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: history of present illness is obtained from the office note. the patient is a known insulin dependent diabetic with chronic renal end stage disease on dialysis who had a plantar ulcer, which was first noted in and underwent excision of the ulcer and debridement and primary closure by dr. . the patient has ultimately broken down and has become an ulcer, which has not healed over many months. she was followed by her podiatrist and her primary care physician . . she returns for evaluation. she is admitted for elective revascularization. past medical history: history of pulmonary hypertension, left ventricular hypertrophy, congestive heart failure. she is a type 2 diabetic times fifteen years insulin dependent. she has chronic obstructive pulmonary disease and morbid obesity. she has end stage renal disease on dialysis monday, wednesday and friday. allergies: multiple includes penicillin, sulfa, ceftazidime, vancomycin and clindamycin. reactions unknown. medications: calcitriol, calcium carbonate, darvon and insulin with regranex dressings to her left foot. physical examination: this is a chronically ill obese female in no acute distress. blood pressure 120/80. pulse 110. respiratory rate 12. right below the knee stump is well healed. there is a hyperpigmentation and lipodermatosis of her left leg from knee to foot. there is marked dependency ruber in her left foot. there is a 3 by 1 cm ulcer at the subcutaneous tissue at the mid portion of the plantar surface of the left foot. this is clean and noninfected. there is scant granulation present. pulse examination shows no palpable popliteal or pedal pulses. her femoral pulses are nonpalpable due to obesity. the remaining of her examination is unremarkable. hospital course: the patient underwent on a left common femoral artery to popliteal bypass graft with dacron. she was transferred to the pacu in stable condition and remained in the vicu overnight and was transferred to the regular nursing floor prior to having her pa line changed to cvl. she developed increasing white count, fevers or chills, abdominal ct of the left was obtained, which did show a fluid collection. she was begun on vancomycin, levofloxacin and flagyl were continued. she underwent on a removal of a femoral popliteal graft with vein angioplasty. ________ was started at this time. she was transferred to the vicu and remained in the vicu until the night when she was transferred to the regular nursing floor. a picc was placed on . on the patient had two episodes of left groin bleeding, which required her return to the operative room for exploration and control of bleeding. on she underwent a left above the knee amputation secondary to left leg ischemia. on , after conservative treatment of the wound she underwent a split thickness skin graft muscle flap of the left groin. she tolerated the procedure well and was transferred to the pacu in stable condition. she remained in the vicu overnight and then was transferred to the regular nursing floor. the left above the knee continued to show necrotic changes and she underwent on revision of her left above the knee. prior to that she had a picc line placement. she did well until when she spiked a temperature max of 101.2. she was pan cultured. her blood cultures grew e-coli and at this time meropenem was added to her antibiotic regimen along with the vancomycin. after discussion with the staff it was felt that there was a need to adjust her antibiotics so that they could all be given at dialysis and the picc line could be discontinued. on her meropenem was discontinued and gentamycin was begun. also noted on her left above the knee amputation stump some drainage in the medial aspect of the stump incision. this was opened and cultured. the final culture results are pending. the gram stain showed no organisms with 2+ polys. she will continue on her antibiotics for a total of four weeks. her donor site wound is clean, dry and intact. her wound dressing on the groin graft area with adaptic and dry sterile dressing b.i.d. she should follow up with dr. once discharged from rehab. discharge medications: vancomycin 1 gram dose according to vancomycin trough level less then 15 redosed. dilaudid 0.125 to 0.75 intravenous q one to three hours prn for pain. senokot 5 to 15 mg at h.s. prn, dulcolax suppository q.d. prn, neurontin 300 mg q 48 hours dosed post dialysis, colace 100 mg b.i.d., epogen units on monday, wednesday and friday at dialysis. miconazole powder 2% applied to axilla and peroneal area b.i.d., nephrocaps q.d., heparin 5000 units subq b.i.d., prevacid suspension 30 mg q.d., vitamin b complex with b-12 one daily, niferex 150 mg q.d. insulin, nph insulin 10 units subq q.a.m. with a breakfast and bedtime sliding scale, glucoses less then 150 no insulin, at breakfast 151 to 200 3 units, 201 to 250 5 units, 251 to 300 7 units, 301 to 350 9 units, greater then 351 11 units. bedtime insulin, glucoses less then 250 no insulin, 251 to 300 3 units, 301 to 351 4 units, greater then 351 6 units. discharge diagnosis: 1. ischemic left foot ulceration status post bypass graft. 2. left groin abscess infected graft status post removal. 3. left groin bleed status post exploration. 4. ischemic leg status post left above the knee amputation. 5. left above the knee amputation wound infection status post revision. 6. diabetes insulin dependent, controlled. 7. end stage renal disease on hemodialysis monday, wednesday and friday. 8. chronic anemia compounded by blood loss anemia corrected. 9. e-coli sepsis treated. , m.d. dictated by: medquist36 procedure: other revision of vascular procedure other (peripheral) vascular shunt or bypass other skin graft to other sites graft of muscle or fascia excisional debridement of wound, infection, or burn excisional debridement of wound, infection, or burn amputation above knee repair of blood vessel with unspecified type of patch graft repair of entropion or ectropion with wedge resection revision of amputation stump diagnoses: congestive heart failure, unspecified chronic airway obstruction, not elsewhere classified hemorrhage complicating a procedure infection and inflammatory reaction due to other vascular device, implant, and graft septicemia due to escherichia coli [e. coli] gangrene atherosclerosis of native arteries of the extremities with ulceration infection (chronic) of amputation stump diabetes with peripheral circulatory disorders, type ii or unspecified type, not stated as uncontrolled 

Answer: The patient is high likely exposed to