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: meropenem / penicillins attending: chief complaint: c2 fracture dislocation with progressive collapse major surgical or invasive procedure: 1. open reduction internal fixation c2 fracture/dislocation. 2. posterior instrumentation c1 to c2 and c2 to c5. 3. posterior arthrodesis c1 to c5. 4. left iliac crest bone graft. history of present illness: mr. is a 83 yo man with mmp including esrd on hd, cad s/p mi, afib not on anticoagulation, gibs, copd and restrictive lung disease, cvas, nephrolithiasis with stent and nephrostomy tube, who was admitted in for c2 dens fracture after falling off wheechair, failed conservative medical treatment, admitted on to ortho service for surgical management. past medical history: - esrd on hd tuesday/thursday/saturday - atrial fibrillation, not on anticoagulation - h/o gi bleeds, diverticulitis - c. diff colitis - h/o cvas (two, with residual right-sided weakness) - h/o nephrolithiasis w/ stent and nephrostomy tube - cad s/p mi - sleep apnea (not on cpap) - depression - pft's with mild restrictive ventilatory defect - anemia with h/o iron deficiency - recent fall with c2 dens fracture with anterior displacement () - numerous line infections, most recently mrsa which was treated with vancomycin until (also with mrsa , esbl e. coli , , , and ) - delirium during hospital admissions - copd and restrictive lung disease - common bile duct stone s/p stenting - urinary tract infections, including vre and klebsiella, with urosepsis social history: patient recently has been at rehabilitation since fall and c2 fracture. lives with wife , daughter lives downstairs, h/o smoking ppd for 50 years, quit 20 years ago, occasional beer, none recently, no drugs. family history: non-contributory. physical exam: physical exam on discharge: vs: t 97 hr 80 bp 98/62 rr 20 sao2: 95% ra ga: alert and oriented, lying in bed, nad heent: mmm. no lad. no jvd. neck in brace. cards: soft heart sounds. rrr. s1/s2. no m/g/r. pulm: moving air appropriately, bibasilar crackles abd: soft, nt, +bs. no g/rt. extremities: wwp, no edema. dps 2+ skin: sacral region with staples and dressing, c/d/i, posterior neck with dressing. neuro/psych: a&o x 3. cn ii-xii intact. 4/5 strength in u/l extremities. sensation intact to lt. pertinent results: 08:10am blood wbc-6.3 rbc-3.94* hgb-12.0* hct-37.6* mcv-96 mch-30.5 mchc-31.9 rdw-18.1* plt ct-120* 10:00am blood wbc-8.9 rbc-3.42* hgb-9.9* hct-31.3* mcv-92 mch-29.1 mchc-31.7 rdw-17.4* plt ct-158 11:30pm blood pt-14.0* ptt-25.8 inr(pt)-1.2* 10:00am blood pt-13.0 ptt-26.3 inr(pt)-1.1 02:30pm blood fibrino-420* 11:30pm blood glucose-125* urean-46* creat-5.5*# na-138 k-4.0 cl-94* hco3-27 angap-21* 10:00am blood glucose-108* urean-28* creat-3.6*# na-138 k-3.8 cl-99 hco3-28 angap-15 08:10am blood calcium-8.5 phos-9.5*# mg-2.1 10:00am blood calcium-8.2* phos-4.6* mg-2.0 03:24pm blood type-art po2-187* pco2-39 ph-7.45 caltco2-28 base xs-3 07:59am blood freeca-1.16 02:33am blood freeca-1.10* imaging: 1. c-spine (portable): in comparison with the study of , the area of the fracture of the dens is very poorly seen. there appears to be some posterior displacement of the body of c2, though it is difficult to determine whether there is any change from the previous study. some soft tissue prominence is again seen at this level. ct may be necessary to properly evaluate the degree of displacement. 2. cxr: questionable new rounded hazy opacities, could be artifactual from rib ends, but cannot exclude other processes such as septic emboli or traumatic etiology. brief hospital course: # c2 dens fracture: patient had originally been hospitalized in after the fall from his wheelchair resulting in c2 dens fracture. at the time, the decision was made to manage him conservatively and patient was discharged to rehab. however, fracture did not heal well and patient developed progressive neurologic loss from spinal cord compression. after medical clearance, patient was admitted to the ortho spine service, where he underwent c1-c4 posterior fusion. postoperatively he was transferred to the tsicu and kept intubated. he was successfully extubated and then underwent hd per normal regimen. he normally is slightly hypotensive during dialysis and required midodrine. he was transfused 2 units of prbc at dialysis. patient did well and then was transferred to the medical floor prior to discharge. . # esrd: patient is well known to the renal service. he was kept on his tue//sat dialysis schedule while inpatient. he received midodrine to keep him normotensive during dialysis. creatinine ranged from 2.1 to 5.5 during this hospitalization. he was kept on his home medications including nephrocaps and calcium acetate. his volume status and electrolytes were closely monitored. . # history of recurrent utis: ua on admission was concerning for uti. patient has a history of numerous resistent pathogens (vre, esnl, klebsiella). while on the ortho service received one dose of vanco in or and was started on bactrim, which was discontinued after urine culture came back negative. foley was removed after transfer to the medicine floor. patient remained afebrile with no leukocytosis, and thus did not require any antibiotics treatment. . # cad: on admission did not show signs of acs. aspirin was held in the context of surgery. on discharge aspirin was continued per orthopedics service suggestion. . medications on admission: 1. atorvastatin 10 mg tablet sig: one (1) tablet po daily 2. cyanocobalamin 100 mcg tablet sig: one (1) tablet po daily 3. ferrous sulfate 300 mg (60 mg iron) tablet sig: one (1) tablet po daily 4. midodrine 5 mg tablet sig: two (2) tablet po tues-thurs-sat: give one hour prior to dialysis. 5. b complex-vitamin c-folic acid 1 mg capsule sig: one (1) cap po daily 6. tiotropium bromide 18 mcg capsule, w/inhalation device sig: one (1) cap inhalation daily 7. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: inhalation q6h (every 6 hours) as needed for shortness of breath. 8. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). discharge disposition: extended care facility: nursing home - discharge diagnosis: c2 dens fracture discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: out of bed with assistance to chair or wheelchair. discharge instructions: dear mr. , you were admitted to the hospital because the fracture in your neck that you had was not healing on its own and so you decided to have surgery. your orthopedic surgeon took bones from your hip and used it to make a bone graft for your neck. your neck was also stabilized with instrumentation inside. after the surgery, you had a breathing tube, which was removed. you were placed in a soft neck collar which you have to continue wearing until you see the orthopedic surgeon for follow-up. throughout the hospitalization you continued to get your normal dialysis treatments for end-stage renal disease. we gave you blood and medicine during dialysis to keep your blood pressure up. you never had a fever or had elevated white blood cell after the surgery. . we made the following changes to your medications: 1. calcium acetate 1334 mg by mouth three times a day with meals followup instructions: department: neurology when: friday at 2:00 pm with: , md building: sc clinical ctr campus: east best parking: garage department: spine center when: monday at 9:40 am with: dr. building: campus: east best parking: garage department: vascular surgery when: wednesday at 8:00 am building: lm campus: west best parking: garage md procedure: hemodialysis excision of bone for graft, other bones repair of vertebral fracture other cervical fusion of the posterior column, posterior technique spinal traction using skull device fusion or refusion of 4-8 vertebrae diagnoses: end stage renal disease renal dialysis status coronary atherosclerosis of native coronary artery chronic airway obstruction, not elsewhere classified atrial fibrillation other late effects of cerebrovascular disease old myocardial infarction iron deficiency anemia, unspecified other malaise and fatigue closed fracture of c1-c4 level with unspecified spinal cord injury accidental fall from wheelchair 

Answer: The patient is high likely exposed to