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: history of present illness: patient is a 73 year old with a history of coronary artery disease status post cabg in and also a history of severe mitral regurgitation with atrial fibrillation, severe cardiomyopathy with ef of approximately 10%. patient was admitted to the medicine service on with congestive heart failure. despite medical care, patient made very little progress and subsequently was evaluated by cardiac surgery and underwent high risk mitral valve replacement operation on . past medical history: coronary artery disease, mitral regurgitation, atrial fibrillation, diabetes mellitus, congestive heart failure, chronic renal failure, anemia. physical examination: patient was noted on admission to be awake and appropriate neurologically with decreased breath sounds at bilateral bases to suggest some failure. patient was tachycardiac with irregular heart beat. abdomen was soft, nondistended, nontender, positive bowel sounds. extremities had no evidence of edema. hospital course: on patient underwent mitral valve repair with a porcine valve and tolerated the procedure well. the mitral replacement was a 29 mm porcine tissue heart valve through a right thoracotomy. postoperatively patient was transferred to the cardiac surgery recovery unit and required epinephrine drip, levophed drip, milrinone drip, propofol drip, insulin drip and intra-aortic balloon pump. with all these supports patient was able to have cardiac output of 5.8 and cardiac index of 3.3. given patient's low ejection fraction and poor risk for operation, patient's drips were turned down very slowly. intra-aortic balloon pump support was also turned down very slowly. nevertheless, on post-op day three patient's pressor drips, which included levophed, epinephrine, milrinone and intra-aortic balloon pump were all able to be turned off and the balloon pump was discontinued. without these supports patient's cardiac output was 4.9 with index of 2.77 on post-op day four. on post-op day six the pulmonary artery catheter was discontinued as well as the foley catheter. initial plan was to have eps place a pacer for her arrhythmia which was a/fib. on patient was suddenly hypotensive and severely acidotic which required her to go back on pressors which included levophed, neo-synephrine, propofol as well as dopamine. patient was also given multiple amps of bicarb to correct her acidosis. moreover, her renal failure acutely decompensated which, at one point, made her not only oliguric, but also anuric for a few hours. patient was quickly placed on broad spectrum antibiotics. given patient's history of a/fib, suspicion was made that perhaps patient had ischemic bowel or mesentery ischemia. general surgery was then consulted who agreed that patient was at high risk for mesenteric ischemia and given her clinical picture, this may, indeed, be the diagnosis. therefore, patient was taken to the operating room and underwent exploratory laparotomy which, unfortunately, did not show any signs of ischemic bowel or any other intra-abdominal pathology to explain her sudden decompensation. at this point the nephrology service was also consulted and they placed patient on cvvhd to help control her acidosis as well as her renal decompensation. two days later her culture returned gram negative rods in her blood, also gram negative rods in the sputum. eventually these gram negative rods turned out to be enterobacter which was sensitive to the antibiotics she was placed on. she was placed on zosyn, gentamicin and vancomycin. in the next day or so her clinical condition actually improved with her creatinine discomfort from as high as 3 to 1.7 and she was making an adequate amount of urine, up to 1700 cc per day. moreover her pressor drips were able to come down very slowly. on suddenly patient once again decompensated. her urine output decreased. moreover her acidosis returned and her white count suddenly increased again to the 30s. patient underwent ultrasound which revealed thickened gallbladder wall, pericholecystic fluid and sludge in the gallbladder, all of which could be explained from previous laparotomy as well as her septic physiology. however, given the fact that we had no obvious source of her bacteremia, general surgery made the decision to reexplore her in the operating room. on patient was taken back to the operating room of reexploration of her abdomen. intraoperatively once again there was no obvious pathology found, however, a cholecystostomy tube was placed given the fact that patient had the ultrasound which suggested that she may have cholecystitis and she does have evidence of stones. postoperatively, however, patient did not improve clinically and continued to require tremendous amounts of pressors which included dopamine at 10, levophed at 0.5, milrinone at 0.5, neo at 10, pitressin at 0.1. the next few days patient did not show any signs of improvement whatsoever. her extremities became more and more mottled secondary to the tremendous amount of pressor agents that she was on. despite adding fluconazole to her antibiotic regimen, patient did not improve. in fact, her blood pressure consistently dropped, requiring going up on the pressors. on epinephrine was added to her pressor agents. this, too, did not help her blood pressure. her blood pressure remained very tenuous in the high 70s systolic blood pressure. on, patient's family met with the attending, dr. , and discussed her poor prognosis. family agreed at that point to make patient dnr and agreed to no escalation of her treatment. on at 7:00 p.m. patient's vital signs began to drop and she expired at exactly 7:00 p.m. on . at this point the family was contact and was notified, specifically , patient's brother, was notified, who, unfortunately, did not agree to a post mortem autopsy. moreover the attending, dr. , was also notified. condition on discharge: patient expired. discharge status: patient expired. final diagnoses: 1. congestive heart failure with low ejection fraction. 2. sepsis. 3. multiple organ failure including lung, kidney, liver. 4. status post mitral valve replacement. 5. status post exploratory laparotomy times two. , m.d. dictated by: medquist36 procedure: angiocardiography of left heart structures left heart cardiac catheterization coronary arteriography using a single catheter exploratory laparotomy implant of pulsation balloon open and other replacement of mitral valve with tissue graft trocar cholecystostomy other repair of mesentery diagnoses: coronary atherosclerosis of native coronary artery mitral valve disorders congestive heart failure, unspecified accidental puncture or laceration during a procedure, not elsewhere classified other septicemia due to gram-negative organisms 

Answer: The patient is high likely exposed to