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: iv dye, iodine containing attending: chief complaint: abdominal pain. major surgical or invasive procedure: 1. exploratory laparotomy. 2. partial gastrectomy, left end discontinuity 3. sigmoid colectomy, left end discontinuity 4. application of open abdominal dressing 1. exploratory laparotomy. 2. completion antrectomy. 3. gastrojejunostomy. 4. creation of colostomy. 5. liver biopsy. 6. definitive closure of abdomen. left picc right picc history of present illness: 67 year old male presented to the ed today from his pcp's office after having 4 days of abdominal pain. pain started suddenly after having a bowel movement that required some straining. pain was intermittent over the past 4 days, worse with "gas moving through." + low grade fever to 100.8, + chills, + dysuria today. denies chest pain, shortness of breath, pneumaturia, diarrhea, or constipation. ct abdomen obtained as an outpatient that shows free intraperitoneal air and a diverticular abscess. past medical history: pmh gerd, barrett's esophagus, hiatal hernia, bph, migraines, depression, anxiety. past surgical history: umbilical hernia repair with mesh. social history: 60 pack year history of tobacco use, quit 7 yrs ago. denies any etoh or drug use. family history: father with emphysema. physical exam: 98.7 63 140/82 18 99% ra a&o x 3, nad perrl, eomi, anicteric rrr ctab abdomen soft, distended, tender to palpation in llq and suprapubically. + rebound and voluntary guarding. active bowel sounds. le warm, no edema rectal: no gross blood pertinent results: 06:00pm wbc-15.2* rbc-3.64* hgb-10.9* hct-31.0* mcv-85 mch-30.0 mchc-35.2* rdw-13.1 06:00pm neuts-82.3* lymphs-12.5* monos-3.9 eos-1.0 basos-0.3 06:00pm plt count-250 06:00pm pt-12.7 ptt-23.6 inr(pt)-1.1 06:00pm alt(sgpt)-92* ast(sgot)-66* alk phos-194* tot bili-1.4 06:00pm lipase-31 06:00pm glucose-103* urea n-11 creat-1.1 sodium-137 potassium-4.7 chloride-101 total co2-23 anion gap-18 06:29pm lactate-1.9 ct abdomen/pelvis from outside hospital showed: free intra-abdominal air in upper abdomen. sigmoid diverticulitis. tte : mildly dilated right ventricle with normal global and regional biventricular systolic function. mild mitral regurgitation ct abd/pelvis : 1. bibasilar consolidation containing air bronchograms concerning for infection. 2. small-to-moderate bilateral pleural effusions. 3. esophageal distention and gastric distention likely due to positioning of the tip of the ng tube within the jejunal limb of the gastrojejunostomy. ng tube could be withdrawn by approximately 6 cm to achieve gastric positioning. 4. status post sigmoidectomy with left end colostomy and hartmann's pouch. free fluid within the peritoneal cavity, but no fluid collections or findings concerning for abscess. ct chest/abd/pelvis : 1. possible partial or complete obstruction of the gastrojejunostomy with oral contrast within the stomach and going up to the thoracic inlet within the esophagus. suctioning of the ng tube is recommended to prevent aspiration of the oral contrast. 2. bilateral ground-glass opacities likely represent sequelae of aspiration, although pneumonia cannot be excluded. 3. air within the bladder is likely secondary to foley catheter. ugi : free passage of contrast from the distal esophagus into the proximal small bowel. no stenosis, obstruction or leak. kub : normal bowel gas pattern. no contrast in stomach. contrast seen in ascending colon. 3:20 pm blood culture #1. blood culture, routine (final ): no growth. 3:20 pm blood culture #2. blood culture, routine (final ): staph aureus coag +. consultations with id are recommended for all blood cultures positive for staphylococcus aureus and species. oxacillin resistant staphylococci must be reported as also resistant to other penicillins, cephalosporins, carbacephems, carbapenems, and beta-lactamase inhibitor combinations. rifampin should not be used alone for therapy. this isolate is presumed to be resistant to clindamycin based on the detection of inducible resistance . final sensitivities. viridans streptococci. isolated from one set only. staphylococcus, coagulase negative. isolated from one set only sensitivities performed on request.. sensitivities: mic expressed in mcg/ml _________________________________________________________ staph aureus coag + | clindamycin----------- r erythromycin---------- =>8 r gentamicin------------ <=0.5 s levofloxacin---------- =>8 r oxacillin------------- =>4 r rifampin-------------- <=0.5 s tetracycline---------- <=1 s trimethoprim/sulfa---- <=0.5 s vancomycin------------ 1 s aerobic bottle gram stain (final ): reported by phone to 1pm. gram positive cocci in clusters. anaerobic bottle gram stain (final ): reported by phone to 2:35pm. gram positive cocci in clusters. gram positive cocci in short chains. brief hospital course: on , the patient was started on piperacillin-tazobactam and metronidazole and transferred emergently to the operating theatre for perforated viscus, given peritoneal signs and significant free intra-abdominal air. intra-operatively, the patient sustained two brief episodes of asystole so the stomach and colon were left in discontinuity and the abdomen remained open for a staged operation. post-operatively, he was admitted to the sicu on acute care surgery and resuscitated. cardiology was consulted, and his episodes of asystole were assessed as severe bradycardia secondary to vagal stimulation during manipulation of the viscera. troponins were normal, showing no signs of myocardial ischemia. ecg showed sinus bradycardia without acute changes. on , the patient remained stable and returned to the operating theatre for completion antrectomy, gastrojejunostomy, end colostomy, and abdominal closure, thus restoring alimentary tract continuity. he was extubated, and on , he was started on tube feeds through an ngt placed distal to the gastrojejunal anastomosis. he remained stable in the sicu so on he was transferred to the floor. unfortunately he went back to the icu on as he had a series of problems which culminated with rigors and a temperature of 101.1, desaturation to 77% on 5lnc and a chest ct consistent with aspiration. issues leading up to it were rapid afib, a distended abdomen, intolerant of tube feedings and some brief vtach. he recovered nicely and the only positive culture was a urine culture with enterococcus. his atrial fibrillation was short lived and he then continued on lopressor. following transfer to the surgical floor he continued to make slow, steady progress. from a cardiovascular standpoint he had no other problems during his recovery. his betablocker was resumed initially iv then orally and his blood pressure was in the 100-125/70 range with a heart rate in the 60's. his bowel function was very slow to return presumed secondary to edema around the anastomosis. in the interim he received both enteral feedings and eventually hyperalimentation when his post pyloric feeding tube came out. bowel rest continued for about 2 weeks. his surgical wound was healing well and his ostomy was pink and in time began to function. he underwent frequent clamping trials with his nasogastric tube, initially failing but in time successful. following an upper gi with follow up serial kub's contrast was demonstrated in both the small and large bowel. he gradually was started on liquids and over 48 hours was advanced to regular without any nausea or vomiting. he developed a high fever again on with an elevated wbc of 19k. he had 2 sets of blood cultures drawn and his picc line was removed. one of two blood cultures was positive for coag positive staph aureus, strep viridans and coag negative staph. he was placed on iv vancomycin and improved within 24 hours. another picc line was placed so that tpn could continue however in the interim his gi tract opened up and his diet was advanced. his tpn stopped on . he was evaluated by the infectious disease service and they recommended a 4 week course of iv vancomycin with weekly folow up of his renal function and cbc. his current dose of vancomycin is 1 gm every 8 hours and his last trough was 18.9 on . he will continue on that dose until and will have home iv therapy service for assistance. the physical therapy and occupational therapy service followed him daily and as he progress he was independent and getting stronger. the ostomy nurse was by on multiple occasions to instruct him in ostomy care but he will still need some assistance from the at discharge. after a long recovery he was discharged to home on able to tolerate a regular diet and with daily ostomy output. medications on admission: propranolol 120', sertraline 75', ritalin 10", uroxatrol 10', omeprazole 20", fish oil, vit c, asa 81' . discharge medications: 1. sertraline 25 mg tablet sig: three (3) tablet po daily (daily). 2. tamsulosin 0.4 mg capsule, sust. release 24 hr sig: one (1) capsule, sust. release 24 hr po hs (at bedtime). 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 4. trazodone 100 mg tablet sig: one (1) tablet po hs (at bedtime). 5. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid (2 times a day). disp:*30 tablet(s)* refills:*2* 6. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po bid (2 times a day). 7. vancomycin in d5w 1 gram/200 ml piggyback sig: one (1) gram intravenous q 8h (every 8 hours): thru . disp:*60 gram* refills:*0* discharge disposition: home with service facility: all care of greater discharge diagnosis: perforated viscus gastric necrosis open abdomen sigmoid diverticulitis staph bacteremia atrial fibrillation pneumonia uti discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: please call your doctor or nurse practitioner or return to the emergency department for any of the following: *you experience new chest pain, pressure, squeezing or tightness. *new or worsening cough, shortness of breath, or wheeze. *if you are vomiting and cannot keep down fluids or your medications. *you are getting dehydrated due to continued vomiting, diarrhea, or other reasons. signs of dehydration include dry mouth, rapid heartbeat, or feeling dizzy or faint when standing. *you experience burning when you urinate, have blood in your urine, or experience a discharge. *you have shaking chills, or fever greater than 101.5 degrees fahrenheit or 38 degrees celsius. *any change in your symptoms, or any new symptoms that concern you. please resume all regular home medications except inderal also, please take any new medications as prescribed. please get plenty of rest, continue to ambulate several times per day, and drink adequate amounts of fluids. avoid lifting weights greater than lbs until you follow-up with your surgeon. incision care: *please call your doctor or nurse practitioner if you have increased pain, swelling, redness, or drainage from the incision site. *you may shower, and wash surgical incisions with a mild soap and warm water. gently pat the area dry. picc line: *this line will be used for completion of iv vancomycin therapy thru . *please monitor the site regularly, and your md, nurse practitioner, or nurse if you notice redness, swelling, tenderness or pain, drainage or bleeding at the insertion site. * your md to the emergency room immediately if the picc line tubing becomes damaged or punctured, or if the line is pulled out partially or completely. do not use the picc line in these circumstances.please keep the dressing clean and dry. contact your nurse if the dressing comes undone or is significantly soiled for further instructions. monitoring ostomy output/prevention of dehydration: *keep well hydrated. *replace fluid loss from ostomy daily. *avoid only drinking plain water. include gatorade and/or other vitamin drinks to replace fluid. *try to maintain ostomy output between 1000ml to 1500ml per day. followup instructions: call the acute care clinic at for a follow up appointment in weeks. call dr. for a follow up appointment in weeks. provider: , .d. infectious disease clinic phone: date/time: 1:30 provider: , md phone: date/time: 10:30 md procedure: venous catheterization, not elsewhere classified parenteral infusion of concentrated nutritional substances other endoscopy of small intestine enteral infusion of concentrated nutritional substances arterial catheterization colostomy, not otherwise specified partial gastrectomy with anastomosis to jejunum open and other sigmoidectomy delayed closure of granulating abdominal wound open biopsy of liver open and other partial gastrectomy central venous catheter placement with guidance diagnoses: pneumonia, organism unspecified esophageal reflux urinary tract infection, site not specified unspecified protein-calorie malnutrition atrial fibrillation hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) diaphragmatic hernia without mention of obstruction or gangrene dysthymic disorder other specified cardiac dysrhythmias bacteremia methicillin susceptible staphylococcus aureus in conditions classified elsewhere and of unspecified site unspecified disorder of skin and subcutaneous tissue streptococcus infection in conditions classified elsewhere and of unspecified site, streptococcus, group d [enterococcus] streptococcus infection in conditions classified elsewhere and of unspecified site, other streptococcus staphylococcus infection in conditions classified elsewhere and of unspecified site, other staphylococcus other specified disorders of stomach and duodenum migraine, unspecified, without mention of intractable migraine without mention of status migrainosus other abnormal blood chemistry barrett's esophagus diverticulitis of colon (without mention of hemorrhage) accidental cut, puncture, perforation or hemorrhage during surgical operation other ill-defined conditions abscess of intestine 

Answer: The patient is high likely exposed to