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: fever, chills major surgical or invasive procedure: cholangiogram left external biliary drain ptc right pleural tap picc line placed history of present illness: 48yom with intrahepatic cholangiocarcinoma s/p right hepatic lobectomy, common bile duct excision, cholecystectomy, portal lymph node dissection, roux-en-y hepaticojejunostomy to left hepatic duct on , admitted with fever to 103 and chills since yesterday. he has a ptc and jp drain in place patient states his appetite has been okay, had one episode of vomiting yesterday, denies diarrhea, nausea. denies chest pain, shortness of breath, cough. denies abdominal pain, but states he has had bilateral flank pain. ptc drain output was almost to zero, jp drain still had some output, but has increased to about 20cc daily. nature of drainage has not changed in color, is not cloudy and does not have a foul smell. has been on augmentin since discharge on when drains were repositioned. past medical history: klatskins tumor, vats for lung bulla, htn, hypercholesterolemia, allergies, t&a, l inguinal hernia repair as child social history: he is married and has two children, ages 21 and 18. he is the vice president of a company. he stopped drinking all alcohol on family history: mother:alive with breast cancer dx in father alive with acute lymphocytic leukemia and had a valve replacement in . brother in good health. physical exam: gen: nad, a&ox3 cv: rrr, no m/g/r lungs: ctab, no increased work of breathing abd: soft, , nd, ptc (segment iv) in place - with bilious fluid in bag. ptc (segment ii/iii) in place - capped jp in place - with bilious/serous fluid in bulb. insertion points of all 3 drains clean and dry. ext: no c/c/e pertinent results: 06:40pm glucose-110* urea n-21* creat-0.9 sodium-140 potassium-3.1* chloride-103 total co2-23 anion gap-17 06:40pm alt(sgpt)-65* ast(sgot)-49* ld(ldh)-191 alk phos-313* tot bili-3.5* dir bili-2.8* indir bil-0.7 06:40pm albumin-2.8* calcium-7.5* phosphate-1.9*# magnesium-1.2* 06:40pm wbc-14.8* rbc-3.74* hgb-11.5* hct-34.2* mcv-92 mch-30.7 mchc-33.5 rdw-14.1 06:40pm neuts-82* bands-14* lymphs-3* monos-1* eos-0 basos-0 atyps-0 metas-0 myelos-0 06:40pm hypochrom-1+ anisocyt-normal poikilocy-normal macrocyt-normal microcyt-normal polychrom-1+ 06:40pm plt smr-low plt count-107*# 06:40pm pt-22.9* ptt-32.9 inr(pt)-2.3* 04:32am blood wbc-9.6 rbc-2.98* hgb-8.6* hct-25.4* mcv-85 mch-28.7 mchc-33.7 rdw-15.7* plt ct-238 05:14am blood neuts-76.2* lymphs-13.3* monos-8.0 eos-2.3 baso-0.3 04:32am blood plt ct-238 04:32am blood pt-16.0* ptt-27.6 inr(pt)-1.5* 04:32am blood glucose-117* urean-5* creat-0.6 na-135 k-3.8 cl-99 hco3-26 angap-14 04:32am blood alt-28 ast-21 alkphos-198* totbili-1.7* 04:42am blood alt-27 ast-24 ck(cpk)-12* alkphos-189* totbili-1.9* 03:33am blood lipase-29 04:32am blood albumin-2.8* calcium-8.0* phos-3.3 mg-2.0 brief hospital course: pt was admitted on , and was transferred to sicu that day secondary to hypotension (100-120's/70's), tachycardia to 130's, and fever to 103. tbili 3.5, wbc 14.8, alt/ast 65/49, ap 313, inr 2.3. he was given 4l fluid, 2u ffp, 20iv lasix, started on vanc & zosyn, and was intubated for respiratory distress (80% on 5l o2). wbc was 40.2, pt febrile to 103.2. he had a ct scan which showed intrahepatic dilation of biliary ducts, and he underwent placement of l ptc external drain with ir (unable to cross roux-en-y anastamosis. bronchoscopy was also done on which showed patent airways, no lesions, bal no growth, no organisms. on , cipro was added to vanc and zosyn for blood culture that was positive for klebsiella ( to cipro). nutrition was consulted, and he remained intubated and sedated in anticipation for ptc manipulation (advance ptc across hepaticojej stricture) on with ir. pt was extubated after the procedure without difficulty. on he was transferred back to the floor, started on clear diet, and zosyn was d/c'd. his diet was advanced to reg, foley was d/c'd, and pt was ambulating by . on , bile cx's positive for enterococcus to vanc. on , he underwent ct cholangio, and tube was exchanged. on peritoneal fluid cx positive for stenotrophomonas maltophilia, to bactrim. pt started on iv bactrim in addition to antibiotic regimen. cvl was d/c'd (tip cultured - no growth), picc line placed. pt underwent u/s-guided tap of pleural fluid (cultures - no growth). infectious disease was consulted, as total cultures from bile were growing kleb, stenotroph, vre, mrsa, non-candidal yeast, and other gram neg rods. per id, he was started on daptomycin, caspofungin, and iv bactrim. he continued to have low-grade fevers, but temperature curve decreased. ptc ii/iii was capped on . on day of discharge, the patient is afebrile (tm 100.4), avss, tuberculosis 1.7, wbc 9.6, tolerating reg diet, ambulating, pain well-controlled with no pain medications. he will follow-up with dr. in clinic in 1 week, with f/u ct scan at that time. per id, he will be discharged with fluc (caspo d/c'd), bactrim, and dapto. we will continue to f/u his culture sensitivities, and he will have ck's checked for dapto, and weekly . medications on admission: prilosec 20 daily, paxil 20 daily, 180 daily, augmentin 875/125 discharge medications: 1. daptomycin 500 mg recon soln sig: three y (350) mg intravenous once a day for 2 weeks: give via picc line stop date to be determined in follow up clinic. disp:*14 doses* refills:*1* 2. picc line care per neht protocol 3. outpatient lab work every monday: cbc with diff, chem 10, ast, alt, alk phos, t.bili, albumin, ck fax to attn: , rn coordinator for hepatobiliary service and attn: dr. 4. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 5. prilosec 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 6. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. disp:*30 tablet(s)* refills:*0* 7. paroxetine hcl 20 mg tablet sig: one (1) tablet po daily (daily). 8. bactrim ds 160-800 mg tablet sig: two (2) tablet po three times a day for 2 weeks. disp:*56 tablet(s)* refills:*0* 9. fluconazole 200 mg tablet sig: two (2) tablet po once a day for 2 weeks. disp:*28 tablet(s)* refills:*0* discharge disposition: home with service facility: home therapies discharge diagnosis: cholangiocarcinoma s/p right hepatic lobectomy, roux en y hepaticojejunostomy to left duct cholangitis biliary stricture pneumonia vre/mrsa in bile , non-albicans & stenotrophomonas in bile discharge condition: good discharge instructions: please call dr. office if fever, chills, nausea, vomiting, drainage at insertion site of drains, increased drainage via open drains, abdominal distension or shortness of breath. empty drain when half full, record output and bring record of outputs to next appointment with dr. twice a week -every monday and thursday followup instructions: provider: , md phone: date/time: 11:15 provider: , md, phd: date/time: 3:20 md, procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified insertion of endotracheal tube thoracentesis closed [endoscopic] biopsy of bronchus other cholangiogram other percutaneous procedures on biliary tract other percutaneous procedures on biliary tract percutaneous hepatic cholangiogram diagnoses: unspecified septicemia sepsis pressure ulcer, other site cholangitis personal history of malignant neoplasm of other gastrointestinal tract 

Answer: The patient is high likely exposed to