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: vancomycin / rifampin attending: chief complaint: fever, malaise. major surgical or invasive procedure: none history of present illness: mr. is a 71 year old male nursing home resident with a history of c6 fracture, recent admission for urosepsis, vre infection, mrsa wound infection, dvts, pulmonary embolus, urinary retention with chronic indwelling foley, cad s/p cabg, diastolic chf, diabetes, and hypertension. taken to ed from nursing home after one day history of fever, lethargy--noted at nh to be hypoxic with o2 sat 87 on room air. on presentation to , pt febrile to 102, hr 100-110, bp in low 90's, rr 22 with o2 sat 92-95 on 4l nc. initial abg 7.48/31/77, lactate 2.1. given 1 l fluid bolus with brief normalization of pressure but then sbp to 90's again. lactate 3.4, cbc revealed wbc of 24.3 with 8 bands. pt given 1 g cefepime, rebolused with fluids, and received central line. started on levophed. subsequent lactate to 1.5. repeat wbc 18.1 with no bands. repeat abg 7.37/39/100. pt transferred to micu for further managmement. . of note, the patient had an admission for uti with sepsis: mr. was started empirically on linezolid, ceftazidime, and flagly based on his history of multi drug resistant infections and urine culture grew pseudomonas and e. coli which was only intermediately susceptible to ceftazidime. he was started on meropenem with satisfactory result. past medical history: 1. mdr e. coli and pseudomonal catheter associated sepsis/uti 2. acute renal failure. 3. urinary retention. 4. meatal tear. 5. traumatic comminuted c7 verterbral fracture 6. orif/laminectomy/instrumentation/posterior fusion 7. csf leak - wound infection s/p drainage and dural repair 8. incision and drainage and hardware exchange 9. mrsa meningitis/mrsa pneumonia 10. diastolic heart failure. 11. non-st elevation myocardial infarction 12. coronary artery disease s/p cabg x 3 13. left occipital stroke vs mrsa cerebritis 14. pulmonary embolism/rle dvt - provoked 15. non-sustained ventricular tachycardia 16. hypersensitivity desquamative dermatitis (rifampin vs vancomycin) 17. bue paresis - mild, ble paresis l>r. 18. gi bleed. 19. nosocomial lll pneumonia 20. anemia - multifactorial: illness, blood loss, ckd. 21. stage iii sacral ulcer. 22. mrsa/vre colonization 23. candidemia 24. pseudomonal line sepsis. 25. diabetes mellitus type ii. 26. hypertension 27. hypercholesterolemia 28. l3-l4 fusion 29. bph 30. chronic kidney disease stage iii with proteinuria (baseline cr social history: former tobacco use - quit 25 years ago, quit alcohol 25 years ago. nursing home resident. married, wife is health care proxy. family history: nc physical exam: t 97.2 hr 100-105 bp 112/57 rr 20 o2 99-100 on 100% nrb gen: elderly male caucasian, sleepy but arousable. eyes: perrl, sclerae anicteric mouth: mmm, no lesions neck: supple, negative brudzynski, no bruits, neck veins flat chest: crackles at bases, no wheeze, fair air movement. cor: rr nl s1s2 no mrg abd: g-tube in place, flat, nt/nd. absent bowel sounds. ext: warm, distal pulses nl, r boot in place. pertinent results: 05:45pm blood wbc-24.3*# rbc-4.25* hgb-12.8*# hct-37.0* mcv-87 mch-30.0 mchc-34.5 rdw-18.6* plt ct-220 11:57am blood wbc-11.8* rbc-3.17* hgb-9.6* hct-28.1* mcv-89 mch-30.2 mchc-34.1 rdw-18.2* plt ct-132* 05:14am blood glucose-170* urean-74* creat-1.6* na-150* k-4.7 cl-119* hco3-24 angap-12 brief hospital course: pt was admitted to the medical icu for uti/sepsis with low bp and a ? of pneumonia. he is a 71 year old gentleman from nursing home with history of recent urosepsis, chronic foley, mrsa infections (pneumonia, meningitis), cad, dm ii, hypertension admitted for sepsis/septic shock likely secondary to pneumonia, urinary tract infection or both. id was consulted, and given his extensive nosocomial infection history, it was decided to empirically start the patient on meropenem and linezolid. pt hemodynamically improved on abx, with pressors rapidly weaned off. resp status improved quickly as well. his lactate, wbc are trended back to within normal limits. urine cultures returned as mdr e. coli sensitive to meropenem. . 1) septic shock: see also above. pt was maintained at cvp 8-12 using fluid boluses, map> 65, uop > 30. pt was weaned off pressors on hd#2. pt was eventually also weaned off nrb. pt was transfused at a hct below 28 as per must protocol (also history of cad). underlying cause was likely pneumonia vs. uti. sputum grew mdr e coli sensitive to meropenem as mentioned above. ucx from grew pseudomonas. sensitivities were pending on discharge. antibiotic selection was complicated by h/o mdr uti, mrsa, vre and vancomycin allergy. pt was started on meropenem and linezolid and should complete a 14 day course. 10 more days to be completed after discharge. pt was afebrile and hemodynamically stable on discharge. it is recommended to follow up on the sensitivities of pseudomonas growing from his urine cx. . 2) acute renal failure, cr 2.1 from 0.9 but quickly trending down to baseline again. thought to have been prerenal based on urine lytes, likely secondary to inadequate perfusion. renal function was stable on discharge. . 3) anemia, 9 point hct drop on admission. transfused for goal of 28 (sepsis, cad history). pt had stable hct above 30 on discharge. . 4) history of cad, s/p cab: pt was continued on asa, statin, fondaparinux. hct goal of 28 (initially 30) while ongoing sepsis. antihypertensives were held until patient was hemodynamically stable again. then pt was restarted on acei and bb. . 5) diastolic chf: was monitored with serial cxr. also on resp monitor while on fluids. held acei and beta-blocker until septic shock fully resolved. then restarted again after that. . 6) h/o dvt, pulmonary embolus: continued fondaparinux. . 7) dm ii: humalog sliding scale, tight control while infected. glargine 5u at bedtime. last fsbg were 210, 175, 125. . 8) sacral decubitus, doesnt appear to be likely source of infection. was monitored regularly. wound care was consulted. pt was continued on zinc and vitamin supplementations. pt also developed erythema and tenderness around both heels towards the end of his stay. continued wound care of these areas is recommended. . 9) hypernatremia: resolved after free water flushes via g-tube. natrium of 143 on discharge. . 10) pain control, chronic r leg pain (ulcers). continued gabapentin. also lidocaine patch locally. . 11) gu: pt known to have bph. pt was continued on finasteride. pt has chronically foley placed. ua showed 21-50 rbc. it is recommended to follow up with his urologist as an outpatient. a cystoscopy and possibly a suprapubic catheter are to be considered. . 12) fen, pt was kept on tube feeds. nutrition was consulted. pt was continued on zinc and vitamin supplementations. i/os were even on discharge. . 13) ppx: lansoprazole, fondaparinux, bowel regimen . 14) access: r ij (was d/c'ed on ), piv, picc placed on . 15) code: full medications on admission: 1. ursodiol 300 mg po bid. 2. gabapentin 200 mg daily. 3. folic acid 1 mg daily 4. aspirin 325 mg daily 5. ascorbic acid 90 mg/ml drops 500 mg daily. 6. zinc sulfate 220 mg daily 7. senna 8.6 mg po bid. 8. lidocaine 5 %(700 mg/patch) adhesive patch, daily 9. metoprolol tartrate 50 mg po bid. 10. fondaparinux 2.5 mg/0.5 ml subcutaneous daily 11. docusate sodium liquid 100 mg po bid 12. lisinopril 5 mg po hs. 13. bisacodyl 10 mg tablet, delayed release prn. 14. lansoprazole 30 mg daily 15. atorvastatin 10 mg daily 16. insulin sliding scale 17. finasteride 5 mg tablet daily 18. doxycycline hyclate 100 mg twice a day. discharge disposition: extended care facility: & rehab center - discharge diagnosis: primary diagnosis: 1. sepsis 2. e. coli pneumonia 3. pseudomonas uti secondary diagnosis: 1. cad 2. dmii 3. htn discharge condition: afebrile. hemodynamically stable. tolerating po. discharge instructions: please call your primary doctor or return to the ed with fever, chills, chest pain, shortness of breath or any other concerning symptoms. please take all your medications as directed. please keep you follow up appointments as below. followup instructions: please follow up with your primary care doctor (fine, h. ) in weeks from now. procedure: venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified enteral infusion of concentrated nutritional substances injection or infusion of oxazolidinone class of antibiotics diagnoses: coronary atherosclerosis of native coronary artery urinary tract infection, site not specified congestive heart failure, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified unspecified septicemia severe sepsis septic shock pneumonia due to escherichia coli [e. coli] pressure ulcer, lower back hyperosmolality and/or hypernatremia diastolic heart failure, unspecified pseudomonas infection in conditions classified elsewhere and of unspecified site 

Answer: The patient is high likely exposed to