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: penicillins attending: chief complaint: incarcerated inguinal hernia major surgical or invasive procedure: exploratory laparotomy, lysis of adhesions, small bowel resection, open abdomen 1. exploratory laparotomy with small-bowel resection times 2 with primary anastomosis. 2. temporary closure of the abdominal wall. 3. repair of incarcerated left inguinal hernia regional abdominal washout with closure of the abdominal wall with a vicryl mesh followed by placement of a vac dressing. post pyloric feeding tube left basilic picc line history of present illness: 61m w/ hx of longstanding dementia and parkinsonism as well as a chronically incarcerated l inguinoscrotal hernia presents today to nebh after an episode of coffee-ground emesis that resulted in subsequent desaturation and concern for aspiration afterward. the patient is apparently nonverbal, holds his tongue in continuous protrusion, and has had no further emesis. he presented with a distended abdomen and plain films that were concerning for a sbo with dilated, ladder-like loops of small bowel. based on this presentation a surgeon at the osh prepared to take this patient to the operating room, but anesthesia concern for the patient's airway prompted txfer to . past medical history: htn, niddm, depression,asthma, parkinson's disease social history: lives in a nursing home. difficult to understand due to parkinsons, was able to swallow prior to this admission family history: nc physical exam: temp 98.9 hr 75 bp 152/87 rr 22 o2 sat 97% 4l flat affect, nonverbal, occasional moans from presumed pain decreased inspiratory effort bilaterally ctab o/w firmly distended without rigidity, no evidence of rebound, no evidence of peritonitis, well-healed scars from prior surgeries, mae when physically prompted pertinent results: 12:06am wbc-9.8 rbc-4.20* hgb-13.2* hct-39.4* mcv-94 mch-31.5 mchc-33.5 rdw-13.5 12:06am neuts-77* bands-2 lymphs-6* monos-12* eos-0 basos-0 atyps-3* metas-0 myelos-0 12:06am hypochrom-2+ anisocyt-2+ poikilocy-1+ macrocyt-1+ microcyt-1+ polychrom-1+ 12:06am plt count-441* 12:06am glucose-149* urea n-47* creat-1.2 sodium-144 potassium-4.9 chloride-108 total co2-21* anion gap-20 12:21am lactate-2.4* 09:27am glucose-154* lactate-3.5* na+-140 k+-4.3 cl--113* pathology: procedure date tissue received report date diagnosed by dr. /ttl diagnosis: small bowel, excision: 1. small intestinal segment with mucosal ischemic change, submucosal edema, serosal adhesions, and transmural acute inflammation. 2. margins of small intestinal segment with focal transmural acute inflammation, mucosal ischemic change, and serosal adhesion formation. procedure date tissue received report date diagnosed by dr. /ttl previous biopsies: small bowel. diagnosis: i. terminal ileum, resection (a-b): small intestinal segment with focal transmural necrosis and diffuse mucosal ischemic change and serosal adhesions; margins of resection demonstrate mucosal ischemia without transmural involvement. ii. soft tissue, left inguinal region (c-d): fibroadipose tissue with hemorrhage and reactive mesothelial lining consistent with hernial sac. ct abd/pelvis : 1. high-grade, likely early small-bowel obstruction appears secondary to a bowel-containing left inguinal hernia, as detailed above. there is also a bowel-containing right inguinal hernia, which contains decompressed distal ileum, and does not appear to represent additional site of obstruction at this time. there is no evidence of bowel ischemia. 2. renal cysts, with additional cortically based hypodensity likely representing additional cysts though too small to characterize on the left. 12:26 pm mrsa screen source: nasal swab. **final report ** mrsa screen (final ): positive for methicillin resistant staph aureus. cxr : the dobbhoff tube passes below the diaphragm with its tip at least in the duodenum. the patient is in interstitial pulmonary edema that appears to be increased since the prior study. there is also worsening of the right basal consolidation as well as right upper lung more rounded opacities that might represent underlying infectious process. bilateral pleural effusions are present, their size is difficult to evaluate on this portable study. apices cannot be evaluated since patient's chin is obscuring lung apices. cxr : 1. satisfactory placement of left upper extremity picc. 2. interval resolution of pneumonia and right lower lobe atelectasis since . 3. persistent left lower lobe atelectasis and moderately large left pleural effusion brief hospital course: on the day of admission the patient was taken promptly to the or for exlap. frank stool seen throughout abdomen. there were multiple areas of microperforation and leaking stool, sb was resected and he was left in discontinuity with an open abdomen as he became labile intraoperatively. the following day, he was taken back to the or for rising bladder pressures overnight. small bowel was resected and reanastamosed. the abdomen was left open as there was a loss of domain. he tolerated surgery well. on he was volume overloaded with low urine outputs so he was diuresed with good response. his pressor requirement was decreasing. on he was taken back to the or for closure of the abdominal wall with vicryl mesh and placement of a vac over the vicryl mesh. he did have oliguria and was given albumin and lasix with good response. on , he was extubated. on , the parkinson's meds were restarted. tube feeds were continued. on , he was given free water flushes for hypernatremia. also, he was having persistent elevated tubefeed residuals. he was manually disimpacted with good effect. on , the vac was changed at the bedside. he was transfered to the floor in stable condition. following transfer to the surgical floor his nasogastric tube was removed in preparation for a swallow evaluation. unfortunately he failed the study with minimal response to food being placed in his mouth. subsequently he was taken to interventional radiology for placement of a dobbhoff feeding tube. two other attempts were made at swallow studies as became more responsive and communicative but he failed all trials. he remains on full tube feedings with a post pyloric dobbhoff feeding tube. he developed some shortness of breath and increased congestion on and a subsequent chest xray revealed some chf with right upper and right lower lobe consolidations. he improved with diuresis but due to his xray appearance he was also placed on vancomycin and cefepime for pneumonia. his vancomycin trough was 20 on which reflected 1 gm daily. currently his vancomycin is being dosed at 1 gm. every other day and he will need a trough on prior to his dose. from a respiratory standpoint his oxygen saturations are 95% on room air and his congestion has resolved. his wbc is 9k and he remains afebrile. his antibiotics will continue thru . his abdominal wound is quite extensive but doing well with vac therapy. white sponges cover the vicryl mesh followed by black sponges. the vac was changed on and is changed every 3 days. he sometimes requires mild pain medication prior to vac changes. after a long protracted stay he was transferred to rehab on to try to increase his mobility, continue enteral nutrition with the hopes of him eventually swallowing effectively to tolerate a regular diet. medications on admission: dep provera 100qwk, trazodone 25', inderal 20'''. fluxoetine 40', remeron 30', sinemet 25-100'''', sinemet 25-100 1/2qpm discharge medications: 1. heparin (porcine) 5,000 unit/ml solution sig: 5000 (5000) injection tid (3 times a day). 2. famotidine 20 mg tablet sig: one (1) tablet po bid (2 times a day). 3. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 4. trazodone 50 mg tablet sig: 0.5 tablet po hs (at bedtime). 5. carbidopa-levodopa 25-100 mg tablet sig: one (1) tablet po qid (4 times a day). 6. fluoxetine 20 mg capsule sig: two (2) capsule po daily (daily). 7. mirtazapine 30 mg tablet sig: one (1) tablet po hs (at bedtime). 8. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) neb inhalation q6h (every 6 hours) as needed for sob. 9. docusate sodium 50 mg/5 ml liquid sig: ten (10) ml po bid (2 times a day). 10. propranolol 10 mg tablet sig: one (1) tablet po tid (3 times a day): hold for sbp < 100, hr < 60. 11. hydromorphone (dilaudid) 0.25 mg iv q3h:prn pain 12. carbidopa-levodopa 25-100 mg tablet sig: tablet po hs (at bedtime). 13. miconazole nitrate 2 % powder sig: one (1) appl topical tid (3 times a day): to buttocks and both groins. 14. ipratropium bromide 0.02 % solution sig: one (1) neb inhalation q6h (every 6 hours). 15. heparin flush (10 units/ml) 2 ml iv prn line flush picc, heparin dependent: flush with 10ml normal saline followed by heparin as above daily and prn per lumen. 16. oxycodone-acetaminophen 5-325 mg/5 ml solution sig: 5-10 mls po q4h (every 4 hours) as needed for pain. 17. cefepime 1 gram recon soln sig: one (1) gm injection every eight (8) hours: thru . 18. vancomycin 1,000 mg recon soln sig: one (1) gm intravenous every other day: next dose treatment thru . discharge disposition: extended care facility: northeast - discharge diagnosis: 1. small-bowel obstruction with incarcerated left inguinal hernia 2. perforated small bowel 3. septic shock 4. ischemic bowel 5. abdominal compartment syndrome 6. acute blood loss anemia 7. pneumonia discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: out of bed with assistance to chair or wheelchair. discharge instructions: * you were admitted to the hospital with abdominal pain due to an incarcerated left inguinal hernia which required an operation. * part of the bowel was necrotic necesitating extensive resection and your abdomen was left open due to swelling of the bowel. * after undergoing 2 additional procedures your abdomen is closed and a vac dressing is in place to promote further closing from the inside out. * nutrition is important to heal this wound and unfortunately you are unable to swallow due to your deconditioned state and parkinson's disease. therefore a feeding tube was necessary as you are too weak to swallow without aspirating. hopefully this will improve as you get stronger. followup instructions: call the acute care clinic at for a follow up appointment in 1 week. md procedure: venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified other partial resection of small intestine enteral infusion of concentrated nutritional substances exploratory laparotomy other repair of abdominal wall other repair of abdominal wall insertion of (naso-)intestinal tube peritoneal lavage unilateral repair of inguinal hernia, not otherwise specified diagnoses: pneumonia, organism unspecified unspecified essential hypertension unspecified septicemia severe sepsis personal history of malignant neoplasm of prostate perforation of intestine septic shock dementia in conditions classified elsewhere without behavioral disturbance acute vascular insufficiency of intestine dementia with lewy bodies inguinal hernia, with obstruction, without mention of gangrene, unilateral or unspecified (not specified as recurrent) unspecified vitamin b deficiency 

Answer: The patient is high likely exposed to