.64* hgb-11.4* hct-33.3* mcv-91 mch-31.2 mchc-34.2 rdw-15.5 plt ct-271 10:00pm blood neuts-84.3* lymphs-8.4* monos-5.4 eos-1.7 baso-0.2 10:00pm blood pt-14.4* ptt-29.8 inr(pt)-1.3* 04:29am blood glucose-81 urean-19 creat-0.1* na-141 k-3.7 cl-103 hco3-29 angap-13 04:29am blood calcium-8.6 phos-3.5 mg-2.0 04:33am blood hapto-162 . hematocrit trend 04:42am blood hct-26.8* 05:04pm blood hct-29.7* 05:30am blood hct-27.4* 01:07am blood hct-28.7* 08:46pm blood hct-29.5* 04:33am blood hct-23.8* 12:14am blood hct-25.9* 06:43pm blood hct-25.3* 06:43pm blood hct-25.3* 04:29am blood hct-29.8* 09:54pm blood hct-30.2* 12:30pm blood hct-31.5* 05:01am blood hct-31.0* 10:00pm blood hct-33.3* . studies: cxrs : no evidence of pneumothorax, chf, or pneumonia. left-sided pleural effusion and retrocardiac opacity likely represent left lower lobe collapse. bleeding at trach site. pigtail catheter is again seen overlying the left abdomen. tracheostomy tube has been replaced with a new tube. picc line tip is in the svc. there is improved aeration in the left lower lobe. : new left upper lobe collapse, and mild atelectasis at the left base recurred. right lung clear. heart size normal. drainage catheter projects over the left upper paramedian : there is resolution of the left upper lobe atelectasis but worsening of the left lower lobe atelectasis with still present left mediastinal shift. small amount of pleural effusion is seen on the left. the drainage catheter in the left upper abdomen is unchanged in position. the left picc line tip is in mid svc. no pneumothorax or overall increase in pleural effusion is demonstrated. : the lateral aspect of the left hemithorax has been excluded from the image. the right lung remains clear. left hemidiaphragm is not well seen and there is some haziness on this side, raising the possibility of layering effusion. poor definition of the medial aspect of the hemidiaphragm is consistent with volume loss in the left lower lobe. tracheostomy tube remains in good position. right picc line extends to the mid portion of the svc . on transfer to rehab: 04:42am blood wbc-9.1 rbc-3.01* hgb-9.4* hct-26.8* mcv-89 mch-31.4 mchc-35.2* rdw-15.6* plt ct-207 05:30am blood pt-14.8* ptt-30.6 inr(pt)-1.3* 04:42am blood glucose-91 urean-17 creat-0.1* na-143 k-3.6 cl-109* hco3-28 angap-10 . urine: 03:16pm urine color-dkamb appear-cloudy sp -1.025 03:16pm urine blood-lg nitrite-pos protein->300 glucose-neg ketone-tr bilirub-mod urobiln-2* ph-5.5 leuks-sm 03:16pm urine rbc->1000* wbc-707* bacteri-many yeast-none epi-0 03:16pm urine caoxalx-occ 03:16pm urine wbc clm-few mucous-many . urine cx pending blood cx pending 8:21 am sputum source: endotracheal. . gram stain (final ): >25 pmns and <10 epithelial cells/100x field. 2+ (1-5 per 1000x field): gram positive rod(s). 2+ (1-5 per 1000x field): gram positive cocci. in pairs and clusters. 1+ (<1 per 1000x field): gram positive cocci. in chains. respiratory culture (preliminary): sparse growth oropharyngeal flora. staph aureus coag +. sparse growth. legionella culture (preliminary): no legionella isolated. fungal culture (preliminary): no fungus isolated. brief hospital course: bleeding in throat/upper airway mr had distressing bleeding which was evidently from his trach site and most likely associated with the attempt to resize the tracheostomy tube. ent service saw him on arrival, did several fiberoptic exams, and followed him while here. they used repeated applications of silver nitrate to stop bleeding around the site and could identify no larger site of bleeding or fistula. a bronchoscopy in the micu did not show any bleeding in the lung. his tracheostomy tube was sized down to portex 7; he had come in with a size 8 tube which was up from his prior 7. he had some minor intermittent leaking around this site which did not appear to compromise his tidal volumes. his tube should be re-evaluated in follow-up with the ent service, and follow-up information is shown below. . als mr did complain of some air hunger during his visit and appeared to especially appreciate being ambu-bagged. based on this we increased his tidal volumes to 500 and this could be increased further for comfort since there is no sign of lung injury. we continued rilutek and coenzyme q10. . anxiety takes seroquel at home which he and his wife agree helps him stay calm and breathe better. we continued this. . mrsa at the end of his stay, a sputum came back positive for mrsa. he does not have evidence of pneumonia but is likely mrsa-colonized. he was sent back to a mrsa bed at rehab. . goals of care patient appears to have not entirely intentionally ended up on vent but did so originally with the hope of going back onto bipap; he is ok with staying on the ventilator now but is firm on his decision for a "do not resuscitate" status; this was discussed and agreed-on with both the patient and his wife. the patient and his wife do appear to recognize the relentlessly progressive nature of the disease. . icu care nutrition usually gets jevity 1.2 tube feeds with boluses at 0600, 0900, 1200, 1500, 1800 and 2100. got equivalent. glycemic control: no issues lines: -midline - 04:22 am -18 gauge - 04:24 am prophylaxis: dvt: boots stress ulcer: ppi . disposition: return to rehab medications on admission: ascorbic acid 1000 mg po bid bacitracin ointment topical q shift coenzyme q10, 30 mg po bid dalteparin 5000 units sq daily miracle cream topical q shift mvi daily prilosec 20 mg po daily miralax daily kcl 20 meq daily seroquel 25 mg q8 hours rilutex 50 mg scopolamine patch 1.5 mg td q72 hours vitamin e 100 iu prn acetaminophen albuterol inhaler dulcolax docusate lidocaine jelly epinephrine (for bronchospasm) lactulose 20 gm daily prn simethicone 80 mg tablet prn discharge medications: 1. acetaminophen 325 mg tablet : 1-2 tablets po q6h (every 6 hours) as needed. 2. chlorhexidine gluconate 0.12 % mouthwash : one (1) ml mucous membrane (2 times a day). 3. ascorbic acid 90 mg/ml drops : 1008 (1008) mg po bid (2 times a day). 4. bacitracin zinc 500 unit/g ointment : one (1) appl topical tid (3 times a day). 5. polyethylene glycol 3350 100 % powder : seventeen (17) gm gm po daily (daily) as needed. 6. quetiapine 25 mg tablet : one (1) tablet po q8h (every 8 hours). 7. riluzole 50 mg tablet : one (1) tablet po daily (). 8. scopolamine base 1.5 mg patch 72 hr : one (1) patch 72 hr transdermal q72h (every 72 hours). 9. therapeutic multivitamin liquid : one (1) tablet po daily (daily). 10. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr daily (daily). 11. albuterol 90 mcg/actuation aerosol : 6-10 puffs inhalation q4h (every 4 hours) as needed for shortness of breath or wheezing. 12. simethicone 80 mg tablet, chewable : one (1) tablet, chewable po qid (4 times a day) as needed. resume prior meds for symptom control/bowel regimen etc as appropriate. discharge disposition: extended care facility: & rehab center - discharge diagnosis: primary: bleeding from tracheostomy site secondary: als anxiety discharge condition: afebrile, vital signs stable discharge instructions: follow up with ent for ongoing trach care and consideration of new trach tube. followup instructions: follow-up with otorhinolaryngology - dr. 9:45am. please arrive 15-20 minutes prior. the office is located at ., . procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more enteral infusion of concentrated nutritional substances control of hemorrhage, not otherwise specified control of hemorrhage, not otherwise specified bronchoscopy through artificial stoma bronchoscopy through artificial stoma transfusion of packed cells replacement of tracheostomy tube diagnoses: pure hypercholesterolemia iron deficiency anemia secondary to blood loss (chronic) pulmonary collapse anxiety state, unspecified other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure amyotrophic lateral sclerosis hypotension, unspecified carrier or suspected carrier of methicillin resistant staphylococcus aureus chronic respiratory failure other tracheostomy complications paralysis, unspecified 

Answer: The patient is high likely exposed to