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: surgical wound draining major surgical or invasive procedure: debridement of laminectomy wound history of present illness: ms. is a year woman with a h/o cad, htn, chf with ef of 25% s/p l4-l5 laminectomy with dr. in , presented from rehab facility with nonhealing lumbar surgical wound. wound began producing serous drainage a week prior to presentation, and started on keflex . drainage was cultured on which grew heavy growth of mssa and moderate alpha strep, as a result was switched to levaquin on , then transferred to . past medical history: s/p l4-5 laminectomy/fusion cad htn hyperlipidemia osteoporosis osteoarthritis skin cancer restless leg syndrome social history: she lives alone in . no tobacco or alcohol use. has four sons, two of whom live close by. family history: no premature cad, scd physical exam: o: tm:98.1 bp:115/64 hr:78 rr:18 spo2:97% on ra general: alert, oriented to person and place, no acute distress heent: sclera anicteric, mmm, oropharynx clear neck: supple, no lad lungs: fine crackles on bl lung bases, no wheezes, ronchi cv: regular rate and rhythm abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly gu: foley draining clear yellow urine ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema pertinent results: 06:10pm blood wbc-6.5 rbc-4.30# hgb-11.1* hct-35.0* mcv-82# mch-25.7*# mchc-31.5 rdw-17.9* plt ct-472* 05:42am blood wbc-7.9 rbc-3.47* hgb-8.6* hct-27.0* mcv-78* mch-24.9* mchc-32.0 rdw-18.6* plt ct-454* . . . 06:10pm blood glucose-86 urean-11 creat-0.6 na-136 k-4.7 cl-101 hco3-28 angap-12 04:45am blood glucose-89 urean-8 creat-0.6 na-138 k-3.6 cl-102 hco3-29 angap-11 10:06am blood na-142 k-4.2 cl-103 . . 8:56 am stool consistency: loose source: stool. **final report ** clostridium difficile toxin a & b test (final ): feces negative for c.difficile toxin a & b by eia. (reference range-negative). . . 10:45 am swab lumbar cervical wound. **final report ** gram stain (final ): 3+ (5-10 per 1000x field): polymorphonuclear leukocytes. no microorganisms seen. wound culture (final ): staphylococcus, coagulase negative. rare growth. staphylococcus species may develop resistance during prolonged therapy with quinolones. therefore, isolates that are initially susceptible may become resistant within three to four days after initiation of therapy. testing of repeat isolates may be warranted. sensitivities: mic expressed in mcg/ml _________________________________________________________ staphylococcus, coagulase negative | clindamycin-----------<=0.25 s erythromycin----------<=0.25 s gentamicin------------ <=0.5 s levofloxacin----------<=0.12 s oxacillin-------------<=0.25 s tetracycline---------- =>16 r vancomycin------------ <=0.5 s anaerobic culture (final ): no anaerobes isolated. brief hospital course: mrs. is a year old woman with a h/o cad, htn, chf with ef of 25% s/p l4-l5 laminectomy with dr. in , who presented from a rehab facility with nonhealing lumbar surgical wound. #) wound infection/sepsis: she had been started on keflex at the rehab facility and the drainage was cultured on , which grew heavy growth of mssa and moderate alpha strep. as a result, she was switched to levaquin on and then transferred to . she was started on vancomycin and unasyn on . she was taken to the or on , where copious purulent fluid was encountered, bathing the hardware. this was thoroughly irrigated, and samples sent to micro, cultures ultimately grew cons. she was initially placed on vancomycin and cefepime and then transitioned to a combination of unasyn 2 q 12 hours (given her renal function) and vancomycin 1 q 24 hours. her or course was complicated by the fact that she was required requiring a fiberoptic intubation, and was noted to have significant tracheomalacia from midtrachea through carina. she was successfully extubated in the pacu and required levophed for blood pressure support in the icu for two days post operatively. she was transferred to the general medicine floor from the icu on where she remained afebrile and had reduced wound drainage requiring twice daily dry sterile dressing changes. she received a picc line for the purpose of administering iv antibiotics at her rehab facility. finial infectious disease recommendations are as follows: plan for 8-10 weeks for spinal osteomyelitis with hardware in place, followed by life-long oral suppression given the presence of hardware in infected bed. opat antibiotic regimen and projected duration unasyn 2 q 12 hours x 8-10 weeks from time of operative debridement, . vancomycin 1 q 24 hours x 8-10 weeks from time of operative debridement, . cultura data (organism and susceptibilities) mssa, gas (osh) cons () essential diagnostic date for opat rx (tee< bx, ect) baseline pertinent co-morbidities or complications: laboratory monitoring required: weekly cbc with differential, bun, cr, ast, alt, alk phos, tbili, vancomycin trough, esr, crp. all laboratory results should be faxed to infectious disease r.ns. at (. all questions regarding outpatient antibiotics should be directed to the infectious disease r.ns. at . #) ams: she was noted to have fluctuating mental status with narcotic pain , thus these were avoided to the extent possible with pain control primarily with tylenol and subsequent improvement in her mentation to baseline per family. at her baseline dementia she can answer questions about her care appropriately. . #) respiratory failure: she was weaned off the ventilator post operatively and was subsequently weaned from a non-rebreather to 4l o2 on nasal canula in the icu and finally to room air with excellent oxygen saturation on the general medicine floor. . #) systolic chf: she has a reported lvef of 25% and requires 20 mg of lasix daily at home. because of the intravenous fluids she as received while admitted this dose should be increased to 40 mg daily and titrated to her daily weight and creatinine. . #) hypokalemia: secondary to diuresis with lasix required monitoring and potassium repletion to reflect lasix dose as appropriate. . #) iron deficiency anemia: she was started on ferrous sulfate 325mg daily while admitted. . #) incontinence: she was incontinent at baseline and thus requires absorbent undergarment and miconazole powder qid. . #) depression: she was not restarted on her citalopram 10mg daily while admitted, however this may be restarted after discharge if her mental status is believed to be at baseline . #) loose stools were noted by the nursing staff - however her c. diff studies were negative and this may be her baseline. . #) dvt prophylaxis was achieved with 5000 units of sc heparin tid. on admission: trazodone 25mg q6h prn anxiety or insomnia aspirin 325mg daily citalopram 10mg daily metoprolol er 25mg daily celebrex 200mg daily lasix 20mg daily tylenol 650mg q4h prn pain (not to exceed 4gms daily) guaifenein 100mg/5ml 10ml every 4 hrs as needed for cough levaquin 500mg daily lipitor 80mg daily gabapentin 400mg tid tramadol 50mg q6h while awake senna 2 tabs po bid prn constipation debrox gtts 5 gtts in each ear x 5 days ntg 0.6mg sl q5min prn chest pain milk of magnesia 400mg/5ml 30ml daily for constipation bisacodyl 10mg supp. rectally citrucel powder daily oxycodone 5mg every 8 hours as needed for pain calcium 500mg tab chewable multiday plus minerals discharge : 1. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 2. acetaminophen 650 mg tablet sustained release sig: one (1) tablet sustained release po q6h (every 6 hours) as needed for pain. 3. metoprolol tartrate 25 mg tablet sig: one (1) tablet po tid (3 times a day). 4. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 5. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 6. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). 7. miconazole nitrate 2 % powder sig: one (1) appl topical qid (4 times a day). 8. ferrous sulfate 300 mg (60 mg iron) tablet sig: one (1) tablet po daily (daily). 9. vancomycin 1000 mg iv q 24h please hold dose for trough >20 10. ampicillin-sulbactam 3 g iv q12h 11. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 12. nitroglycerin 0.6 mg tablet, sublingual sig: one (1) sublingual q 5 minutes x 3 as needed for chest pain. 13. milk of magnesia 400 mg/5 ml suspension sig: 30 ml po once a day as needed for constipation. 14. tramadol 50 mg tablet sig: one (1) tablet po every six (6) hours as needed for pain. discharge disposition: extended care facility: liberty commons nursing & rehab center - discharge diagnosis: hardware associated lumbar infection systolic congestive heart failure discharge condition: mental status: confused - sometimes. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: mrs. you were admitted to the hospital for an infection of your spinal surgical wound. your infection required surgical treatment in addition to intravenous antibiotics. you will need to continue these antibiotics for 8 to 10 weeks as recommeded by your infectious disease doctors. you should take your as described in this discharge document and keep your outpatient appointments with your spine docotrs and infectious disease doctors. the following changes have been made to your : 1.) your furosemide has been increased to 40mg daily 2.) your aspirin has been decreased to 81mg daily 3.) your metoprolol has been increased to 25mg three times daily 4.) your citalopram has been held and may be resumed as your mental status continues to improve. 5.) you have been started on heparin sc 5000 units tid 6.) you have been started on unasyn and vancomycin antibiotics iv please follow instructions from you infectious disease doctors about these . followup instructions: department: spine center when: tuesday at 11:30 am with: , np (works with dr ) building: sc clinical ctr campus: east best parking: garage department: infectious disease when: friday at 9:00 am with: , md building: lm bldg () campus: west best parking: garage procedure: venous catheterization, not elsewhere classified reconstruction of eyelid with hair follicle graft other local excision or destruction of lesion or tissue of skin and subcutaneous tissue local excision of lesion or tissue of bone, other bones open biopsy of soft tissue biopsy of bone, other bones diagnoses: coronary atherosclerosis of native coronary artery congestive heart failure, unspecified unspecified essential hypertension atrial fibrillation unspecified osteomyelitis, other specified sites depressive disorder, not elsewhere classified other persistent mental disorders due to conditions classified elsewhere hypopotassemia acute respiratory failure personal history of other malignant neoplasm of skin osteoporosis, unspecified old myocardial infarction other respiratory complications acute on chronic systolic heart failure oliguria and anuria disruption of external operation (surgical) wound other diseases of trachea and bronchus restless legs syndrome (rls) infection and inflammatory reaction due to other internal orthopedic device, implant, and graft unspecified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation 

Answer: The patient is high likely exposed to