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 63-year-old male with long tobacco use history, known coronary artery disease, severe chronic obstructive pulmonary disease, status post myocardial infarction in , and restenosis in , now transferred from for cardiac catheterization. patient of dr. , presented to dr. earlier this month with a complaint of increased dyspnea and stress test showed severe reversible inferior ischemia. the patient was taken to cardiac catheterization on at which showed ra pressure of 6, pa pressure of 46/20, lv pressure of 112/26, rv pressure of 46/6, and pulmonary capillary wedge pressure of 14. patient had a cardiac index of 2.05, and a svr of 1494. he was also shown to have moderate luminal irregularities in the mid rca. there was 99% stenosis of the prior stent in the rca distally. the left circumflex artery was patent, as was the left main and the left anterior descending artery. ejection fraction of 30-40% with global hypokinesis, no mr, there was a question of a 60% stenosis of the external iliac. status post catheterization, patient went into hypoxic respiratory failure. he was suctioned without improvement, and was transferred to micu, where he was intubated. he was thought to be in congestive heart failure and was diuresed and extubated on . he was also given steroids for presumed chronic obstructive pulmonary disease exacerbation. postintubation, the patient again became dyspneic and tachypneic, and had to be reintubated. there is a question of a right lower lobe infiltrate. the patient was bronched with mucus plug aspirate from the right lower lobe and left lower lobe. of note, the patient's systolic blood pressure at decreased into the 70s to 80s when he was sedated. nutrition evaluation revealed moderate malnutrition. patient was transferred to for ptca and brachytherapy of instent restenosis. cardiac catheterization on at revealed 99% right coronary artery lesion, successfully ptca with brachytherapy. his pressures were ra 43/13, rv 45/14, pa 44/27, pulmonary capillary wedge was 20, and aortic outflow was 118/76. past medical history: 1. ankylosing spondylitis. 2. status post gastrectomy. 3. peripheral vascular disease. 4. paget's disease. 5. chronic obstructive pulmonary disease, on home o2 through trache. 6. coronary artery disease, status post inferior and anterior myocardial infarction in with cardiogenic shock requiring intra-aortic balloon pump. lad, lcx, rca stented. restenosis and ptca in 7. mrsa, two years ago. 8. congestive heart failure with ejection fraction of 25-30% in . transfer medications: 1. percocet prn. 2. ms contin 100 mg po q8h. 3. -dur sr 100 mg po q day. 4. aldactone 25 mg po q day. 5. zestril 5 mg po q day. 6. plavix 75 mg po q day. 7. propofol. 8. protonix 40 mg po q day. 9. flovent. 10. reglan. 11. prednisone at home, discontinued. 12. solu-medrol 50 mg iv q6h. 13. zithromax 500 mg po q day taken from through . 14. zoloft 50 mg po q day. 15. lopressor 2.5 mg iv q4h. 16. lasix 40 mg iv q day. 17. ativan prn. laboratories from on : white count 13.3, hematocrit 30.2, platelets 472. ptt 66.8, inr 1.0. sodium 140, potassium 4.1, chloride 104, bicarb 21, bun 22, creatinine 0.7, glucose 194. albumin 2.3, total protein 5.6, total bilirubin 0.3, direct bilirubin 0.1. alkaline phosphatase 282, alt 16, ast 45, theophylline 308. ck trended from 42 to 106 to 76, troponin trended from 2.4 to 2.7 to 1.5. electrocardiogram: precath shows q waves in leads ii, iii, and avf which are old, low voltage, t-wave inversions in avl. postcatheterization electrocardiogram from shows low voltage, old q waves in ii, iii, and avf, and t-wave inversion in v2. physical examination: vital signs: temperature 99.0, blood pressure 127/82, heart rate 109, respiratory rate 20, vent sating is ac at 60%, tidal volume of 600, respiratory rate of 14, and a peep of 5. in general, the patient is emaciated appearing, older than his age. heent: jugular venous pressure at 10-11 cm. chest: crackles at the right base laterally. cardiovascular: tachycardic, no murmurs, rubs, or gallops. abdomen is soft, nontender, nondistended, chest wall is severely hyperexpanded. extremities: 2+ dorsalis pedis pulses bilaterally. neurologic: intubated, following commands. hospital course: in short, this is a 60-year-old male with history of severe chronic obstructive pulmonary disease, coronary artery disease, who presents with instent restenosis, status post ptca and brachytherapy with respiratory failure. 1. coronary artery disease: after his catheterization in-house, the patient did not complain of any kind of chest pain or discomfort. he was placed on a good cardiac regimen. he was continued on aspirin, started on plavix. he was also continued on lopressor 25 mg po bid. patient's lisinopril dose was titrated up to 10 mg po q day as his pressure tolerated. patient did not receive integrilin postcatheterization as per dr. . 2. pump: patient's echocardiogram from shows an ejection fraction of 30% with inferior akinesis and a hypokinetic rv. during the patient's hospitalization, he did have an episode of hypoxia, and it was thought that there was a contribution from failure. his regular lasix dose was not sufficing. patient received 40 of iv lasix which led to good diuresis, but the patient was quite sensitive in terms of his blood pressure. otherwise, the patient's lisinopril dose was able to be titrated up to 10 mg po q day over several days as his hemodynamics improved. 3. blood pressure: the patient had an episode of hypertension while on the vent, going down to 75/48. this was thought to be secondary to lasix. 4. rhythm: patient did not have any arrhythmias while in-house. 5. pulmonary: patient was overall difficult to wean, which extended his hospital stay. this was thought to be due to a combination of his chronic obstructive pulmonary disease and developing pneumonia in his lower lung bases. the pulmonary team was consulted. patient was initially on ac mode ventilation. while he tolerated this, he was quite easily able to transition to pressure support mode, and it was not felt that the patient was tiring out. however, at one point, the patient may have received too much in terms of narcotics, which elevated his pco2. this is still unclear as the patient has a very high narcotic threshold. while in-house, the patient received bronchoscopy. this revealed clean bronchial tree. there was very little that was suctioned out. once the infection was under control with the proper antibiotics, we were able to lower his peep enough that he could be extubated. patient was extubated on , . overall, his chest x-ray was consistent with bilateral atelectasis versus pneumonia, with varying degrees of pulmonary edema. once the patient was extubated, he was placed on 6 liters of o2 through his trache stoma, and 12 liters of shovel mask as needed. given his pulmonary improvement, the patient did not need any revision of his trache stoma as it had originally been thought during his stay here. patient's gas from after he was extubated was 7.42, 51, 50. we believe that the patient generally has a very low pao2 baseline around 45-50. we have been targeting his o2 saturation to high 80's to low 90's. patient was also weaned off of his steroids as he was not really thought to be in chronic obstructive pulmonary disease exacerbation. patient is currently on 5 mg of prednisone. that will be continued for one week, through . 6. id: during the patient's hospitalization, he spiked up to 102. blood cultures from showed 1/2 bottles that eventually grew serratia marcescens, sensitive to ceftazidime, which was the antibiotic with the lowest mic other than meropenem. in addition, the patient's sputum from grew mrsa, sensitive to vancomycin and clindamycin. patient was started on ceftazidime and vancomycin for a two week course. a single lumen picc line was placed without difficulty. after commencing antibiotics, the patient no longer had any spikes. patient's white blood cell count remained stable. 7. pain control: the patient is normally on ms contin for his ankylosing spondylitis. he was converted to msir while intubated. he was placed back on ms contin at 60 mg po q8h. this is lower than his normal dose. he was also given prn oxycodone. he may need to have his ms contin dose raised. condition on discharge: stable. discharge medications: 1. lasix 40 mg po q day. 2. alprazolam 0.25 mg po tid. 3. lopressor 25 mg po bid. 4. protonix 40 mg po q day. 5. theophylline sr 100 mg po bid. 6. lisinopril 10 mg po q day. 7. ms contin 60 mg po q8h. 8. xanax 0.25 mg po tid prn. 9. prednisone 5 mg po q day. 10. oxycodone 5-10 mg po q4-6h prn. 11. digoxin 0.125 mg po q day. 12. vancomycin 1 mg iv q12h, through . 13. atrovent mdi four puffs ih . 14. insulin-sliding scale. 15. lactulose 30 ml po q8h prn constipation. 16. ceftazidime 1 gram iv q8h through . 17. heparin 5,000 units subq q12h. 18. aspirin 325 mg po q day. 19. albuterol two puffs ih q6h and 1-2 puffs ih q2h prn. 20. zoloft 50 mg po q day. 21. colace 100 mg po bid. 22. salmeterol two puffs ih . 23. fluticasone 110 mcg, six puffs ih . 24. aldactone 25 mg po q day. 25. tylenol 325-650 mg po q4-6h prn. 26. plavix 75 mg po q day, duration 30 days. discharge instructions: patient will followup with dr. for his cardiac needs. otherwise, he will complete the two week course of vancomycin and ceftazidime for presumed pneumonia. discharge diagnoses: 1. severe chronic obstructive pulmonary disease, with difficulty weaning from ventilator. 2. pneumonia. 3. coronary artery disease, status post percutaneous transluminal angioplasty and brachytherapy of right coronary artery stent. 4. ankylosing spondylitis with chronic pain. , md dictated by: medquist36 procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more angiocardiography of left heart structures left heart cardiac catheterization enteral infusion of concentrated nutritional substances other bronchoscopy implantation or insertion of radioactive elements diagnoses: pneumonia, organism unspecified coronary atherosclerosis of native coronary artery congestive heart failure, unspecified chronic airway obstruction, not elsewhere classified acute respiratory failure bacteremia old myocardial infarction other complications due to other cardiac device, implant, and graft ankylosing spondylitis 

Answer: The patient is high likely exposed to