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: heparin agents / succinylcholine attending: chief complaint: chief complaint:initially presented to osh ( ) with generalized weakness and chest pain after hd. micu admit for:osh transfer for respiratory distress major surgical or invasive procedure: picc line placement. history of present illness: 79f with complicated pmh including esrd on hd 3x/week, cad, dm, h/o c. diff. of note pt was hospitalized at last in with complicated icu course with multiple severe infections (including pseudomonas vap, cmv viremia and vre bactermia), respiratory failure requiring intubation and eventual tracheostomy and peg placement. pt was formerly a resident of nh, presented from there after hd to st. hospital with complaint of 1 week of generalized weakness and 1 day of chest pain. at the osh she was dound to be in af with rvr. ruled out for mi with serial enzymes. was found to have a uti which was treated initially with renally dosed levaquin. on cxr had evolving lll infiltrate with pleural effusion. per their records she had recently completed a course of bactrim for an abdominal cellulitis/rash and had been completing a course of vancomycin for a mrsa infection at her hd catheter site. she was treated with flagyl prophylactically while on other abx given hx of c. diff. had 1/4 bottles blood cultures + for gpcs, given linezolid x 1 d until cx resulted cns, considered contaminant. was started on zosyn for lll infiltrate. urine cultures resulted as e. coli resistant to levaquin and zosyn, sensitive to 3rd gen cephalosporins. pulmonary service consulted, recommended continuing flagyl, discontinuing levaquin and zosyn and starting ceftriaxone. on while at hd pt had an episode of bradycardia and hypotension, after which her digoxin was held and metoprolol dose was decreased. her pna coverage was broadened to imipenem to cover for pseudomonas in setting of worsening cxr. in early am of pt had acute respiratory distress with desat to 30-50%, was suctioned, placed transiently on bipap (which she did not tolerate), cxr showed interval l lung whiteout. bronch was offered but refused by the family, pt remained firmly dni. on repeat suctioning, large mucous plug extracted and pt recoved with 02 sats ~100% on nrb. pt's family requested tx to for continued care. . on arrival to icu pt appeared comfortable, vss, sating well on nc. denied pain, stated she was not sob and that her breathing was back to baseline. son stated that she would occasionally have substernal cp during dialysis that radiated to her back. currently denies cp. past medical history: -hypertension -hyperlipidemia -cad - s/p mi , s/p stents x 3 @ , nl ef in -hypothyroid -ra -gout -esrd -anemia ckd - on epo -dm2 - on insulin -asthma - not on home o2 -pseudocholinesterase insufficiency -h/o hitt ( ) -h/o hemoptysis on heparin ( ) -h/o ugib on heparin ( ) -h/o respiratory failure with pseudomonas vap, vre bactermia and cmv viremia, necessitating trach and peg, both subsequently removed social history: lived in nh. sons live close by are joint hcps. /etoh/drugs. portugese speaking. family history: non contributory physical exam: vitals: t: 95.6 bp: 118/52 p:87 r: 21 sao2: 96% 3l nc general: awake, responding to commands and questions, appears comfortable. heent: alopecia. mm dry neck: supple, thick, no jvp appreciated, healed trach site pulmonary: decreased l base. cardiac: rr, nl s1 s2, no murmurs, rubs or gallops appreciated abdomen: soft, nt, nd, normoactive bowel sounds, no masses or organomegaly noted. several small healing erythematous scabs. well healed peg site. extremities: trace non-pitting edema b/l skin: no rashes or lesions noted. neurologic: alert, oriented to , cannot say name of place but "i know i have been here before.", moving all extremities, no facial asymmetry, responds to questions through translator. pertinent results: cbc: wbc-9.3 rbc-4.41 hgb-11.5* hct-35.8* plt ct-191 . chemistry: glucose-94 urean-12 creat-2.0 na-136 k-4.1 cl-101 hco3-27 angap-12 calcium-8.5 phos-3.0 mg-1.9 . vanc level: vanco-2.2* cxr: : since prior study, there has been no relevant change in bilateral left greater than right effusions as well as retrocardiac opacity. the right picc and dialysis catheter are in unchanged positions. there is no pulmonary edema. . cxr: : as compared to the previous radiograph, there is no relevant change. the position of the left-sided central venous access line is unchanged. also unchanged is the size of the cardiac silhouette and the left-sided parenchymal consolidation with air bronchograms. there is no evidence of newly occurred focal parenchymal opacities brief hospital course: 1. lll pneumonia: at , she was briefly observed in the icu, where she did well and was transferred to the floor 24 hours later. she had no oxygen requirement, although repeat chest imaging did demonstrate a left retrocardiac opacity. repeated sputum cultures were unrevealing, and blood cultures all remained negative. she essentially completed 7 days of various antimicrobial agents for pneumonia coverage. 2. e. coli lower uti: she was placed on meropenem to cover for her resistant e. coli uti (esbl qualities, although still noted as sensitive to third generation cephalosporins), and will complete a 7-day course of therapy (last day on ). 3. history of c. difficile colitis: flagyl po was continued, with the plan to continue therapy at least 7 days beyond completion of the above meropenem course given her history of c. difficile colitis. 4. possible recent line infection: she was continued on vancomycin for a period of time, discontinued on given no clear evidence of mrsa infection. repeated blood cultures remained negative. 5. esrd on hd: she was followed by the renal service during her hospitalization, and underwent dialysis three times weekly (tu/th/sat). 6. atrial fibrillation: rate controlled with beta blockade therapy, which was titrated. digoxin was not restarted. we will defer the decision to initiate anticoagulation to you, since her outside physicians elected not to start it, and i see in her records that she has a prior history of gi bleeding. her other problems remains relatively stable in the hospital. medications: meropenem was continued with a plan for a 7 day course. flagyl was started as patient on multiple antibiotics and having some diarrhea. flagyl course for ten days. metoprolol 25 mg . can be titrated up to heart rate of 65 as long as pressure tolerates. medications on admission: (on transfer) guaifenesin iss/glargine 10 ipratropium nebs albuterol nebs levothyroxine 125mcg daily loratadine 10mg daily metoprolol 25mg metronidazole 500mg iv tid paroxetine 20mg daily senna sevelamer 800mg tidac imipenem/cilastatin 250mg q12 mucomyst nebs asa 81mg daily dulcolax docusate duloxetine 30mg qhs lorazepam 0.5mg q6 esomeprazole 40mg daily . (meds at nh) digoxin 0.125mg q 48 colace duloxetine lantus/novolog ss albuterol lactulose levothyroxine ativan metoprolol warfarin sevelamer senna bisacodyl ipratropium oxycodone prevacid acetylcysteine paxil nepro loratadine bactrim discharge medications: 1. bisacodyl 5 mg tablet, delayed release (e.c.) : two (2) tablet, delayed release (e.c.) po daily (daily) as needed. 2. senna 8.6 mg tablet : one (1) tablet po bid (2 times a day) as needed. 3. docusate sodium 50 mg/5 ml liquid : one (1) po bid (2 times a day). 4. ipratropium bromide 0.02 % solution : one (1) inhalation q6h (every 6 hours). 5. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization : one (1) inhalation q2h (every 2 hours) as needed for sob, wheeze. 6. levothyroxine 125 mcg tablet : one (1) tablet po daily (daily). 7. fexofenadine 60 mg tablet : one (1) tablet po bid (2 times a day). 8. sevelamer hcl 800 mg tablet : one (1) tablet po tid w/meals (3 times a day with meals). 9. aspirin 81 mg tablet, chewable : one (1) tablet, chewable po daily (daily). 10. acetaminophen 500 mg tablet : one (1) tablet po q6h (every 6 hours) as needed. 11. duloxetine 30 mg capsule, delayed release(e.c.) : one (1) capsule, delayed release(e.c.) po qhs (once a day (at bedtime)). 12. pantoprazole 40 mg tablet, delayed release (e.c.) : one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 13. metronidazole 500 mg tablet : one (1) tablet po tid (3 times a day) for 14 days: to be completed on . 14. meropenem 500 mg recon soln : one (1) intravenous every twelve (12) hours for 4 days: for 7 day course to be completed on . 15. metoprolol tartrate 25 mg tablet : one (1) tablet po bid (2 times a day). discharge disposition: extended care facility: greater health center discharge diagnosis: urinary tract infection pneumonia atrial fibrillation end-stage renal disease on hemodialysis history of c. difficile colitis discharge condition: stable discharge instructions: you were admitted to st. hospital for weakness and chest pain on dialysis. you were found to have a rapid and irregular heart beat. medication was given to slow your heart down. you were also found to have a urinary tract infection as well as a pneumonia (infection of the lung). you were started on antibiotics for these infections. your lungs were suctioned and a large mucous plug was removed. you were then transfered to . . at you were intially admitted to the intensive care unit. you did well and were able to be transfered to a general medical floor. your shortness of breath improved and your chest pain resolved. a picc line was placed for your antibiotics. . medications: meropenum iv. the rest of your home medications were continued. followup instructions: with pcp md procedure: venous catheterization, not elsewhere classified hemodialysis diagnoses: pneumonia, organism unspecified anemia in chronic kidney disease end stage renal disease coronary atherosclerosis of native coronary artery esophageal reflux urinary tract infection, site not specified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified acquired hypothyroidism atrial fibrillation asthma, unspecified type, unspecified percutaneous transluminal coronary angioplasty status hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease long-term (current) use of insulin intestinal infection due to clostridium difficile old myocardial infarction rheumatoid arthritis foreign body in respiratory tree, unspecified inhalation and ingestion of other object causing obstruction of respiratory tract or suffocation infection with drug-resistant microorganisms, unspecified, with multiple drug resistance other specified diseases of blood and blood-forming organs 

Answer: The patient is high likely exposed to