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: sigmoid colon cancer major surgical or invasive procedure: or : lap converted to open sigmoid colectomy or : closure of abdomen with retention sutures #2 nylon, #1 prolene figure 8's icu : trach #8 portex and peg tube insertion icu : central line change/resite history of present illness: mr. is a yo male who developed heme positive stools in , but declined any intervention at that time. this year (), he developed a t4 compression fracture. his work-up included a pet scan, which identified a mass in the sigmoid colon. he underwent colonoscopy at osh which revealed 3 benign polyps & 1 polyp at 20cm containing adenocarcinoma. pathology revealed positive margns. he presented to for further evaluation and management. he underwent a repeat colonoscopy with bx, eus and ct scan which did not reveal any abnormalities. his preoperative cea was 2.2. patient and family counselled that watch-waiting appropriate at this age. patient & family strongly desired surgery. past medical history: pmh: afib, htn, pacemaker, carotid stenosis, cad, copd, pud, ed, chronic anemia . psh: s/p vagotomy/?anterectomy s/p pacemaker placement s/p ventral hernia repair social history: year old widow living alone prior to procedure. 2 children, both married and with married children of their own. supportive family. pt highly functional w/ adl's , involved in his neighborhood. denies use of etoh, tobacco, and illicit drugs. family history: unknown physical exam: pat pre-procedure assessment vitals: hr-78, bp-148/62, o2 sat-97%, lb-160, height-70in gen: spry, elderly gentleman accompanied by daughter mental: a/ox3, speech clear, + hand tremors, pupils 3mm & sluggish bilaterally heart: irregular rate, normal s1/s2, no s3/s4, no murmurs, no carotid bruits bilaterally lungs: ctab abd: soft, well healed midline incision, umbilical hernia, no masses extrem: no pedal edema bilaterally, + dp bilaterally other: no cervical lymphadenopathy bilaterally, no thyroid masses, trachea midline pertinent results: 09:05am blood wbc-7.8 rbc-2.94* hgb-8.5* hct-26.7* mcv-91 mch-28.9 mchc-31.7 rdw-16.6* plt ct-389 03:21am blood wbc-32.0* rbc-2.88* hgb-8.7* hct-26.2* mcv-91 mch-30.2 mchc-33.2 rdw-16.9* plt ct-752* 06:30am blood wbc-10.3# rbc-3.25* hgb-10.1*# hct-30.3* mcv-93 mch-31.2 mchc-33.4 rdw-13.6 plt ct-147* 09:05am blood plt ct-389 09:05am blood pt-13.0 ptt-39.8* inr(pt)-1.1 06:21pm blood pt-14.7* ptt-29.7 inr(pt)-1.3* 06:30am blood plt ct-147* 09:05am blood glucose-127* urean-33* creat-0.9 na-139 k-4.1 cl-104 hco3-30 angap-9 03:21am blood glucose-131* urean-41* creat-2.0* na-137 k-3.4 cl-107 hco3-20* angap-13 06:30am blood glucose-125* urean-15 creat-1.0 na-138 k-4.7 cl-105 hco3-26 angap-12 03:11am blood alt-28 ast-57* alkphos-47 amylase-183* totbili-1.3 12:04am blood ck(cpk)-218* 01:00am blood alt-21 ast-32 ck(cpk)-91 alkphos-40 amylase-353* totbili-0.7 09:14am blood ck(cpk)-467* 12:04am blood ck-mb-8 04:53pm blood ck-mb-8 ctropnt-0.11* 09:14am blood ck-mb-9 ctropnt-0.04* 09:05am blood calcium-8.9 phos-3.0 mg-1.8 06:30am blood calcium-8.0* phos-2.9 mg-2.1 02:23am blood digoxin-0.4* 09:14am blood digoxin-0.6* . urine urine culture-final inpatient sputum gram stain-final; respiratory culture-final {klebsiella pneumoniae, serratia marcescens} inpatient swab r/o vancomycin resistant enterococcus-final inpatient mrsa screen mrsa screen-final inpatient mrsa screen mrsa screen-final inpatient stool clostridium difficile toxin assay-final inpatient swab gram stain-final; fluid culture-final {staphylococcus, coagulase negative, pseudomonas aeruginosa}; anaerobic culture-final inpatient stool clostridium difficile toxin assay-final inpatient mrsa screen mrsa screen-final inpatient swab r/o vancomycin resistant enterococcus-final inpatient mrsa screen mrsa screen-final inpatient sputum gram stain-final; respiratory culture-final {gram negative rod(s)} inpatient pleural fluid gram stain-final; fluid culture-final; anaerobic culture-final inpatient catheter tip-iv wound culture-final inpatient blood culture aerobic bottle-final; anaerobic bottle-final inpatient urine urine culture-final; anaerobic culture-final inpatient blood culture aerobic bottle-final {staphylococcus, coagulase negative, staphylococcus, coagulase negative}; anaerobic bottle-final inpatient mrsa screen mrsa screen-final inpatient swab r/o vancomycin resistant enterococcus-final inpatient mrsa screen mrsa screen-final inpatient pleural fluid gram stain-final; fluid culture-final {klebsiella pneumoniae}; anaerobic culture-final; fungal culture-final inpatient stool clostridium difficile toxin assay-final inpatient swab r/o vancomycin resistant enterococcus-final inpatient mrsa screen mrsa screen-final inpatient sputum gram stain-final; respiratory culture-final {klebsiella pneumoniae, staph aureus coag +} inpatient urine urine culture-final {enterococcus sp.} inpatient blood culture aerobic bottle-final; anaerobic bottle-final inpatient stool clostridium difficile toxin assay-final {clostridium difficile} inpatient urine urine culture-final {probable enterococcus, gram negative rod(s)} inpatient brief hospital course: mr. was take to the operating room on for a laparoscopic resection of the colon mass. due to multiple adhesions and friable tissue, the case was converted to open. the sigmoid colon was resected and an end-to-end anastamosis was performed via stapler. he tolerated the procedure well with an ebl of 100cc. he was routinely observed in the pacu. he was transferred to the floors for routine post-operative care. . pod#: he was triggered for agitation with hr 130's (afib), o2 sat 93%ra. he was transferred to telemetry floor. cardiology was consulted and he was started on a diltiazem drip wit improvment in heart rate. he was ruled out for a myocardial infarction, and made strict npo due to altered mental status. both his cardiac and mental condition slowly improved, his bowel function returned, and his diet was advanced over the next few days. . pod#6: he developed abdominal distention, profuse diarrhea with a increased wbc to 18.3. stool cultures were sent, and he was empircally started on iv flagyl. he then had an aspiration event requiring intubation. bilious material was suctioned from et tube. he was transferred to the icu, pressure support was started and a pa catheter inserted for fluid management. . pod#7: he remained on the respiratory ventilator. his stool cultures came back postive for c.difficile (). his urine culture was sent and eventually grew out enterococcus. over time, his sputum grew klebsiella pneumonia and s. aureus that were coagulase positive. vancomycin, zosyn, & orals vancomycin were added to regimen. a tte echo was performed and revealed lvef46%, no thrombus with mild global hypokinesis. . pod#11: he continued on the ventilator with mutliple attempts to wean, but unsuccessful. patient developed pneumothorax requiring placement of left sided chest tube. his mentation was gradually improving throughout his icu stay. he continued on antibiotics and intravenous vasopressors. . pod#15: due to inability to wean from ventilator, a tracheostomy tube and peg tube were placed at bedside. the procedures were discussed with the patient's daughter who agreed, and consented. . pod#19: his temp spiked to 101 with an increase in wbc to 27 requiring an increase in the neosynephrine rate. a ct of the chest & abdomen was obtained revealing bilateral pleural effusions (loculated on the right), lll consolodation, and ground glass opacities bilaterally. a right sided chest tube was placed, and fluconazole was added to his regimen. at this time, post-surgical abdominal changes were noted. . pod#23: his abdominal staples were removed, and he ws found to have fascial dehiscence. he was taken back to the or for a wash out and closure. retention sutures were placed. . pod#24-29: he was weaned to trach mask, and the antibiotic regimen was stopped. his tube feeds were advanced to goal, and the tpn discontinued. his mental status continued to improve. . pod#30-32: he was noted to have increased secretions, sputum cultures were sent and eventually grew out klebsiella pneunoniae. he was started on ciprofloxacin and oral vancomycin with symptomatic improvement. . pod#37-present: he remained stable was transferred to . he was evaluated per physical therapy and occupational therapy. both services recommended rehabilitation. he continues to tolerate tube feeds which remain at goal. his secretions have decreased. he is able to better tolerate the passy/muir valve. he continues to benefit from nebulizer treatments, aggressive chest pt, and frequent turning & repositioning. . elim/skin: he continues to have loose, frequent stools. he is incontinent of both urine a stools. his last two c.diff cultures have been negative. imodium 2mg tabs were started today; insufficient time has elapsed to assess efficacy. his perineum and buttocks are erythematous. nystatin powder and ointment have been applied with some resolution in symptoms. he should have this therapy continue. his coccyx is intact. no evidence of pressure ulcers. . afib/coumadin: he will continue on heparin sc tid. he will re-start coumadin once his condition stabilizes. this information was reviewed with his pcp's edical assistant, , who manages the coumadin patients in the office. . abd/peg: his incision continues to heal, with the rentention sutures in place. the open areas should continue to be dressed with aquacel. his peg site is intact, and requires daily cleaning and flushing to maintain patent. . mental/psych: his mental status has improved substantially. he has remained a/o x since transfer to . he occasionally forgets where he is. he did express some hopeless thought processes; stating, "why me" and "the surgery was a bad idea". he was evalutated per psych who reported that he was appropriately depressed, and recommended re-evaluation once he was more stable. this can be done in the rehab setting. . aspiration precautions: he has remained npo due to high risk for aspirating, and copious amounts of respiratory secretions. he was evaluated per speech and swallow who recommended that he be re-assessed later once his secretions decrease in amount, and he becomes more stable. . trach: he sats have remained >95%. his #8 portex trach is intact. continue to provide trach care per the rehab institutions protocol. ensure that the inner cannula is cleaned at least daily, and that the cuff remain deflated with application of pmv during daytime to allow communication. the cuff should be inflated for sleep to prevent aspiration. . id: he has remained afebrile, and he has not required antibiotics for numerous days post-op. medications on admission: coumadin 2,3 alternating, zebeta 10', digoxin 0.125', xanax 0.25'prn, viagra 75qwk, combivent prn, singulair 10qpm, pravachol 20', hytrin 5' discharge medications: 1. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 2. miconazole nitrate 2 % powder sig: one (1) appl topical qid (4 times a day) as needed for fungal infection. 3. albuterol sulfate 0.083 % (0.83 mg/ml) solution sig: one (1) inhalation q4h (every 4 hours) as needed. 4. ipratropium bromide 17 mcg/actuation aerosol sig: four (4) puff inhalation q2h (every 2 hours) as needed. 5. albuterol 90 mcg/actuation aerosol sig: 2-4 puffs inhalation q4h (every 4 hours). 6. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain. 7. digoxin 125 mcg tablet sig: one (1) tablet po every other day (every other day): per gtube. 8. furosemide 20 mg tablet sig: one (1) tablet po bid (2 times a day): per gtube. 9. diltiazem hcl 90 mg tablet sig: one (1) tablet po q6h (every 6 hours): per gtube. 10. miconazole nitrate 2 % cream sig: one (1) appl topical (2 times a day) as needed for perineum/gluteus. 11. famotidine 20 mg tablet sig: one (1) tablet po daily (daily): per gtube. 12. insulin regular human 100 unit/ml solution sig: one (1) injection asdir (as directed). 13. loperamide 2 mg capsule sig: one (1) capsule po tid (3 times a day) as needed for diarrhea/loose stools. 14. lorazepam 0.25-0.5 mg iv q4h:prn anxiety discharge disposition: extended care facility: - discharge diagnosis: primary: sigmoid polyp-biopsied, positive for adenocarcinoma post-op atrial fibrillation post-op c/ difficile infection post-op ileus post-op aspiration pneumonia post-op abdominal wound dehiscence . secondary: afib, htn, pacemaker, carotid stenosis, cad, copd, pud, ed, chronic anemia discharge condition: stable trach npo-aspiration precautions tolerating tube feedings via peg tube denies pain. able to tolerate medications via peg tube discharge instructions: please call your doctor or return to the er for any of the following: * you experience new chest pain, pressure, squeezing or tightness. * new or worsening cough or wheezing. * if you are vomitting and cannot keep in fluids or your medications. * you are getting dehydrated due to continued vomitting, diarrhea or other reasons. signs of dehydration include dry mouth, rapid heartbeat or feeling dizzy or faint when standing. * you see blood or dark/black material when you vomit or have a bowel movement. * your skin, or the whites of your eyes become yellow. * your pain is not improving within 8-12 hours or not gone within 24 hours. call or return immediately if your pain is getting worse or is changing location or moving to your chest or back. * you have shaking chills, or a fever greater than 101.5 (f) degrees or 38(c) degrees. * any serious change in your symptoms, or any new symptoms that concern you. * please resume all regular home medications and take any new meds as ordered. * continue to amubulate several times per day. . incision care: -you may shower, and wash surgical incisions. -avoid swimming and baths until your follow-up appointment. -please call the doctor if you have increased pain, swelling, redness, or drainage from the incision sites. . anticoagulation: -continue to heparing sc tid. -follow-up with pcp regarding of coumadin once more stable followup instructions: 1. please call dr. office for a follow-up appointment. 2. please follow-up with dr. , regarding restarting your coumadin. procedure: insertion of intercostal catheter for drainage insertion of intercostal catheter for drainage venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more parenteral infusion of concentrated nutritional substances insertion of endotracheal tube enteral infusion of concentrated nutritional substances percutaneous [endoscopic] gastrostomy [peg] insertion of other (naso-)gastric tube temporary tracheostomy open and other sigmoidectomy transfusion of packed cells replacement of tracheostomy tube reclosure of postoperative disruption of abdominal wall diagnoses: other iatrogenic hypotension anemia, unspecified coronary atherosclerosis of native coronary artery urinary tract infection, site not specified congestive heart failure, unspecified unspecified essential hypertension friedl?nder's bacillus infection in conditions classified elsewhere and of unspecified site acute kidney failure, unspecified severe sepsis atrial fibrillation unspecified transient mental disorder in conditions classified elsewhere systolic heart failure, unspecified pneumonitis due to inhalation of food or vomitus peritoneal adhesions (postoperative) (postinfection) surgical operation with anastomosis, bypass, or graft, with natural or artificial tissues used as implant causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation intestinal infection due to clostridium difficile paralytic ileus cardiac pacemaker in situ streptococcus infection in conditions classified elsewhere and of unspecified site, streptococcus, group d [enterococcus] chronic obstructive asthma, unspecified other and unspecified postsurgical nonabsorption diverticulosis of colon (without mention of hemorrhage) disruption of external operation (surgical) wound laparoscopic surgical procedure converted to open procedure mechanical complication of tracheostomy malignant neoplasm of sigmoid colon 

Answer: The patient is high likely exposed to