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: respiratory failure major surgical or invasive procedure: intubated on mechanical ventilation. s/p colectomy with hartmann's pouch at history of present illness: 70 y/o female transferred from on mechanical ventilation for respiratory failure. patient presented to on with abdominal pain and underwent a sigmoid colectomy with hartmann's pouch on /o4 for microperforated diverticulitis. on , the patient suffered a nstemi and developed respiratory failure secondary to multilobar pneumonia and chf overlying her severe copd. in addition to hyercarbic and hypoxemic respiratory failure requiring intubation, the patient had fevers unresponsive to gentamycin, flagyl, vancomycin, aztreonam and linezolid. one blood culture of 4 was postive for mrsa from at . subsequent blood, urine, and sputum cultures at were negative. past medical history: 1. obesity 2. copd on chronic prednisone and home oxygen 3. cad h/o nstemi and h/o positive ett 4. htn 5. chf ef<45% 6. h/o diverticulitis 7. raynaud's 8. h/o nosocomial pneumonia on mechanical ventilation 9. hypothyroidism 10 hyperglycemia social history: 100+ pack years tobacco abuse on oxygen supplementation at home and daily prednisone for severe copd. no alcohol or iv drug abuse. the patient was widowed and lived alone. she had seven children. family history: non-contributory physical exam: at 0700 tm 97.9 t95.8 hr70 bp153/56 i/o /2325 ps 5 fio20.6 tv615 r13 ve7.8 peep8 95%02 rsbi26.7 7.41/43/81 gen-obese, sedated in nad heent-ncat, perrl, mmmi, +scleral icterus neck-thick, supple, no jvd pulm-ctab, no crackles/rhonchi/wheezes cv-rrr, s1s2, no m/r/g, pulses 1+ throughout abd-obese, soft, non-distended, no masses wound-laparotomy +steristrips without drainage top . bottom of wound dehissced and packed with clean dressings without blood or pus. ostomy-pink stoma, +green stool/gas, peri-stomal necrotic skin ext-warm, no c/c, 4+ pitting edema all extremities neuro-arousable to voice, no fc, no tracking, not moving extremities pertinent results: cbc wbc-16.9* rbc-3.11* hgb-10.4* hct-30.6* mcv-99* mch-33.5* mchc-34.0 rdw-17.8* plt ct-110* pt-13.1 ptt-27.6 inr(pt)-1.1 sputum gram stain >25 pmns and <10 epithelial cells/100x field. 2+ gram negative rod(s). final sputum gram stain >25 pmns and >10 epithelial cells/100x field. 2+ multiple organisms consistent with oropharyngeal flora. final respiratory culture: no predominance of these respiratory pathogens: s. pneumoniae, h. influenzae, and m. catarrhalis. legionella culture (preliminary): no legionella isolated. fungal culture (preliminary): gram stain of this specimen indicates contamination with oropharyngeal secretions and invalidates results. chest (portable ap) chest ap: the tip of the right ij line is in the mid svc. the endotracheal tip about 5 cm above the carina. the distal end of the feeding tube is not visualized and is below the diaphragm. there is mild cardiomegaly. there are bilateral alveolar opacities, right greater than left. some prominent interstitial markings are also seen in both mid and lower zones. there are no pleural effusions. the right costophrenic angle has been cut off from this study. there is no pneumothorax. impression: right ij line in appropriate position without evidence of pneumothorax. pneumonia in the right middle and lower zones with some pulmonary edema. the study and the report were reviewed by the staff radiologist. dr. dr. n. approved: 11:58 am chest (portable ap) history: 70 y/o with history of ---no sochromal-- pneumonia. status post colectomy. this study is compared to previous study of 1 day earlier and since the previous study there has been reexpansion of previously seen atelectatic left lower lobe. there has been worsening in the degree of consolidation involving the right middle lobe and right lower lobe since the previous study. a small associated right pleural effusion is suspected. the left lung and the right upper lobe are clear. there is continued application of the right subclavian cvp line, et tube and ng tube. impression: interval expansion of the left lower lobe.worsening infiltration of the right middle lobe and right lower lobe suggestive of pneumonia. dr. liver or gallbladder us indication: elevated bilirubin, alkaline phosphatase, and transaminitis. intubated on tube feeds. technique: right upper quadrant ultrasound was performed. findings: the gallbladder is nondistended, with a thin wall. no stones or sludge is seen within the gallbladder. there is no intra or extrahepatic biliary duct dilatation. the common bile duct measures 4 mm in size. no hepatic lesions are seen. impression: no evidence of cholecystitis. study and the report were reviewed by the staff radiologist. dr. dr. approved: mon 3:06 pm ct of the chest with contrast: impression: 1) diffuse severe emphysema. 2) diffuse superimposed ground-glass and interstitial opacities. this likely related to superimposed pulmonary edema secondary to cardiac failure. 3) several nodular opacities, most prominent at the lung bases. confirmation of resolution of these nodular opacities after treatment is recommended to rule-out possible metastatic disease. conversely, these nodular opacities along with patchy opacities seen in the lower lobes may relate to superimposed aspiration and/or pneumonia. ct abdomen and pelvis: impression: 1) small amount of fluid adjacent to the left colon stump, likely post operative in nature. there is no collection suspicious for a mature abscess at this time. 2) small low attenuation lesions in the liver and spleen. these are likely benign but are not fully characterized on this study. 3) calcified irregular aorta and prominent infrarenal plaque/thrombus. 4) findings discussed with the surgical service. the study and the report were reviewed by the staff radiologist. dr. dr. approved: sat 2:28 pm brief hospital course: on , the patient was electively transferred to where pneumonia and chf were confirmed by cxr and ct scan. she was continued on vancomycin for a total of thirteen days while the other antibiotics were discontinued since her course had been completed or they were not providing useful coverage for nosocomial pneumonia. subsequently, the patient tolerated pressure support ventilation with acceptable oxygen saturation considering her severe copd with home oxygen requirement. however, she was never successfully able to pass spontaneous breathing trials with ability to remain alert to support her airway. her mental status at best was arousable to voice and very seldomly able to blink her eyes upon command. she became very hypertensive and anxious or in pain when weaned off sedation with fentanyl and/or midazolam. throughout her hospital course, the patient was gently diuresed with lasix for chf exacerbation and hypertension. additionally, she received metoprolol, captopril, asa, atorvastatin, and combivent nebulizer therapy. she remained afebrile throughout her hospital stay with a leukocytosis with wbc<20 due to pneumonia vs. chronic steroid use. the patient's cxr and ecg remained unchanged througout her hospital stay on mechanical ventilation until when she became hypoxemic on fio2 of 1 and peep of 14 on assist control with po2 levels in the low 50's. her cxr showed worsening right sided infiltrate and a new course of antibiotic therapy was begun. she never recovered ability to oxygenate well in spite of maximum ventilatory support. a brief bronchoscopy was performed to identify mechanical causes of hypoventilation or hypoxemia. a small amount of mucous plugging was suctioned and the hypoxemia did not resolve. next, the patient developed an arrhythmia without recovering oxygen saturation following a recruitment maneuver that was a final opportunity for the patient to recover oxygenation. the patient's family and her proxy health care decision , , decided to render the patient dnr and she died at from respiratory failure due to hypoxemia. the patient received an insulin drip for hyperglycemia, levothyroxine for hypothyroidism, and methylprednisone for chronic copd. she received tube feedings through the ngt with monitoring of ostomy output. ngt secretions and ostomy excretion was consistently guiac positive but the patient had a stable hematocrit above 30. she had scleral icterus and mildly increased tbr, dbr, ast, alt, alk phos, and amylase that was resolving after the aztreonam was completed. for prophylaxis, the patient received protonix, subcutaneous heparin, pneumoboots, sucralfate, and aspiration precautions. medications on admission: 1. flagyl 500mg q6hrs 2. aztreonam 2g q8hrs 3. linezolid 600mg q12hrs 4. amlodipine 5. metoprolol 6. nitropaste 7. solumedrol 8. versed 9. levothyroxine 10.nicotine patch discharge disposition: home discharge diagnosis: deceased. discharge condition: deceased. procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more parenteral infusion of concentrated nutritional substances enteral infusion of concentrated nutritional substances other bronchoscopy diagnoses: congestive heart failure, unspecified chronic airway obstruction, not elsewhere classified acute respiratory failure bacteremia methicillin susceptible pneumonia due to staphylococcus aureus seroma complicating a procedure subendocardial infarction, subsequent episode of care colostomy status 

Answer: The patient is high likely exposed to