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 / codeine / bactrim attending: chief complaint: cough, fever, ams, and hypotension major surgical or invasive procedure: intubation x2 history of present illness: 83 year old female with diastolic dysfuntion, copd on 2l nc, osa, afib on asa, who presents with ams and hypoxia. the patient notes that she had been feeling well until today. she states that around the time her neighbor picked her up to take her to her doctor's appointment that she began feeling unwell with shortness of breath and cough. she describes her cough as productive of light tan sputum. she denies any fever or chills, no n/v/d, no abd pain. she does not feel confused. . her neighbor took her to for outpt evaluation. her pcp . saw her in the waiting room. per omr notes, dr. stated that " she is very lethargic and falls asleep during conversation with me. she states that she feels slightly short of breath." dr arranged for transport to the ed. . of note, she was recently discharged on after an admission for viral gastroenteritis and renal failure. she was noted to have hypotension to sbp 80's and cr 1.5 both of which responted to fluids and was attributed to dehydration in the setting of poor po intake. . in the ed, there was a question of facial droop in triage which was not present on evaluation in the ed. her neighbor who was with her on arrival at the ed states the patient was wandering around mumbling.the patient had fever to 103, cough and hypotension down to sbp 80's requiring 4l ns. lactate nl 1.3 and 0.9. but given persisent hypotension, central line was placed and levophed started. cxr showed multifocal pna vs edema, but given clinical picture of fever and cough, it was thought that she had pna. the patient was given vanc, ceftaz and levofloxacin as well as tamiflu. she was swabed for flu as well. she was also noted to be hypoxic to 88% on ra and required 4-5lnc to oxygenate 92%. ph 7.32 pco252 po2 58. . vitals on arrival: 100.6 94 89/53 20 88% ra vitals on transfer: 80/32 83 17 92% 4l nc . review of systems: (+) per hpi (-) denies fever, chills, night sweats, recent weight loss or gain. denies headache, sinus tenderness, rhinorrhea or congestion. denied cough, shortness of breath. denied chest pain or tightness, palpitations. denied nausea, vomiting, diarrhea, constipation or abdominal pain. no recent change in bowel or bladder habits. no dysuria. denied arthralgias or myalgias. past medical history: past medical history: 1. copd: on home oxygen 2l nc continuous 2. paroxysmal atrial fibrillation s/p pacemaker - refuses coumadin, takes full dose aspirin instead 3. hypertension 4. diastolic congestive heart failure 5. stroke - no residual deficit - manifested as dizziness 6. bilateral cataracts 7. obstructive sleep apnea - uses cpap 8. arthritis 9. s/p compression fx t7 10. r foot and r wrist fracture . past surgical history: 1. nissen 2. partial hysterectomy 3. multiple lumbar back procedures 4. lap ccy () 5. ventral hernia repair w/ mesh () 6. right knee prosthesis . social history: lives in . not married and does not have any children. uses a walker at baseline. quit tobacco 20 years ago. rare alcohol use. no illicit drug use. family history: sister has endometriosis and breast cancer. physical exam: physical exam: vitals: t: bp: p: r: 18 o2: general: alert, oriented, no acute distress heent: sclera anicteric, mmm, oropharynx clear neck: supple, jvp not elevated but diff to assess with central line, no lad lungs: speaking easily w/o labored breathing, diffusely wheezing with inspiratory crackles in right lung fields cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly gu: no foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema neuro: aox3, conversant, easily able to relate history, cnii-xii intact, strength intact bilaterally pertinent results: labs on admission: cbc: wbc-9.4# rbc-3.55* hgb-10.4* hct-32.4* mcv-91 mch-29.2 mchc-31.9 rdw-14.2 plt ct-183 neuts-82* bands-9* lymphs-5* monos-4 eos-0 baso-0 atyps-0 metas-0 myelos-0 coags: pt-12.8 ptt-30.0 inr(pt)-1.1 bmp: glucose-100 urean-50* creat-1.7* na-138 k-4.4 cl-100 hco3-27 angap-15 lft: alt-15 ast-21 alkphos-63 totbili-0.2 albumin-3.7 phos-3.8 mg-2.1 ck-mb-2 ctropnt-0.10* micro: nasal swab: positive for influenza a viral antigen. positive for swine-like influenza a (h1n1) virus by rt-pcr at state lab. sputum culutre (expectorated) staph aureus coag +. sparse growth. sensitivities: mic expressed in mcg/ml _________________________________________________________ staph aureus coag + | clindamycin----------- =>8 r erythromycin---------- =>8 r gentamicin------------ <=0.5 s levofloxacin---------- =>8 r oxacillin------------- =>4 r rifampin-------------- <=0.5 s tetracycline---------- =>16 r trimethoprim/sulfa---- <=0.5 s vancomycin------------ <=1 s blood cultures: , urine cultures: no growth , stool negative for c.diff cxr pa & lat (): there is a left-sided pacemaker with leads terminating appropriately within the right atrium and right ventricle, there are multiple surgical clips within the left upper abdomen. there is stable, mild cardiomegaly. the aorta is mildly tortuous. there is a prominent right paratracheal opacity, consistent with regional vascular ectasia. there are increased interstitial markings bilaterally, worse on the right, compatible with mild congestion. there is no pleural effusion or pneumothorax. there is diffuse osteopenia, seen in prior radiographs. cxr (): worsening right upper lobe and improved right lower lobe consolidation with stable mild superimposed pulmonary edema. rue ultrasound (): no evidence of deep vein thrombosis involving the right upper extremity. please note the right internal jugular vein was not assessed. cxr (portable) : impression: 1) interval improvement in the mild-to-moderate pulmonary edema. 2) unchanged small right pleural effusion with a new retrocardiac left lower lobe opacity, most likely due to atelectasis. kub : essentially unremarkable examination of the abdomen. no evidence of obstruction. ct may be helpful if further evaluation is clinically indicated. ct chest : left lower lobe consolidation with bronchial wall thickening and endobronchial mucus impaction. multiple pulmonary nodules, most of which are stable back to / with the exception of new nodules in the superior segment of the right lower lobe and in the upper lobes could be due to concurrent infection, followup chest ct is recommended in three months to evaluate interval change. stable mediastinal lymph node enlargement. wedge compression fractures in the thoracic spine.pulmonary arterial enlargement suggests pulmonary arterial hypertension. the study and the report were reviewed by the staff radiologist. brief hospital course: ms. is a 83 yo f with copd on 2l home o2, diastolic hf, paf (not on coumadin) who presented with fever, cough, ams and hypotension and was admitted to icu. she was found to be in respiratory failure and sepsis. she required intubation and subsequently was found positive for h1n1 flu. her course was complicated by mrsa pneumonia and difficult extubation (she was extubated, but had to be reintubated due to ongoing respiratory failure). she finished a 10 day course of oseltamavir and vancomycin. her respiratory status improved, though not back to baseline by time of discharge. she continued on 3l nc. following the initial extubation attempt, the patient was noted to be in persistent hypotension with increased ectopy on telemetry. cardiac enzymes were significant for troponins of 0.10, ekg with pseudonormalization in lateral percordial leads. aspirin was given, outpatient simvastain 40 mg was changed to atorvastatin 80 mg. per cardiology, this was believed to be secondary to demand ischemia. iv heparin was not initiated. as patient developed msk pain, similar to past when she was on atorvastatin, her atorvastatin was once again changed back to simvastatin she was noted to develop leukocystosis after completion of her antibiotics, urine and blood cultures were negative. she remained afebrile. she had a ct chest to evaluate for abscess or effusion, which were not present. her wbc count declined. chronic pain neuropathy: her outpatient neurontin and morphine prn were transiently held due to hypotension and arf. neurontin was re-started upon resolution of arf, and morphine was restarted at a lower dose, of 15mg twice daily. she was transiently hypernatremic secondary to poor oral hydration. she was found to aspirate thin liquids post extubation period and her her fluids were modified thick liquids, which she refused to take, leading to worsening of her hypernatremia. repeat swallow evaluation found improvement of swallow function, and restrictions were taken off. with normal oral fluid intake her serum sodium normalized. she developed acute renal failure after lasix was restarted at home dose. this medication was held and renal function improved. she was discharged off this medication. inr was noted to be 1.8, felt to be nutritional; it corrected with oral vitamin k. ct chest noted rul nodules, likely related to acute infection, however, 3 month follow up is recommended to assess for interval change. medications on admission: colace 100 mg po bid morphine multiphasic release 45 mg po q12h aspirin 325 mg daily cholecalciferol 800 mg daily multivitamin daily simvastatin 40 mg daily fluticasone 110 mcg 2 puffs salmeterol 50 mcg q12h calcium carbonate 500 mg tid alendronate 70 mg qweek spiriva daily tylenol 1-2 tabs po q6h:prn gabapentin 400 mg po tid lisinopril 5 mg daily lasix 60 mg daily discharge medications: 1. fluticasone 110 mcg/actuation aerosol sig: two (2) puff inhalation (2 times a day). 2. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 3. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po tid (3 times a day). 4. menthol-cetylpyridinium 3 mg lozenge sig: one (1) lozenge mucous membrane q4h (every 4 hours) as needed for dry mouth. 5. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain, fever. 6. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 7. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 8. docusate sodium 100 mg capsule sig: one (1) capsule po tid (3 times a day). 9. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) unit inhalation q6h (every 6 hours) as needed for wheezing/sob. 10. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 11. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 12. cholecalciferol (vitamin d3) 400 unit tablet sig: two (2) tablet po daily (daily). 13. tiotropium bromide 18 mcg capsule, w/inhalation device sig: one (1) cap inhalation daily (daily). 14. salmeterol 50 mcg/dose disk with device sig: one (1) disk with device inhalation q12h (every 12 hours). 15. morphine 15 mg tablet sustained release sig: one (1) tablet sustained release po q12h (every 12 hours). 16. gabapentin 400 mg capsule sig: one (1) capsule po three times a day. 17. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). 18. alendronate 70 mg tablet sig: one (1) tablet po once a week. discharge disposition: extended care facility: bostonian - discharge diagnosis: primary: acute respiratory failure due to flu mrsa pneumonia secondary copd: on home oxygen 2l nc continuous paroxysmal atrial fibrillation s/p pacemaker - refuses coumadin, takes full dose aspirin instead hypertension diastolic congestive heart failure stroke - no residual deficit - manifested as dizziness bilateral cataracts obstructive sleep apnea arthritis discharge condition: good discharge instructions: you were admitted to the intensive care unit for breathing difficulty. you required intubation and mechanical ventilation. this was due to flu and you recovered, however you developed bacterial lung infection (mrsa) for which you recovered fully as well. you are being discharge to a rehabilitation center for further physical therapy. the following changes were made to your medications: your lasix was discontinued as it caused you to be dehydrated. your ms contin dose was reduced to 15mg twice daily. as you improve your mobility you may need to increase it. on ct scan there were some pulmonary nodules, which need follow up chest ct in 3 months, to rule out possible malignancy. . please continue all your medication, and follow up with your appointments as instructed below. . call your docotr or come to ed if you have any fever, chills, abdominal pain, nausea, diarrhea, or any other health concern. followup instructions: you have an appointment with your primary care doctor on at 10:00, dr. : , md location: healthcare - medical group address: ,8th fl, , phone: other appointments: provider: , md phone: date/time: 10:30 provider: clinic phone: date/time: 11:00 provider: , m.d. phone: date/time: 11:40 procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified insertion of endotracheal tube insertion of endotracheal tube arterial catheterization diagnoses: obstructive sleep apnea (adult)(pediatric) congestive heart failure, unspecified unspecified essential hypertension acute kidney failure, unspecified severe sepsis atrial fibrillation obstructive chronic bronchitis with (acute) exacerbation acute on chronic diastolic heart failure acute and chronic respiratory failure cardiac pacemaker in situ hyperosmolality and/or hypernatremia unspecified hereditary and idiopathic peripheral neuropathy knee joint replacement methicillin resistant staphylococcus aureus septicemia methicillin resistant pneumonia due to staphylococcus aureus 

Answer: The patient is high likely exposed to