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: the patient is a 52-year-old male who is a nursing home resident with a history of a multi-system atrophy, right dvt and recent aspiration pneumonia. he presents with an episode of hematuria from a longstanding foley which was recently removed two days prior to admission. in addition, he had a meatal tear noted and bleeding from the laceration was noted and he was brought to for further management of the hematuria. also of note there were blood clots surrounding the meatus and clots in the urine and they were unable to replace the foley at that time. on admission he also has had increasing sizes of his sacral pressure ulcers which despite topical treatment have increased in size and depth. also of note, he has recently completed a 10 day course of levo/flagyl on for aspiration pneumonia. he has a history of multiple aspiration pneumonias. past medical history: multisystem atrophy, dysphagia, he is not a g tube candidate per patient's previous wishes. benign prostatic hypertrophy. diabetes mellitus diet controlled. distant history of hypertension. chronic obstructive pulmonary disease. history of schizophrenia, currently off psych meds for multiple months. right femoral dvt in , in . depression. medications: on admission included celexa 20 mg po q day, lovenox 100 mg subcu , permax 1.5 mg po bid, tylenol #3 prn, multivitamin, promod tid, trazodone 100 mg q h.s., vitamin c 500 mg , zinc 220 mg three times per week. allergies: patient is allergic to haldol which causes extra pyramidal symptoms. social history: patient is a resident of the home. his guardian is , . physical examination: patient is ill appearing, slightly tachypneic on admission. his vital signs on admission were blood pressure of 116/66, temperature 100, pulse 133, satting 91% on room air. heent: bilateral conjunctival injection with moist oropharynx, nasopharynx. on pulmonary exam he has coarse rhonchi throughout his entire lung fields with upper and lower chest congestion. cardiovascular is regular rate and rhythm with normal s1 and s2. abdomen is soft, nontender, non distended, positive bowel sounds and no masses. gu exam, he has traumatic hypospadias with blood surrounding the urethral meatus. on dermatologic exam he has large, greater than 6 cm stage iv sacral ulcers. neuro exam, patient opens his eyes, was non verbal and lethargic. he is extremely stiff throughout and has severe contracture in his extremities. laboratory data: on admission, white count 15.7 with 88% neutrophils. his hematocrit was 35.1 which is his baseline and his platelet count was 597,000. his bmp with sodium 140, potassium 4.1, chloride 105, co2 24, bun 20, creatinine 0.5 and glucose 87 with an albumin of 2.8. his lactate was normal at 1.1. coags were notable for an inr of 1.4, pt 14.0 and ptt 23.9. initial urinalysis showed that patient had specific gravity of 1.025 with positive nitrites, negative leukocyte esterase and white blood cells with occasional bacteria and red blood cells with large blood. arterial blood gas on admission was 7.44, 34 and 64, po2 on three liters of oxygen. hospital course: the patient initially was brought to the hospital given his episode of hematuria noted after removal of the foley. during his admission in the emergency room he was noted to become hypotensive with a blood pressure in the 50's/30's as well as tachycardic with a rate to the 130's. he was started on zosyn and vanco at this time and had a chest x-ray which showed that he had a new left lower lobe opacity. he did not require pressors for his hypotension. the patient then was noted to have hypoxemic respiratory failure and was intubated on for this. he had difficulty and was admitted to the medical care intensive unit. he had difficulty with extubation and weaning from the ventilator due to high levels of copious secretions. also during the micu course he continued to spike fevers despite being treated with vancomycin and zosyn. he had sputum cultures which grew out klebsiella which were resistant to all antibiotics tested except for zosyn and imipenem. also it was noted that he had yeast in the urine and diflucan was started for this. in addition, patient was seen by the gu service during his micu admission and they recommended possible placement of a suprapubic catheter due to his decubitus ulcers, history of hypospadias and history of urethral meatal tear. ng tube was placed and patient was fed with ng tube feedings and was also supplemented with vitamin c and zinc for improved wound healing. the patient was extubated on after an extended intubation course due to significant amount of secretions. the patient's secretions eventually had decreased and patient was transferred to the acove service. the patient, after he was extubated, had a repeat episode of tachypnea on where his respiratory rate was in the 40's and elevated heart rate. his o2 sats were dropping. he spiked a fever to 100.8 and chest x-ray showed repeat right lower lobe infiltrate. arterial blood gas showed an aa gradient of approximately 39. at this point he had still been on zosyn and vancomycin which had been started upon his admission. it was discussed with id who recommended a 21 day course treatment of the zosyn and vanco. tube feeds were stopped at this point, given it was felt that he had an aspiration pneumonitis. on the following day the patient had multiple episodes of desaturation with pco2 to the 60's for approximately 20 minutes and noted to have extremely thick secretions upon suctioning. prior to this, aggressive chest physical therapy had been continued. the patient also was noted to be relatively hypotensive with a systolic blood pressure over the 90's later that day. given the patient's worsening respiratory status, it was discussed with the guardian about patient's overall prognosis. the patient's guardian believes the importance of keeping the patient comfortable during the remainder of his hospital course as well as future treatments. at this point it was decided that patient would have focus on his comfort measures. the patient's ng tube was removed and afterwards the patient felt more comfortable subjectively. in addition, patient was started on pain medications for pain control. also patient's other medications such as antibiotics were stopped as it was felt that if patient were to have a septic compromise, it would be more gentler and kinder than a respiratory compromise. the patient at this point appears comfortable, in no acute distress and previously when he had been turned he expressed signs of discomfort such as moaning, but currently feels comfortable upon position changes. regarding patient's pain medications, patient initially was started on iv morphine at 2 mg per hour and appeared comfortable on this medication. his medications were changed over to po roxanol sublingual q 2 hours. if patient is to have continuing breakthrough pain, we plan to decrease this interval to q 1 hour. it is important that patient have a continuos pain medication so he does not have breakthrough pain. in addition, the scopolamine patch was added to help decrease the patient's secretions. also, fentanyl patch was added to the patient's pain regimen. discharge condition: good. discharge status: patient to be discharged to nursing home. discharge diagnosis: 1. history of multisystem atrophy. 2. history of multiple aspiration pneumonia. 3. history of stage 3 and 4 pressure ulcers. discharge medications: roxanol 4 mg sublingual po q 2 hours, fentanyl patch 50 mcg q 72 hours, scopolamine patch patches q 72 hours, tylenol 325 mg to 650 mg per rectum prn fever. , m.d. dictated by: medquist36 procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube enteral infusion of concentrated nutritional substances nonexcisional debridement of wound, infection or burn nonexcisional debridement of wound, infection or burn diagnoses: diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified septicemia acute and chronic respiratory failure hypotension, unspecified pneumonitis due to inhalation of food or vomitus other complications due to genitourinary device, implant, and graft other degenerative diseases of the basal ganglia 

Answer: The patient is high likely exposed to