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: esrd major surgical or invasive procedure: living non-related renal transplant history of present illness: 44 year old woman who developed type 1 dm at age 27 (no family history of dm) and now has ckd stage 4, egfr 16 ml/min. a kidney biopy on showed advanced diabetic nephropathy with nodular glomerulosclerosis. she completed transplant evaluation and presented for living non-related renal transplant from her husband. past medical history: pmh: hypertension and hyperlipidemia. she denies any cardiac history of mi or arrhythmia. she has no history of pulmonary complaints. she denies any significant urinary tract infections, hematuria or kidney stones. psh: imn in the left tibia due to a combined tibia-fibula fracture seven years ago. social history: married physical exam: see preop note pertinent results: 04:45pm blood wbc-6.3 rbc-3.02* hgb-9.7* hct-29.6* mcv-98 mch-32.0 mchc-32.7 rdw-13.9 plt ct-249 06:40am blood wbc-14.7* rbc-3.45* hgb-11.2* hct-33.7* mcv-98 mch-32.5* mchc-33.3 rdw-14.2 plt ct-251 05:42am blood pt-11.7 ptt-23.6* inr(pt)-1.1 04:45pm blood glucose-154* urean-89* creat-2.4* na-140 k-3.7 cl-110* hco3-18* angap-16 06:40am blood glucose-161* urean-26* creat-1.3* na-137 k-3.5 cl-106 hco3-17* angap-18 01:34am blood alt-22 ast-25 alkphos-60 totbili-0.5 06:40am blood calcium-8.1* phos-2.6* mg-1.6 09:10am blood hcg-<5 06:40am blood tacrofk-10.3 brief hospital course: on , she underwent living non-related renal transplant from husband. a 6- double j stent was inserted into the renal pelvis. surgeon was dr. . please refer to operative note for details. urine output was excellent. iv fluid replacements were given. induction immunosuppression was administered (atg, solumedrol and cellcept). creatinine decreased to 1.1 on postop day one. urine output was 10 liters for the day. she experienced a lot of nausea. iv zofran was given with only minimal relief. iv phenergan was given. she received a 2nd dose of atg (75mg). during this infusion she became febrile to 101.7. blood and urine cultures were done. temperature increased to 102.6. she was pan-cultured again and a portable cxr was unremarkable. urine output decreased significantly. iv fluid boluses and albumin were given. renal duplex was done and showed patent vessels. a small perinephric collection was noted.foley was irrigated without increase in urine output. given persistent decrease in urine output and development of tachycardia with low blood pressure, she was transferred to the sicu for management. hct was stable. tte was done and was normal. she continued to receive aggressive iv fluid replacement with response of increased urine. atg (3rd dose)was held. lopressor was given for tachycardia. on , repeat cxr demonstrated bibasilar opacities compatible with consolidation and/or atelectasis. slight increase in pulmonary vascular congestion. non-contrast abdominal ct was done on after blood cultures were noted to be positive. bilateral pneumonia, left worse than right, compatible with aspiration pneumonia, no collection or infectious process was noted within the abdomen and pelvis, or evidence of bowel injury. once stable, she transferred out of the sicu. urine output greater than a liter per day. blood cultures from isolated pseudomonas aeruginosa (pan-sensitive)on . iv vancomycin was started on . wbc was up to 17 on . vancomycin was switched to cefepime on per id. a 2 week course of cefepime was recommended. a left arm midline was placed on for iv antibiotics. she remained afebrile. bp was elevated. lopressor was continued. weight was up to 74.7 kg from admission weight of 61 kg. lasix was given with excellent diuresis. weight decreased to 70 kg. creatinine was done to 1.3. urine output averaged 2700 with lasix. diet was advanced and tolerated. she passed stool. was involved and adjusted insulin for hyperglycemia. abdominal incision was intact with staples and no redness/drainage. she was ambulating independently on postop day 6. immunosuppression consisted of cellcept which was well tolerated, and prograf which was adjusted to 2mg per trough levels of 10.3. steroid taper was complete. of note, she was never given 3rd dose of atg. she felt well enough to go home on and was discharged on lasix 20mg daily as weight was still up 10kg from baseline. lopressor was switched to home dose of amlodipine. she will have labs on . medications on admission: amlodipine, vitamin d2, furosemide, lantus, humalog, lisinopril, lorazepam, omeprazole and calcium carbonate. discharge medications: 1. furosemide 20 mg po qd rx *furosemide 40 mg 1 tablet(s) by mouth twice a day disp #*14 tablet refills:*0 2. acetaminophen 650 mg po q6h:prn pain/pre med atg 3. cefepime 2 g iv q12h rx *cefepime 2 gram give via picc every twelve (12) hours disp #*19 not specified refills:*0 4. docusate sodium 100 mg po bid 5. nystatin oral suspension 5 ml po qid swish and swallow 6. omeprazole 20 mg po daily 7. oxycodone (immediate release) 5 mg po q4h:prn pain rx *oxycodone 5 mg 1 tablet(s) by mouth every four (4) hours disp #*40 tablet refills:*0 8. sulfameth/trimethoprim ss 1 tab po daily 9. tacrolimus 2 mg po q12h 10. valganciclovir 900 mg po q24h start 11. atorvastatin 20 mg po daily 12. vitamin d 50,000 unit po 1x/week () 13. mycophenolate mofetil 1000 mg po bid 14. lorazepam 0.5 mg po hs:prn anxiety do not take at same time as oxycodone 15. amlodipine 5 mg po daily 16. glargine 24 units bedtime insulin sc sliding scale using hum insulin discharge disposition: home with service facility: critical care systems discharge diagnosis: esrd dm htn pseudomonas bacteremia pneumonia discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: please call the transplant office at if you have any of the following; temperature of 101 or greater, chills, nausea, vomiting, inability to take any of your medication, increased abdominal pain, incision redness/bleeding/drainage, decreased urine output, edema, dizziness/thirst or constipation/diarrhea -keep picc line clean and dry -you may shower is you keep picc line dry. no swimming or tub baths -you will need to have blood drawn on mondays and thursday for lab monitoring -no driving while taking pain medication -weigh yourself every day critical care will supply antibiotic and iv/picc line supplies will assist you with caring for the picc/cefepime administration followup instructions: please schedule a follow up appointment with your pcp, . provider: , md phone: date/time: 8:45 provider: , transplant social work date/time: 10:30 provider: , md phone: date/time: 11:00 procedure: venous catheterization, not elsewhere classified other kidney transplantation transplant from live non-related donor diagnoses: pneumonia, organism unspecified end stage renal disease tobacco use disorder acute kidney failure, unspecified sepsis hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease other and unspecified hyperlipidemia anxiety state, unspecified long-term (current) use of insulin nausea alone diabetes with renal manifestations, type i [juvenile type], not stated as uncontrolled insomnia, unspecified septicemia due to pseudomonas 

Answer: The patient is high likely exposed to