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: no known allergies / adverse drug reactions attending: chief complaint: hypoxia/hypercarbic respiratory failure major surgical or invasive procedure: intubation history of present illness: mr. is a 78yom with mild dementia, obstructive uropathy with chronic foley, known stage iii-iv decubs, and dm who initally was brought to the by his nursing home for evaluation of hypoxia. he was found this morning to be hypoxic and cyanotic with an o2 saturation of 64% on room air. he appeared more lethargic per nursing staff. he was placed on a nonrebreather by ems and transferred to . initial vitals at : 98.1 f (36.7 c). pulse: 76. respiratory rate: 16. blood-pressure: 95/56. oxygen saturation: 96%; 4l/min; normal. while at , he became hypotensive to the 80s, received 500cc ns and came up to 90s. he received levaquin and ceftriaxone. ed attending felt pt needed icu care, and given no icu beds at , pt was transferred to . in ed, inital vitals: 96.1 60 93/54 22 99% 4l nc. exam notable for rhonchi on the right decreased breath sounds on the left. + ua. cxr with l-sided "white-out," concerning for infiltrate +/- effusion. vancomycin was given in our ed for mrsa coverage. md ed contact pt's legal guardian, who has not yet met patient, but would persue aggressive measures if needed for now. pt appeared lethargic, but was arousable. vitals prior to transfer: t 96.6, hr 62, rr 28, bp 102/55, 94% 4l of note, pt was last admitted to with hematuria. he has a chronic foley for obstructive uropathy. urology recommended turp, which pt refused, and so was deferred given plan to persue legal guardianship. pt was d/ced on levoflox for uti. on arrival to micu, patient only oriented to self, with periods of apnea, and intermittent moaning past medical history: diabetes peripheral neuropathy hypertension anemia depression dementia - per last d/c summary, pt was a&o to self and place and conversing appropriately. osteoarthritis b12 deficiency history of obstructive uropathy - chronic foley, changed monthly history of urethral calculus on the left necrotic stage iii and iv sacral and ischial decubitus ulcers - debrided at in no known pulmonary disease, but sats at nh were 90-94% overnight and 92-98% during the day social history: lives in nursing home, has newly court appointed guardian who had never met patient. family history: non-contributory physical exam: physical exam: vitals: general: alert to self, intermittent moaning heent: sclera anicteric, poor denitition, eomi, pupils non reactive to light neck: supple, jvp to 14cm, no lad cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops lungs: no breath sounds over left side, decreased breath sounds half way up right side abdomen: soft, non-distended, bowel sounds present, no tenderness to palpation, no rebound or guarding on my exam, but moaning in pain on subsequent exam gu: foley ext: cool, 1+ pulses, 3+ pitting edema , l>r neuro: maee, deferred other portions of exam pertinent results: 12:00pm wbc-6.7 rbc-3.03* hgb-8.6* hct-29.5* mcv-97# mch-28.4 mchc-29.2*# rdw-15.5 12:00pm plt count-201 12:00pm neuts-89.6* lymphs-6.2* monos-2.0 eos-1.5 basos-0.8 12:00pm glucose-118* urea n-26* creat-0.9 sodium-145 potassium-3.9 chloride-110* total co2-32 anion gap-7* 12:00pm alt(sgpt)-11 ast(sgot)-19 alk phos-136* tot bili-0.1 12:00pm lipase-20 12:00pm albumin-2.5* calcium-8.3* phosphate-4.3 magnesium-1.8 12:08pm lactate-0.7 12:00pm urine blood-mod nitrite-neg protein-100 glucose-neg ketone-neg bilirubin-neg urobilngn-2* ph-5.5 leuk-lg 12:00pm urine rbc-21* wbc->182* bacteria-many yeast-none epi-0 12:00pm urine hyaline-13* 12:00pm urine wbcclump-many mucous-rare cardiac enzymes 12:00pm ctropnt-0.07* probnp-582 11:28pm ck-mb-6 ctropnt-0.06* 11:28pm ck(cpk)-39* 03:07am blood ck-mb-5 ctropnt-0.07* relevant labs: 05:19pm type-art po2-94 pco2-89* ph-7.17* total co2-34* base xs-1 09:45pm s/p intubation type-art po2-126* pco2-27* ph-7.58* total co2-26 base xs-5 03:07am blood cortsol-21.4* 06:26pm pleural wbc-655* rbc-830* polys-25* lymphs-32* monos-2* eos-1* macro-40* 06:26pm pleural totprot-3.6 glucose-85 ld(ldh)-110 amylase-20 albumin-1.7 cholest-49 triglyc-17 04:44am blood ld(ldh)-130 04:44am blood totprot-4.7* calcium-7.6* phos-4.8* mg-1.9 microbio: urine culture (final ): escherichia coli. 10,000-100,000 organisms/ml. of two colonial morphologies. presumptive identification. piperacillin/tazobactam sensitivity testing available on request. cefazolin interpretative criteria are based on a dosage regimen of 2g every 8h. enterococcus sp.. 10,000-100,000 organisms/ml.. sensitivities: mic expressed in mcg/ml _________________________________________________________ escherichia coli | enterococcus sp. | | ampicillin------------ =>32 r <=2 s ampicillin/sulbactam-- 16 i cefazolin------------- <=4 s cefepime-------------- <=1 s ceftazidime----------- <=1 s ceftriaxone----------- <=1 s ciprofloxacin--------- =>4 r gentamicin------------ <=1 s meropenem-------------<=0.25 s nitrofurantoin-------- <=16 s <=16 s tetracycline---------- =>16 r tobramycin------------ <=1 s trimethoprim/sulfa---- =>16 r vancomycin------------ 1 s blood culture negative x2 legionella urinary antigen negative pleural fluid: gram stain (final ): no polymorphonuclear leukocytes seen. no microorganisms seen. fluid culture (preliminary): no growth. anaerobic culture (preliminary): no growth. fungal culture (preliminary): no fungus isolated. acid fast smear (final ): no acid fast bacilli seen on direct smear. acid fast culture (preliminary): imaging: cxray: impression: nearly complete opacification of the left hemithorax with balanced mass effect, suggesting a large pleural effusion among other potential causes, including the possibility of malignancy. chest ct may be useful to evaluate further if clinically indicated. echo: the left atrium is normal in size. left ventricular wall thicknesses are normal. the left ventricular cavity is unusually small. due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. overall left ventricular systolic function is normal (lvef 70%). right ventricular chamber size and free wall motion are normal. the aortic valve is not well seen. there is no aortic valve stenosis. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. the left ventricular inflow pattern suggests impaired relaxation. there is mild pulmonary artery systolic hypertension. there is no pericardial effusion. bilateral lenis: the left atrium is normal in size. left ventricular wall thicknesses are normal. the left ventricular cavity is unusually small. due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. overall left ventricular systolic function is normal (lvef 70%). right ventricular chamber size and free wall motion are normal. the aortic valve is not well seen. there is no aortic valve stenosis. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. the left ventricular inflow pattern suggests impaired relaxation. there is mild pulmonary artery systolic hypertension. there is no pericardial effusion. cxray s/p chest tube: new left basal pigtail pleural drain has cleared virtually all the previous large left pleural effusion. there is a small volume of pleural air at the apex and base of the left lung. moderate right pleural effusion is unchanged since earlier in the day. mediastinum has returned to the midline. pending pleural fluid cytology brief hospital course: 78 yo gentleman with pmhx s/f sacral decub and chronic obstructive uropathy transferred from osh in shock (baseline pressures 120) with opacified left lung and found to be in hypercarbic respiratory failure with severely altered mentation necessitating intubation. the patient self extubated, was made dnr/dni, and subsequently passed away. # hypercarbic respiratory failure: the patient was admitted to the icu for hypoxia and ams nearing obtundation. an abg revealed hypercarbia and respiratory acidosis. a trial of bipap was not successful, and the patient required (after discussion with his court appointed guardian). mental status improved. however, he self extubated the following day, and initially remained clinicaly stable. over the course of the following 18 hours, patient demonstrated gradual decline in respiratory status and mental status (more somnulant). it was initially felt that he was likely hypoventilating due to low tidal volumes from left lung due to collapse and inability to compensate with appropriate minute ventilation in right lung. however, after chest tube pleural fluid drainage fully expanded the left lung, the patient's respiratory status did not improve. records obtained from prior hospitalizations and nursing home clearly indicated that patient did not want intubation and mechanical ventilation. this signed document was immediatedly provided to the court appointed guardian, who agreed and confirmed that the patient was dnr/dni. the patient demonstrated continued clinical decline in respiratory efforts, and peacefully and quietly expired. # large left pleural effusion causing lung white out: unclear etiology of pleural fluid, but it is exudative in nature and non-infectious. at time of writing of discharge summary, the cytology is still pending. a large amount was drained and pig tail catheter placed resulting in full reexpansion of lung. even after drainage and dramatic radiographic improvement of left lung, the patient remained in hypercarbic respiratory failure. # shock: no fever, no white count but pt did have predominant neutrophilia in setting of low blood pressures and floridly positive ua as well as living in nursing facility. the patient's ua was positive for enterococcus and e coli. other than urine, potential sources included lung, which is unlikely in retrospect given the lack of consolidation on xray after pleural fluid tap and the non-infectious nature of the fluid itself, and stage iv sacral decubitus. an echo revealed good ef, ruling out cardiogenic shock. the patient was fluid resuscitated and placed on broad spectrum abx with zosyn, vanc, and levofloxacin to cover potential hcap. a cortistol level excluded adrenal insufficiency. # left leg>right leg swelling: us did not show dvt. # stage iii-iv decub: potential source of infection. debrided at in . culture results note mrsa, but unclear whether this was superficial versus deep culture. patient was covered with vancomycin. # chronic obstructive uropathy: pt requires chronic foley. likely contributing source for recurrent utis and was recently treated at osh with levofloxacin for e coli uti that was resistant to levofloxacin. pt was placed on broad spectrum abx. # diabetes: pt did not require insulin. # hypertension: hold bp meds # legal guardian: (guardian) - telephone : has never met patient. as she did not have patient's records and had never met the patient, the patient was initially full code resulting in initial intubation. however, records obtained later revealed a signed dnr/dni. the patient was then made dnr/dni and was not reintubated after self-extubation medications on admission: ferrous sulfate 325 mg by mouth twice a day oxycontin sustained release 10 mg by mouth twice a day vit b12 1000 mcg intramuscular once a month lasix 20 mg by mouth daily multivitamin 1 tablet by mouth daily omeprazole 20 mg daily vitamin c 500 mg daily zinc sulfate 220 mg by mouth daily lactobacillus 1 tablet by mouth twice a day norvasc 10 mg daily aspirin 81 mg daily celexa 10 mg daily folic acid 1 mg daily oxycodone 5 mg by mouth every 4 hours when necessary pain tamulosin 0.4mg daily neurontin 100 mg by mouth 3 times a day zyprexa 2.5 mg daily at bedtime trazodone 25mg q6h prn aggitation discharge medications: n/a discharge disposition: expired discharge diagnosis: n/a discharge condition: n/a discharge instructions: n/a followup instructions: n/a md procedure: insertion of intercostal catheter for drainage continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube arterial catheterization diagnoses: pneumonia, organism unspecified acidosis anemia, unspecified unspecified pleural effusion urinary tract infection, site not specified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified septicemia severe sepsis acute respiratory failure other specified cardiac dysrhythmias septic shock pressure ulcer, lower back do not resuscitate status pressure ulcer, stage iv dementia, unspecified, without behavioral disturbance urinary obstruction, unspecified 

Answer: The patient is high likely exposed to