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: patient recorded as having no known allergies to drugs attending: chief complaint: low back pain major surgical or invasive procedure: : i&d of posterior spine wound infection with removal of hardware (t2-l3) and vac placement. : repeat i&d of spine wound infection with vac placement. : repeat i&d of spine wound infection with re-instrumentation of t3-l5 posterior spinal fusion and incisional vac placement. history of present illness: 81yom s/p t3-l3 fusion by dr. with t4/5 and l1 laminectomies, l2 laminotomy with allograft placed on for t5 and l1 fracture-dislocations after fall from roof, now with increased pain at lumbar spine. has had progressive pullout of screws at l2 and l3. denies fevers, but does have 3cm wound dehiscence at superior portion of wound, but no purulence seen. esr: 138. wbc 11. crp 300. based on symptoms and lab values, decision was made to perform i&d of wound. past medical history: pmh: gerd, htn, ankylosing spondylitis, hyperlipidemia. social history: currently at rehab. physical exam: elderly male, mild distress, pleasantly conversant. mildly ttp over lumbar spine. about 3cm area of wound dehiscence near superior end of incision, but no expressible purulence. good strength and sensation in ble. pertinent results: 01:15pm glucose-113* urea n-17 creat-0.7 sodium-134 potassium-4.9 chloride-96 total co2-28 anion gap-15 01:15pm crp-greater than 300 01:15pm wbc-11.7* rbc-3.38* hgb-9.0* hct-29.0* mcv-86 mch-26.7*# mchc-31.1 rdw-13.6 01:15pm neuts-75.9* lymphs-14.1* monos-5.6 eos-4.0 basos-0.4 01:15pm plt count-787*# 01:15pm sed rate-138* brief hospital course: admitted to the spine surgery service on from the er. seen by medicine consult service for preop eval. due to recent doe they suggested having a chest ct done. this was negative for a pulmonary embolism and he was ready for the or on . he underwent i&d with removal of hardware and vac placement on . he was extubated and transferred to the floor after a pacu stay. he had tachycardia despite ivf boluses on and was transferred to the ticu for closer monitoring. started on vanco/cipro/ceftazidime pending culture results. this was narrowed to vanco when cx's showed mrsa from or samples. no growth in blood or urine cx's. he had repeat i&d with vac placement on . he was transferred back to the ticu intubated after this surgery. he was extubated but required several transfusions due to high vac output. on he had repeat i&d with reinstrumention from t3-l5 posterior spine fusion hardware. he was transferred to the ticu postop and subsequently extubated and transferred to the floor on . he has now remained afebrile and his white count has normalized. he has slowly mobilized with pt/ot using his tlso brace when upright. his brace was adjusted by nopco. he was initially on teds/scds for dvt prophylaxis and started on subq heparin following his final surgery. his vanco dose has been titrated based upon trough levels and id recommended starting rifampin in combination with vanco on . he had a left arm picc placed on . his pain is controlled with po analgesia and he is tolerating a regular diet. he continued to have some serosanguinous drainage from his incision after the incisional vac dressing was removed on , but this is lessening and he is undergoing daily dressing changes. vac was replaced on to a 2cm portion near the inferior portion of the wound that is still with mild drainage. otherwise he is getting out of bed to the chair with his brace on and his labs are normalizing. he is ready for discharge to rehab. he will continue with vac therapy for now and wean to daily dsd as the wound heals. he will continue on iv and po abx for about 6 weeks and then likely continue with po suppressive abx for lifetime. medications on admission: nkda. meds: alubterol, lipitor, metoprolol, oxycodone, protonix, apap, colace, senna, mom, bisacodyl. discharge medications: 1. senna 8.6 mg tablet sig: one (1) tablet po hs (at bedtime) as needed for constipation. 2. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 3. lidocaine 5 %(700 mg/patch) adhesive patch, medicated sig: one (1) adhesive patch, medicated topical qd () as needed for pain. 4. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for fever/pain. 5. heparin (porcine) 5,000 unit/ml solution sig: 5000 (5000) units injection tid (3 times a day). 6. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 7. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. 8. simvastatin 40 mg tablet sig: two (2) tablet po daily (daily). 9. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 10. rifampin 300 mg capsule sig: one (1) capsule po q12h (every 12 hours): plan for 6-wk duration. 11. heparin flush (10 units/ml) 2 ml iv prn line flush picc, heparin dependent: flush with 10ml normal saline followed by heparin as above daily and prn per lumen. 12. vancomycin in dextrose 1 gram/200 ml piggyback sig: one (1) gm intravenous q 24h (every 24 hours): plan for 6-wk duration. 13. lab checks weekly lab checks while on antibiotics. cbc with diff, chem 8, lfts, esr, crp, vanco trough. fax results to clinic: (. discharge disposition: extended care facility: & rehab center - discharge diagnosis: infection of t3-l3 posterior spine fusion discharge condition: stable discharge instructions: you have undergone the following operation: irrigation and debridement with revision of posterior thoracolumbar fusion hardware for infection. immediately after the operation: - activity: you should not lift anything greater than 10 lbs for 2 weeks. you will be more comfortable if you do not sit or stand more than ~45 minutes without getting up and walking around. - rehabilitation/ physical therapy: o 2-3 times a day you should go for a walk for 15-30 minutes as part of your recovery. you can walk as much as you can tolerate. o limit any kind of lifting. - diet: eat a normal healthy diet. you may have some constipation after surgery. you have been given medication to help with this issue. - brace: you may have been given a brace. this brace is to be worn when you are upright (sitting/walking). you may take it off while lying in bed. - wound care: place a dry, sterile dressing daily until it has completely healed. if it is dry then you can leave the incision open to the air. once the incision is completely dry you may take a shower. do not soak the incision in a bath or pool. if the incision starts draining at anytime after surgery, do not get the incision wet. cover it with a sterile dressing. call the office. - you should resume taking your normal home medications. - you have also been given additional medications to control your pain. please allow 72 hours for refill of narcotic prescriptions, so please plan ahead. you can either have them mailed to your home or pick them up at the clinic located on 2. we are not allowed to call in or fax narcotic prescriptions (oxycontin, oxycodone, percocet) to your pharmacy. in addition, we are only allowed to write for pain medications for 90 days from the date of surgery. - follow up: o please call the office and make an appointment for 2 weeks after the day of your operation if this has not been done already. o at the 2-week visit we will check your incision, take baseline x-rays and answer any questions. we may at that time start physical therapy. o we will then see you at 6 weeks from the day of the operation and at that time release you to full activity. please call the office if you have a fever>101.5 degrees fahrenheit and/or drainage from your wound. physical therapy: tlso brace when upright. no heavy lifting. wbat ble. treatments frequency: daily dsd until there is no drainage from posterior spine incision. followup instructions: call to schedule a follow-up appt with dr. in about 10-14 days. call ( to schedule a follow-up appt with the infectious disease clinic in about 1-2 weeks. continue weekly lab checks with results faxed to clinic. procedure: venous catheterization, not elsewhere classified lumbar and lumbosacral fusion of the anterior column, posterior technique removal of implanted devices from bone, other bones local excision of lesion or tissue of bone, other bones nonexcisional debridement of wound, infection or burn open biopsy of soft tissue open biopsy of soft tissue biopsy of bone, other bones biopsy of bone, other bones refusion of dorsal and dorsolumbar spine, posterior column, posterior technique fusion or refusion of 9 or more vertebrae insertion of recombinant bone morphogenetic protein diagnoses: other iatrogenic hypotension esophageal reflux unspecified essential hypertension acute posthemorrhagic anemia unspecified septicemia unspecified osteomyelitis, other specified sites personal history of tobacco use sepsis other and unspecified hyperlipidemia surgical operation with implant of artificial internal device causing abnormal patient reaction, or later complication,without mention of misadventure at time of operation methicillin resistant staphylococcus aureus in conditions classified elsewhere and of unspecified site hypovolemia tachycardia, unspecified disruption of external operation (surgical) wound infection and inflammatory reaction due to other internal orthopedic device, implant, and graft essential thrombocythemia other mechanical complication of other internal orthopedic device, implant, and graft ankylosing spondylitis 

Answer: The patient is high likely exposed to