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: procaine attending: chief complaint: reason for transfer to the unit: increased work of breathing, pco2 in the 60's to 70's. major surgical or invasive procedure: bedside picc placement history of present illness: 74yo f rehab resident with hx type ii dm, htn, copd who presents with presents with worsening hypoxia through ongoing tratment of bronchitis and copd flare. pt reports that on last tuesday she developed fever to 102, st, and cough. a cxr was done at that time (results not known). she was started on levofloxacin for bronchitis/pneumonia and nebulizers to address bronchospasm. she developed liter 02 requirement. she had productive sputum that was initally yellow but then turned brownish -blood. she reports having some loose stools as well. + dry heaves -vomiting. pt has developed right sided reproducible cp non-pleuitic but worse with coughing and soreness of her lower ribs/abd muscles with coughing. she developed worsening hypoxia with one report of her being 77% on room air. her 02 requirement increased to 4-5 liters so she was sent to ed for further managment. . in transit to ed, hr 112, 160/82 22 94% on nrb? > he was given 20mg iv lasix and 1 sl ntg. in ed. she received asa 325mg, combivent neb, lasix 40mg iv, guaifenesin, vanco 1gm, zosyn 4.5gm iv and had cxr. . on the floor overnight, she was managed with iv lasix (20 mg then 40 mg) with diuresis of 1600 ml, solumedrol 80 iv q8h, vancomycin, zosyn. she had an acute desaturation to the 60's, and abg was done on 5l nc which showed 7.33/71/132. a repeat abg was done 10 minutes later which was improved to 7.35/63/161. she was transferred to the micu for closer observation and consideration of noninvasive ventilation. past medical history: type ii dm obesity htn gerd copd depression hx pna anemia gout osteoarthritis hx renal stone s/p oophorectmy s/p trimalleolar fx right leg ppd neg . meds on transfer to micu: ipratropium bromide neb 1 neb ih q6h acetaminophen 325-650 mg po q4-6h:prn albuterol 0.083% neb soln 1 neb ih q4h metoprolol 25 mg po tid allopurinol 300 mg po daily methylprednisolone na succ 80 mg iv q8h albuterol 0.083% neb soln 1 neb ih q2h:prn multivitamins 1 cap po daily citalopram hydrobromide 10 mg po hs nitroglycerin 0.05-0.2 mcg/kg/min iv drip titrate to sbp<140 order date: @ 0612 docusate sodium 100 mg po bid nitroglycerin ointment 2% 1 in tp once furosemide 20 mg iv once pantoprazole 40 mg po q24h furosemide 40 mg iv once piperacillin-tazobactam na 4.5 gm iv q8h guaifenesin ml po q6h piperacillin-tazobactam na 4.5 gm iv once heparin 5000 unit sc tid senna 1 tab po bid hydralazine hcl 10 mg iv once insulin sc (per insulin flowsheet) sliding scale vancomycin hcl 1000 mg iv q 24h social history: nh resident at rehab, son lives in , phone # (or distant hx smoking, pt reports <10 years of smoking < 1/2ppd -etoh family history: nc physical exam: v: t 96 bp 111/75 p104 r24-30 100% nrb -> 95% 5lnc fs 141 gen: awake, alert, speaking in partial sentences heent: mm dry neck: obese neck, no apprecible jvp resp: diffuse rhonchi bilaterally, no wheezes cv: rrr nl s1s2 no apprecible murmurs abd: obese, soft, nt nd ext: 2+ pitting edema bilaterally skin: legs with venous stasis changes neuro: a+ox3 pertinent results: cxr pa and lat : impression: bilateral pleural effusions, right greater than left. retrocardiac opacity consistent with pneumonia. previously identified prominent left hilum is likely related to the pulmonary artery and is not evident on the current study. . ekg: sinus tach 106, nl intervals, leftward xis, st elevation v1,v2. lvh avl>11, i>15, st dep/twi strain pattern in i, avl, slight st dep v6 . mrsa/vre screen both negative . rapid respiratory viral screen negative . urine legionella antigen negative . urine culture (final ): escherichia coli. >100,000 organisms/ml.. sensitivities: mic expressed in mcg/ml _________________________________________________________ escherichia coli | ampicillin------------ =>32 r ampicillin/sulbactam-- =>32 r cefazolin------------- <=4 s cefepime-------------- <=1 s ceftazidime----------- <=1 s ceftriaxone----------- <=1 s cefuroxime------------ 8 s ciprofloxacin--------- =>4 r gentamicin------------ <=1 s imipenem-------------- <=1 s levofloxacin---------- =>8 r meropenem-------------<=0.25 s nitrofurantoin-------- <=16 s piperacillin---------- 32 i piperacillin/tazo----- <=4 s tobramycin------------ <=1 s trimethoprim/sulfa---- =>16 r . blood cultures ngtd at discharge brief hospital course: a/p 74 yo htn, copd, type ii dm p/w signs of pneumonia and chf. . 1) hypercarbic respiratory failure - likely multifactorial, including possible pneumonia, chf with diastolic dysfunction (elevated bnp), copd/reactive airway disease (despite minimal smoking history) with mucus plugging. treated multiple etiologies while hospitalized given initial tenuous respiratory status. rapid respiratory viral screen negative, urine legionella antigen negative. (a) pna: started on ceftriaxone for presumed pna given recent course of levofloxacin; ceftriaxone will also cover e coli in urine. will need 7 day course (last dose ). sputum cultures sent but contaminated with oral flora. (b) chf treatement: diuresed with lasix (c) copd: no history of rad but treated with steroids and nebs; will need continued q4hr nebs as well as chest pt and encouragement to be out of bed. she will also need a steroid taper (see medication list) . 3) dm- maintained on riss for now, can restart metformin. continue to need riss while on steroids . 4) fen- diabetic, 2gm na mvi. continue diet . 5) depression- continued citalopram . 6) code status- pt affirms that she is full code . 7) prophylaxis: ppi, heparin sc, colace, dulcolax; pt reports h/o constipation and had no bm in hospital (but no abd pain and abd soft) . 8) communication: son in . 9) dispo: to mac unit at rehab medications on admission: albuterol/ipratropium nebs guaifenesin acetaminophen q4hours prn pantoprazole40mg po qd colace 100mg zolpidem 5mg hs citalopram 10mg hs metformin 500mg toprol xl 100mg qd allopurinol 300mg po mom 30ml qd prn glimepride 2mg po qd discharge medications: 1. pantoprazole 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* 2. albuterol sulfate 0.083 % solution sig: one (1) neb inhalation q4h (every 4 hours). disp:*180 neb* refills:*2* 3. ipratropium bromide 0.02 % solution sig: one (1) neb inhalation q6h (every 6 hours). disp:*120 neb* refills:*2* 4. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 5. heparin (porcine) 5,000 unit/ml solution sig: 5000 (5000) units injection tid (3 times a day). disp:* units* refills:*2* 6. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 7. guaifenesin 100 mg/5 ml syrup sig: 5-10 mls po q6h (every 6 hours). disp:*100 ml(s)* refills:*2* 8. acetaminophen 325 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed. disp:*60 tablet(s)* refills:*0* 9. citalopram 20 mg tablet sig: 0.5 tablet po hs (at bedtime). disp:*30 tablet(s)* refills:*2* 10. allopurinol 300 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 11. multivitamin capsule sig: one (1) cap po daily (daily). disp:*30 cap(s)* refills:*2* 12. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 13. metoprolol tartrate 25 mg tablet sig: 1.5 tablets po tid (3 times a day): hold for sbp<100, hr<60 . disp:*135 tablet(s)* refills:*2* 14. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for consipation. disp:*60 tablet, delayed release (e.c.)(s)* refills:*0* 15. captopril 12.5 mg tablet sig: one (1) tablet po tid (3 times a day). disp:*90 tablet(s)* refills:*2* 16. ceftriaxone 1 gm iv q24h day 1 = 17. metformin 500 mg tablet sig: one (1) tablet po twice a day. disp:*60 tablet(s)* refills:*2* 18. prednisone 20 mg tablet sig: 0.5 to 3 asdir tablet po daily (daily): 60mg qd through4/28 40mg qd to 20mg qd to 10mg qd to then off. disp:*60 tablet(s)* refills:*2* 19. insulin lispro (human) 100 unit/ml solution sig: 0-20 units subcutaneous asdir (as directed): see attached sliding scale. disp:*qs units* refills:*2* discharge disposition: extended care facility: for the aged - acute rehab discharge diagnosis: pneumonia diabetes hypercarbic respiratory distress discharge condition: good discharge instructions: take all medications as directed. call a doctor or nurse for chest pain, difficulty breathing, fever, worsening cough, abdominal pain, or any other concerns. followup instructions: your doctors rehab will arrange any necessary follow-up. procedure: venous catheterization, not elsewhere classified diagnoses: pneumonia, organism unspecified esophageal reflux urinary tract infection, site not specified congestive heart failure, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled gout, unspecified acute respiratory failure acute diastolic heart failure obstructive chronic bronchitis with acute bronchitis 

Answer: The patient is high likely exposed to