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 / amiodarone attending: chief complaint: cough major surgical or invasive procedure: femoral line placement picc line placement peg tube placement history of present illness: the patient is a 76 yo m with recent icu admission for pna/hypotension now presents from rehab with 4-5 days of cough and decreased enegery. + productive cough. denies fevers, chills. currently denying chest pain, headaches, abdominal pain, urinary or bowel complaints. . in the ed, initial vitals were t98.5 hr79 bp110/62 rr18 o2100%2l. a cxr was concerning for lll pna. he received levofloxacin 750mg iv x 1. wbc elevated to 14, lactate 3.0. admitted to medicine for pna. past medical history: 1. cad, s/p 2mis , with vf arrest/coma/neurologic sequelae, placement - pacemaker/, in first placed in , biv in , currently has insync model 7272 biventricular ( is an abdominal implant, lv and la leads are epicardial; rv is a transvene and there is a stand-alone scv coil. abandoned rv/ra leads located in right pectoral region. 2. cm, ischemic, ef 10-20%, biv since 3. mod-severe mr 4. atrial fibrillation 5. htn 6. hypercholesterolemia 7. ?chronic kidney disease per omr, however gfr appears consistently normal in labs 8. anemia 9. svc thrombosis 10. nephrolithiasis 11. hx gi bleed 12. pharyngeal dysphagia secondary to structural abnormalities social history: # personal: lives in with wife. to cardiac rehab 2 x weekly and walks with a walker. no in-home health services. # professional: retired banker # substance use: never smoked nor used recreational drugs. past remote drinking. family history: - cad: sister - prostate ca: father physical exam: vs: 97.0 104/61 73 24 98%2l gen: cachectic with temporal wasting, lying in bed, able to answer questions heent: sclera anicteric, dry mucous membranes resp: scattered rhonchi, no crackles cv: irregular, systolic murmur abd: soft, nontender, nondistended, bowel sounds present, box in abdominal wall ext: no edema pertinent results: 07:36pm plt count-240 07:36pm neuts-91.2* lymphs-4.2* monos-4.2 eos-0.2 basos-0.2 07:36pm wbc-14.5*# rbc-4.23* hgb-13.5* hct-43.3 mcv-102* mch-32.0 mchc-31.2 rdw-16.1* 07:36pm estgfr-using this 07:36pm glucose-96 urea n-29* creat-1.1 sodium-132* potassium-5.5* chloride-96 total co2-27 anion gap-15 07:53pm lactate-3.0* . cxr : 1. interval improvement in chf compared to , with very slight vascular congestion. 2. persistent left retrocardiac opacity, probably due to atelectasis; pneumonia cannot be definitively excluded. 3. underlying emphysema. . bilateral upper extremity ultrasound : deep vein thrombosis identified within the right internal jugular vein and within one of the two right brachial veins. no deep vein thrombosis identified in the left arm. . bilateral lower extremity ultrasound : no evidence for dvt bilateral lower extremities. right common femoral line. . cxr: in comparison with the study of , the patient has taken a better inspiration but there is otherwise little change. again, the cardiac silhouette is mildly prominent and there is fullness of indistinct pulmonary vessels consistent with elevated pulmonary venous pressure. the area behind the heart is impossible to though some atelectatic change and/or pleural effusion can certainly not be excluded. various tubes and wires remain in place. . cxr: the ng tube tip passes below the diaphragm with its tip terminating below the inferior margin of the field of view most likely in the stomach. there is no change in the multiple pacemaker leads with the external pacemakers terminating at the left ventricle epicardium. mild cardiomegaly is unchanged. bilateral perihilar haziness representing pulmonary edema is grossly unchanged. bilateral pleural effusions are small to moderate, layering. . cxr: little overall change. brief hospital course: mr. is a 76 year old man with cad, chf ef 15%, cardiomyopathy with recent icu admission for pna/hypotension presented from rehab with 4-5 days of cough and decreased energy. + productive cough. he denied fevers, chills. admitted intially to medicine service with a question of pna, volume status unclear. received gentle ivf due to depressed ef, increasing o2 req. while on the floor, his volume status and low urine output were concerns. he appears dry, but care was taken with iv fluids given known cardiomyopathy. during the day he had an increasing oxygen requirement with increased work of breathing. he was found with sao2= 70s-80s in marked respiratory distress and placed on a nrb. a code was then called for rapid anesthesia response and urgent intubation. he was transfered to the icu. . first micu course: he was intubated , a mucous plug was suctioned and his breathing improved markedly afterwards. he was extubated and his o2sats were stable on 2l nc. vancomycin and aztreonam had been started in icu, but he continued on only vanco x4 days for mrsa in sputum. he had low uop which responded to gentle ivf 250cc boluses. he also had hypotension that was ivf responsive not on pressors. upper extremity swelling was noted and due to rij/scv clots in setting of therapeutic inr with a question of coumadin failure so he was placed on a heparin gtt. for acces he initially had a femoral line which was eventually taken out as he had a midline placed by ir . his underlying af w/ was stable with a heart rate in the 70s-80s. it was determined that he needed peg due to aspiration noted on s&s done in micu . pt's hypotension resolved, and his oxygen saturation remained 100% 2lnc so he was transferred to the medical floor. at 5pm he triggered for hypoxia (80s on 5 liters nc). sao2 continued to drop to 72% on nrb. he was sunctioned with return of thick, tan, bloody secretions; his o2 sat improved to 100%. at 9:45pm, he again experience o2 desaturation to the low 70s on a shovel mask with an abg showing 7.45/42/426; the sao2 increased to 100% on a nrb. lasix (10mg iv) was given. a few hours later his hr increased to the 130s; this was 30 minutes after the lasix had been administered with ~40cc of urine. he was treated with 250cc of ns and then transferred to the icu for further care for hypoxia and mental status changes. second micu course: he was diagnosed with a mrsa pneumonia by culture, though there is no clear infiltrate on cxr (possibly in left retrocardiac region). of note, this patient was admitted in early with a rll opacity and completed a 7 day course of cefpodoxime and 5 days of azithromycin. he has clear cough and had mucous plugging necessitating intubation. he completed a course of vancomycin and flagyl. he was kept npo, and put on aspiration precautions, hob>30. in addition he received aggressive chest pt. his wbc was elevated on admission to the hospital but normalized. he remained afebrile. he continued to produce secretions that required frequent suctioning but remained on a nasal cannula between 2-5l. he is unable to clear these secretions effectively and it was discussed with his wife that a tracheostomy tube may be indicated. on discharge he was satting in the high nineties on room air. . he had a peg tube placed to aid with dysphagia and aspiration. he received tube feeds and tolerated them well, was able to advance feeds to goal as defined by nutrition. . he has chronic systolic ischemic heart failure with a most recent echo () showed ef 20%, s/p biv . after receiving his peg tube, the team restarted oral meds including low dose acei, carvedilol, digoxin. as he was 11l fluid positive this admission with low uop, not on lasix at home he was given small ns boluses. on the last two days of hospitalization small lasix iv doses were given for gentle diuresis. his blood pressure usually in the low 100's dropped to the nineties, asymptomatically. he was given 2 boluses of 250cc iv times two with good result. . he has underlying atrial fibrillation with v-pacing and went into nsvt intermittently. he had an episode of af with rvr after placement of the peg in post-op setting, controlled with iv diltiazem. he was restarted on mexilitine tid for history of vt, and had a heparin gtt restarted for vte ppx as well as restarted on his coumadin at 5mg qhs his carvedilol and digoxin were restarted. . he was continued on his , statin, bb for his cad and had a midline for access code: dnr, not dni per attending discussion with wife communication: patient and wife (h), (c) medications on admission: 1. carvedilol 12.5 mg 2. digoxin 125 mcg qtuesday, thursday, saturday 3. digoxin 62.5 mcg po qsunday, monday, wednesday, friday 4. simvastatin 80 mg daily 5. omeprazole 40 mg once a day. 6. mexiletine 150 mg tid at 6am, 2pm, 10pm 7. aspirin 81 mg daily 8. hexavitamin daily 9. bupropion 75 mg 10. albuterol nebs q6-8 hours as needed 11. ipratropium as needed 13. ferrous sulfate 325 mg daily 14. senna 8.6 mg 15. warfarin 4 mg daily16 16. lisinopril 5 mg once a day. discharge medications: 1. albuterol 90 mcg/actuation aerosol : 1-2 puffs inhalation q6h (every 6 hours) as needed. 2. ipratropium bromide 0.02 % solution : one (1) inhalation q6h (every 6 hours). 3. warfarin 5 mg tablet : one (1) tablet po daily16 (once daily at 16). 4. carvedilol 3.125 mg tablet : one (1) tablet po bid (2 times a day). 5. digoxin 125 mcg tablet : one (1) tablet po tues/thurs/sat (). 6. digoxin 125 mcg tablet : 0.5 tablet po sun/mon/wed/ (). 7. simvastatin 40 mg tablet : two (2) tablet po hs (at bedtime). 8. mexiletine 150 mg capsule : one (1) capsule po q8h (every 8 hours). 9. aspirin 81 mg tablet, chewable : one (1) tablet, chewable po daily (daily). 10. bupropion 75 mg tablet : one (1) tablet po bid (2 times a day). 11. senna 8.6 mg tablet : one (1) tablet po bid (2 times a day). 12. lisinopril 5 mg tablet : 0.5 tablet po daily (daily). 13. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr daily (daily). 14. sodium chloride 0.9% flush 3 ml iv daily:prn peripheral iv - inspect site every shift 15. heparin flush midline (100 units/ml) 2 ml iv daily:prn 10 ml ns followed by 2 ml of 100 units/ml heparin (200 units heparin) each lumen daily and prn. inspect site every shift. 16. heparin heparin drip, titrate to goal ptt 60-80, until 24 hours after inr is therapeutic (inr goal ) 17. heparin (porcine)-0.45% nacl 12,500 unit/250 ml parenteral solution : six y (650) units intravenous per hour: please continue heparin drip at 650cc per hour, titrating to goal ptt 60-80 until 24 hours after inr is therapeutic on warfarin (inr goal ). disp:*1000 ml* refills:*2* discharge disposition: extended care facility: medical center - discharge diagnosis: mrsa pneumonia dysphagia chronic systolic heart failure status post peg tube placement atrial fibrillation hypertnesion coronary artery disease history of tia discharge condition: stable, afebrile, satting well on room air discharge instructions: you were admitted from your rehabilitation facility with 4-5 days of cough and decreased energy. you had problems breathing while on the medical floor and had to be intubated and treated in the medical intensive care unit. your breathing improved after thorough suctioning and you were extubated. you went back to the medical floor but your oxygen saturation was dropping so you were treated in the icu again. you were treated for your pneumonia with antibiotics. you also were found to have secretions that interfere with your breathing that need to be suctioned. because you were found to aspirate you had a peg (feeding) tube placed. your breathing improved and you were found to be stable for rehabilitation. weigh yourself every morning, md if weight > 3 lbs. adhere to 2 gm sodium diet fluid restriction: 1.5l please take your medications as prescribed. seek medical attention for fevers, chills, cough, difficulty breathing, chest pain, dizzyness or any other concerning symptoms. followup instructions: provider: , md phone: date/time: 12:00 provider: call transmissions phone: date/time: 11:00 provider: call transmissions phone: date/time: 11:00 md procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube enteral infusion of concentrated nutritional substances percutaneous [endoscopic] gastrostomy [peg] diagnoses: coronary atherosclerosis of native coronary artery congestive heart failure, unspecified unspecified essential hypertension unspecified protein-calorie malnutrition atrial fibrillation infection with microorganisms resistant to penicillins acute respiratory failure chronic systolic heart failure methicillin susceptible pneumonia due to staphylococcus aureus dehydration 

Answer: The patient is high likely exposed to