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: neurontin attending: chief complaint: left leg pain and non healing ulcers left foot. major surgical or invasive procedure: :serial arteriogram of left lower extremity. : left common femoral endarterectomy, left femoral to below-knee popliteal bypass graft using 8-mm propaten graft, ring. left first toe open amputation. : left transmetatarsal amputation. history of present illness: 57 yo male significant pvd, sp left sfa stent and right cfa pseudoaneurysm presented to clinic with increased left foot pain on . ultrasound at the time showed no flow through the stent. left toes and lateral and medial malleolar ulcers all appeared to have worsened since last visit so patient was admitted to the hospital for iv antibiotics, wound care and angiogram. past medical history: pvd, chronic diastolic chf with lvef >55% by tte , exercise mibi in with no reversible defects, ckd on hemodialysis, hypertension, type 2 diabetes, alcohol abuse, chronic anemia, prior left leg dvt (previously on warfarin), peripheral neuropathy requiring long-term percocet/oxycodone use. past surgical history: : lle angio, ak- stenting : i&d lle abscess : stsg to lle ulcers : rle angio showing sfa occlusion : r fem-ak bypass with ptfe : r second toe amp : left 2nd and 3rd toe debridements : lue av graft : lle angio, sfa stent, 2nd, 3rd toe amps : amp site debridement, vac : r heel debridement : r 4th toe amp social history: lives at home with girlfriend. retired. denies etoh consumption, and denies recreational drug use. family history: diabetes mellitus in both parents. physical exam: physical exam: alert and oriented x 3 vss neck: supple, no jvd, trach midline lungs: cta bilat abd: soft, no m/t/o ext: pulses: left femoral palp, dp dop ,pt dop right femoral palp, dp dop ,pt dop feet warm, well perfused. tma incisions:c/d/i wounds: lateral and medial malleolar ulcers clean, scant drainage. covered with acel dressing - this should not be removed until office follow up. pertinent results: other pertinent labs: 7:15 pm swab source: left lower extremity non-healing wound. **final report ** gram stain (final ): 1+ (<1 per 1000x field): polymorphonuclear leukocytes. no microorganisms seen. wound culture (final ): this culture contains mixed bacterial types (>=3) so an abbreviated workup is performed. any growth of p.aeruginosa, s.aureus and beta hemolytic streptococci will be reported. if these bacteria are not reported below, they are not present in this culture.. staph aureus coag +. rare growth. 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. staphylococcus species may develop resistance during prolonged therapy with quinolones. therefore, isolates that are initially susceptible may become resistant within three to four days after initiation of therapy. testing of repeat isolates may be warranted. sensitivities: mic expressed in mcg/ml _________________________________________________________ staph aureus coag + | clindamycin-----------<=0.25 s erythromycin---------- =>8 r gentamicin------------ <=0.5 s levofloxacin----------<=0.12 s oxacillin------------- =>4 r rifampin-------------- <=0.5 s tetracycline---------- <=1 s trimethoprim/sulfa---- <=0.5 s vancomycin------------ <=0.5 s anaerobic culture (final ): no anaerobes isolated. 05:31am blood wbc-4.9 rbc-3.03* hgb-8.8* hct-28.3* mcv-93 mch-28.9 mchc-31.0 rdw-14.8 plt ct-174 05:31am blood glucose-91 urean-28* creat-6.7* na-129* k-4.2 cl-92* hco3-26 angap-15 07:09am blood alt-5 ast-25 alkphos-53 totbili-0.3 05:31am blood calcium-8.7 phos-5.7* mg-2.0 10:55am blood vanco-15.6 brief hospital course: 57 yo male significant pvd, sp left sfa stent and right cfa pseudoaneurysm presented to clinic for routine followup on . ultrasound at the time showed no flow through the stent. left toes and lateral and medial malleolar ulcers all appeared to have worsened since last visit so patient was admitted to the hospital for iv antibiotics, wound care and angiogram. we were unable to cross the left sfa in-stent occlusion on so we proceeded to left femoral to posterior tibial bypass with left first toe amputation on . because of ongoing concerns for healing and infecton we needed to do a left tma on . he did well with his multiple procedures, worked with pt, tolerated a regular diet and ambulated minimally with assistance. 1.pad: mr. angiogram followed by fem-pt bypass. he had non healing gangrene of his toes and did ultimately undergo a left tma. he followed the bypass/tma pathway and progressed nicely during his stay. 2.arterial ulcerations: mr. was initialy treated with santyl and silvadine for his left ankle ulcerations. dr. ultimately placed an acel dressing, which will stay in place until follow up on thursday, . 3.esrd: he was continued on his home dyalisis schedule of tues/thurs/sat, and meds were renally dosed. he received vancomycin with hd during his hospitalization, and will continue to recieve it for 2 weeks at rehab. 4.id: his left toe wound grew mrsa and he was treated with iv vancomycin via hd protocol. although he had a tma, it was decided that he should continue antibiotics for 2 weeks post discharge. 5.dm: the patient was maintained on his home sliding scale. he also monitored his diet as he does at home. his blood sugars were well controlled. medications on admission: atorvastatin 80 mg daily, spiriva 18 mcg daily, humalog sc sliding scale, aspirin 81 mg daily, albuterol sulfate hfa 90 mcg inh qid prn sob, hydralazine 25 mg q6h, oxycodone 15 mg q4-6 hours prn peripheral neuropathy, amlodipine 5 mg daily, lac-hydrin 12 % lotion prn dry skin, calcium acetate 667 mg tid, cefazolin with hd, carvedilol 12.5' discharge medications: 1. amlodipine 5 mg tablet sig: one (1) tablet po daily (daily). 2. hydralazine 25 mg tablet sig: one (1) tablet po q6h (every 6 hours). 3. calcium acetate 667 mg capsule sig: one (1) capsule po tid w/meals (3 times a day with meals). 4. tiotropium bromide 18 mcg capsule, w/inhalation device sig: one (1) cap inhalation daily (daily). 5. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 6. carvedilol 6.25 mg tablet sig: one (1) tablet po bid (2 times a day). 7. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 8. hydromorphone 2 mg tablet sig: 1-2 tablets po q3h (every 3 hours) as needed for pain: pt is on standing oxycodone at home with pain contract from pcp. in the post op period. 9. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). 10. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) inhalation q6h (every 6 hours) as needed for asthma. 11. insulin:humalog breakfast lunch dinner bedtime 0-70 mg/dl proceed with hypoglycemia protocol 71-159 mg/dl 0 units 0 units 0 units 0 units 160-179 mg/dl 2 units 2 units 2 units 2 units 180-199 mg/dl 4 units 4 units 4 units 4 units 200-219 mg/dl 6 units 6 units 6 units 6 units 220-239 mg/dl 8 units 8 units 8 units 8 units 240-259 mg/dl 10 units 10 units 10 units 10 units 260-279 mg/dl 12 units 12 units 12 units 12 units 12. glucagon (human recombinant) 1 mg recon soln sig: one (1) recon soln injection q15min () as needed for hypoglycemia protocol. 13. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours). 14. docusate sodium 100 mg capsule sig: one (1) capsule po tid (3 times a day). 15. vancomycin 1,000 mg recon soln sig: one (1) intravenous per hd protocol for 2 weeks. 16. nephrocaps 1 mg capsule sig: one (1) cap po daily (daily). discharge disposition: extended care facility: - discharge diagnosis: left lower extremity ischemia with gangrene non healing arterial ulcers end stage renal disease discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: with assistance, l heel weight bearing discharge instructions: you were admitted to the hospital on with an infection in your left foot. we were unable to open the blockage in your artery with balloon angioplasty or stenting so we needed to do a bypass surgery on your left leg. after we improved the circulation with surgery, it was felt that the open areas would still not heal so we did a transmetatarsal amputation. we started you on a new medication, plavix. you have a special dressing on your left ankle. do not remove the dressing. it will be changed by dr. , only at your follow up appt. discharge instructions following transmetatarsal amputation this information is designed as a guideline to assist you in a speedy recovery from your surgery. please follow these guidelines unless your physician has specifically instructed you otherwise. please call our office nurse if you have any questions. dial 911 if you have any medical emergency. activity: there are restrictions on activity. on the side of your transmetatarsal amputation(left) you may bear weight on your heel only for 4-6 weeks. you should keep this amputation site elevated when ever possible. you may use the heel of your amputation site for transfer and pivots. do not put any pressure on the amputation site. exercise: limit strenuous activity for 6 weeks. no heavy lifting greater than 20 pounds for the next 14 days. try to keep leg elevated when able. bathing/showering: you may shower immediately upon coming home. no bathing. a dressing may cover you??????re amputation site and this should be left in place for three (3) days. remove it after this time and wash your incision(s) gently with soap and water. you will have sutures, which are usually removed in 4 weeks. this will be done by the surgeon on your follow-up appointment. wound care: avoid taking a tub bath, swimming, or soaking in a hot tub for four weeks after surgery. avoid pressure to your amputation site. followup instructions: department: vascular surgery when: thursday at 2:15 pm with: , md building: lm bldg () campus: west best parking: garage procedure: hemodialysis arteriography of femoral and other lower extremity arteries amputation of toe other (peripheral) vascular shunt or bypass amputation through foot endarterectomy, lower limb arteries procedure on single vessel diagnoses: anemia in chronic kidney disease end stage renal disease nephritis and nephropathy, not specified as acute or chronic, in diseases classified elsewhere tobacco use disorder unspecified viral hepatitis c without hepatic coma diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled polyneuropathy in diabetes hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease ulcer of other part of foot long-term (current) use of insulin other complications due to other vascular device, implant, and graft personal history of venous thrombosis and embolism methicillin resistant staphylococcus aureus in conditions classified elsewhere and of unspecified site atherosclerosis of native arteries of the extremities with gangrene examination of participant in clinical trial diabetes with renal manifestations, type ii or unspecified type, not stated as uncontrolled ulcer of ankle 

Answer: The patient is high likely exposed to