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 attending: chief complaint: sacral osteomyelitis and pelvic abscesses, mrsa major surgical or invasive procedure: anterior and posterior debridement of vertebral osteomyelitis and multiple pelvic abscesses with diverting loop colostomy history of present illness: cc: abscess hpi: 57 yo m with paraplegia, status post mrsa bacteremia (st. . hosp) likely from r trochanteric decub, tx with vanc/rifampin x 5 wks, then 84 days of linezolid. patient's problems began in early of this year, when he developed fevers to 104 and chills, and presented to hospital. at that time, he was bacteremic with mrsa and a source for the infection was sought after, with an extensive negative work up. this included a transesophageal echocardiogram time two, ct of chest /abdomen and pelvis. he does have a large right gluteal decubitus ulcer, which was debrided , and this may have been the presumed source. he was treated with vancomycin, as well as rifampin. he at some point returned to with similar problems, and was transferred to on for further mgt of his persistent fever and mrsa bacteremia. at , he had a ct scan demonstrating osteomyelitis with destruction of l5-s1. he was to be continued on vancomycin for a full 12-week course - however, on the pt was found to have a pneumonia, so the vancomycin was stopped and he was begun on a 12-week course of linezolid instead. he was discharged from , to a rehab facility, on . on , the pt presented to hospital after experiencing fever to 103. on admission, his decub ulcer was noted to extend down to the bone. he got levofloxacin iv in the emergency department. wbc-16.3, urine culture with > 100 thousand gram negative rods, growing pan-resistant enterbacter cloace and psuedomonas sensitive to gent only. started on gent. blood cultures from and with mrsa. ct ls spine/pelvis showed marked destruction of osseous fragment involving part of l5 and s1. mri showed inflam phlegmon l5-s1, and l sacrospinous ligament collection. seen by n-, recommended extensive , to be done here. ros: patient denies recent wt gain/loss, headaches, visual changes, shortness of breath, chest pain or tightness, cough, nausea, vomiting. labs: cbc-wbc 15.6, hct 26 (30 at osh five days ago) k 5.2, cr 0.7, coags wnl ua: +nitrites, mod leuk, 0-2 wbc, few bact past medical history: pmh: 0. mrsa bacteremia, started , tee neg., tx with 5 wks vanc, 84 d. course of linezolid 1. paraplegia (t5) - mva 27 years ago 2. diabetes-1,diagnosed 10 years ago, on insulin 3. atrial flutter, new during admission in . was begun on coumadin but no longer takes. 4. hypertension 5. chf 6. gi bleed esophageal ulcers 7. h/ esophagitis 8. h/o persistent lung collapse 9. h/o dvt 10. h/o pna in social history: lives in home nonsmoker, non drinker family history: non contributory physical exam: pe: t 100.3 bp: 100/60 p: 88 r: 20 94% on ra gen: alert and oriented male, pleasant, appears in no apparent distress. heent: pupils equal round and reactive to light, extraocular movements intact, orophyarnx clear, moist mucous membranes. no jugular venous distention. lungs: clear to auscultation bilaterally, no wheezes/rhonchi/crackles cv: heart sounds distant, regular rate and rhythm, no murmurs rubs or gallops abd: soft, non tender and non distended, positive for bowel sounds. no palpable hepatosplenomegaly. ext: no clubbing cyanosis or edema, 2+ distal pulses. skin: patients entire gluteal region is erythematous. on right side, there is an approx 3 cm decub ulcer that extends down to his pelvic bone. no frank pus around wound, but but when dressing was removed it did have a greenish fluid on it. pertinent results: mri lumbar spine : impression: osteomyelitis of l5 and s1 level with large interosseous abscess extending into the presacral region anteriorly and posteriorly to the interspinous regions and soft tissue. enhancing inflammatory soft tissues are seen within the spinal canal in the lumbar region. findings were discussed with the resident covering the patient at the time of interpretation of this study on at 3:30 p.m. mri right hip: impression: 1. suboptimal study. repeat study including pre and post contrast images with non-breath hold technique is recommended. 2. extensive osseous destruction involving the bilateral sacral ala and lower lumbar spine, with adjacent fluid collection extending into the buttocks. findings are consistent with osteomyelitis. 3. large ulceration of the superficial tissue underlying the right ischial tuberosity, involving the hamstring insertion. 4. 5 cm long fistulous tract extending from the midline above the buttocks to the rectum. ct abdomen: impression: 1. extensive inflammatory mass centered about the l5/s1 interspace with associated frank bony destruction. these findings are compatible with the patient's known history of chronic osteomyelitis. at this time, no drainable fluid collection is identified. 2. ulceration of the superficial soft tissues underlying the right ischial tuberosity as above with associated inflammatory changes and soft tissue thickening surrounding the right hip joint but no abscess formation. this process appears separate from the spinal process. cultures: : enterobacter and pseudomonas : blood cultures negative to date : urine eterobacter cloacae time 2 brief hospital course: he was transferred from hospital on . he was on iv meropenem () and vancomycin () for his mrsa infection. he was hydrated and given antibiotics and was admitted for depbridement of his paraspinal, psoas, aravertebral and presacral abscesses. he had a debridement of the ulcer with diverting transverse loop colostomy on . he was placed in the intensive care unit on a ventilator. his antibiotics were continued. he he had twice daily dresing changes from wet to dry. plastic surgery and neurosurgery evaluated him daily and assisted in the dressing changes. he was also followed by while in the hospital, to help maintain tight control of his blood sugars. he was extubated by , and was transferred out to the floor on . he began a diet and tolerated regular food. the patient did remarkably well after his surgery, was tolerating a regular diet, his vital signs and lab values were normal and his white blood cell count trended back to normal. he was stable to go to rehab by , and needed rehab for help with dressing changes. the infectious disease service suggested 3 weeks of vancomycin for a total course of 6 weeks, and to stop the merepenem on discharge. plastic surgery decided that wet to dry dressings were appropriate, and that a vac dressing would not be placed at this time. he has plans to follow up with id and with plastic surgery for further management of his wounds. he was discharged in stable condition to the rehab facility medications on admission: meds: vanc 750 qd, hep sq 5000 , protonix 40 qd, mvi 1 qd, feso4 325 qd, senna 2 tab qhs, insuline nph 20/5, riss, cardizem cd 90 qd, isordil 10 tid, rythmol 100 q 8h, lopressor 50 tid, hydral 10 q6, mylicon 80 q 6h, dulcolax supp 10 qd, baclofen 20 q6h, folate 1 , 81 qd, kcl 40 qd, vit c 500 , zinc sulfate 220 qd discharge medications: 1. heparin sodium (porcine) 5,000 unit/ml solution sig: one (1) injection q12h (every 12 hours). disp:*60 injections* refills:*2* 2. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours). disp:*120 nebs* refills:*2* 3. albuterol sulfate 0.083 % solution sig: one (1) inhalation q6h (every 6 hours). disp:*120 nebs* refills:*2* 4. triamcinolone acetonide 0.1 % cream sig: one (1) appl topical prn (as needed) as needed for psoriasis. disp:*1 tube* refills:*0* 5. baclofen 10 mg tablet sig: two (2) tablet po qid (4 times a day). disp:*240 tablet(s)* refills:*2* 6. isosorbide dinitrate 10 mg tablet sig: one (1) tablet po tid (3 times a day). disp:*90 tablet(s)* refills:*2* 7. clotrimazole 1 % cream sig: one (1) appl topical (2 times a day). disp:*1 tube* refills:*2* 8. triamcinolone acetonide 0.025 % cream sig: one (1) appl topical qd (once a day). disp:*1 tube* refills:*2* 9. pantoprazole sodium 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 10. multivitamin,tx-minerals tablet sig: one (1) tablet po qd (once a day). disp:*30 tablet(s)* refills:*2* 11. ferrous sulfate 325 (65) mg tablet sig: one (1) tablet po qd (once a day). disp:*30 tablet(s)* refills:*2* 12. metoprolol tartrate 50 mg tablet sig: one (1) tablet po tid (3 times a day). disp:*90 tablet(s)* refills:*2* 13. simethicone 80 mg tablet, chewable sig: one (1) tablet, chewable po qid (4 times a day). disp:*120 tablet, chewable(s)* refills:*2* 14. folic acid 1 mg tablet sig: one (1) tablet po qd (once a day). disp:*30 tablet(s)* refills:*2* 15. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po qd (once a day). disp:*30 tablet, chewable(s)* refills:*2* 16. ascorbic acid 500 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 17. zinc sulfate 220 mg capsule sig: one (1) capsule po qd (once a day). disp:*30 capsule(s)* refills:*2* 18. diltiazem hcl 90 mg capsule, sust. release 12hr sig: one (1) capsule, sust. release 12hr po qd (once a day). disp:*30 capsule, sust. release 12hr(s)* refills:*2* 19. vancomycin hcl 10 g recon soln sig: one (1) recon soln intravenous q12h (every 12 hours) for 3 weeks. disp:*42 recon soln(s)* refills:*0* 20. morphine sulfate 2 mg/ml syringe sig: one (1) injection asdir (as directed). disp:*30 syringe* refills:*2* discharge disposition: extended care facility: elihu white nursing & rehabilitation - discharge diagnosis: 1. sacral osteomyelitis 2. status post sacral debridement 3. parapelegia 4. atrial flutter 5. hypertension 6. congestive heart failure 7. esophogeal ulcer 8. history of deep vein thrombosis discharge condition: stable discharge instructions: please call with any spiking fevers, intractable nausea, inability to tolerate food, new drainage from wounds followup instructions: please follow up in 1 week with dr. in plastic surgery. please follow up with dr. in weeks, call his office for an appointment the patient needs to set up an appointment with dr. in clinic in 4 weeks (). patient needs to have a vancomycin peak level drawn and a chemistry (sodium, potassium, glucose, bun, creatinine, bicarbonate, chloride). please fax results to dr. attention at procedure: imageless computer assisted surgery excision or destruction of lesion of spinal cord or spinal meninges excisional debridement of wound, infection, or burn exteriorization of large intestine diagnoses: congestive heart failure, unspecified atrial flutter intraspinal abscess other bone involvement in diseases classified elsewhere chronic osteomyelitis, other specified sites diabetes with other specified manifestations, type i [juvenile type], not stated as uncontrolled unspecified local infection of skin and subcutaneous tissue 

Answer: The patient is high likely exposed to