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: ativan / tetracycline attending: chief complaint: fever major surgical or invasive procedure: 1. tunnelled catheter placement 2. history of present illness: 61yo end stage renal disease on hemodialysis, cad s/p cabg, pvd s/p bilateral bkas, recents mrsa line sepsis who presents from hd with fever and suspected recurrent line sepsis. . patient reports on wednesday having stomach discomfort. he states he felt like he did with previous line infections. patiends tunneled line was placed on . he checked his temperature which was 101.3. on thursday he had partial session (2hours) but was ended early due to his fever/lightheadedness/nausea. his temperature was noted to be 103. in hemodialysis he recieved vancomycin was given at hd and he then transfered to ed. . in , pt recieved 2 liters iv fluids and was started on gentamycin. his sbp went to 60's so periheral dopa was started with improvement of pressures. multiple attempts at central access were made but without success. renal consultation was done with no indication for emergent hd. renal approved use of hd catheter for temporary access. . in micu, patient had aggressive fluid, continued on vanco and gent, renal consulted. heparin started past medical history: - esrd on hd mwf - dm 1 or 2 c/b pvd, cad, esrd - bilateral bkas - cad s/p cabg - clot in l arm av graft - no longer functioning - r sc tunnel cath placed - s/p mssa bacteremia - htn - h/o vre, mrsa social history: lives in with his mother. a retired pharmacist. never smoked, rare etoh use. family history: mother and father with dm, father with pvd. no h/o cad. physical exam: pe: temp 98.2 bp 118/62 84 gen: nad, obese man, flushed face lungs: cta no w/r/r chest: right subclavian line without evidence of infection heart: rrr no m/r/g abd; soft nontender ext: s/p bilat bka neuro: cn ii-xii intact, cerbellar function intact pertinent results: 10:30pm urine color-straw appear-hazy sp -1.014 10:30pm urine blood-sm nitrite-neg protein-100 glucose-100 ketone-tr bilirubin-neg urobilngn-neg ph-8.0 leuk-mod 10:30pm urine sperm-mod 10:00pm type-art po2-187* pco2-41 ph-7.48* total co2-31* base xs-7 intubated-not intuba comments-green top 09:50pm glucose-249* urea n-48* creat-7.2*# sodium-137 potassium-5.8* chloride-95* total co2-26 anion gap-22* 09:50pm alt(sgpt)-11 ast(sgot)-15 ld(ldh)-198 ck(cpk)-164 alk phos-70 tot bili-0.8 09:50pm ck-mb-2 ctropnt-0.10* 09:50pm calcium-8.6 phosphate-4.6* magnesium-1.6 09:50pm wbc-14.5*# rbc-3.93* hgb-13.1* hct-36.3* mcv-92 mch-33.2* mchc-36.0* rdw-14.6 09:50pm neuts-93* bands-3 lymphs-1* monos-3 eos-0 basos-0 atyps-0 metas-0 myelos-0 09:50pm hypochrom-normal anisocyt-normal poikilocy-normal macrocyt-normal microcyt-normal polychrom-normal 09:50pm plt smr-normal plt count-125* 09:50pm pt-22.8* ptt-31.1 inr(pt)-3.4 06:25pm lactate-4.9* k+-6.8* brief hospital course: 61yo male with esrd on hd, bilateral ij clots on coumadin, cad s/p cabg, mrsa sepsis who presents with sepsis. transferred from micu to floor on . 1) sepsis- sirs (initial lactate of 4.9), in micu pt give iv fluids. recieved depo in ed. switched to levofed in micu. off pressors as of . line resited to right subclavian w/ central access available . gent was d/c on . mrsa + in blood cx , now on vanc and gent for synergy. dosed gent after hd. hd catheter re-sited on r side. spiked and has gpc's from also, most likely transient bacteremia during line change. tee done showed no evidence of endocarditi. ct abodmen showed hypo attenuating lesion in the head of pancreas with possible dilatation of the pancreatic duct. this can be further evaluated with mrcp as it could represent ipmt or a cyst. mrcp was ordered, however patient refused study. he will be scheduled for outpatient mrcp with ourpatient gi follow up. patient will continue vanco (level dosed) per id rec for 6 wks, 2) renal - renal consulted in ed. pt got new tempory r sc line . recieved uf on (). perma cath placed monday . patient continued sevelamer, ca carbonate, nephrocaps. in future plan for transplant surgery to evaluate pt for possible kidney transplant . 3)fen- metabolic alkalosis on admission, recieved over 7l in micu. patient was continued cardiac diabetic diet . 4)cad-enzymes negative.continue aspirin, statin. patient restarted on metroprolol and lisinopril with holding parameters systolic <90 . 6)gi- patient continued anti-emetics for nausea. patient also recieved ppi. . 7)hem -thrombocytopenia-may be due to sepsis. daily cbc were checked to monitor platlets. . 9) bilateral ij clots- hep gtt. patient continued on heparin. he started coumadin on . he remained hospitalized until his coumadin became theurpetic (inr 2.0-3.0) . 10) respiratory- in icu patient has desaturated less than 90 on room air. on floor patient longer required oxygen . 11) dm ii- patient restarted glipizide on the floor with sliding scale . 12) access: line resited to r subclav and replaced over wire , cxr on to check placement of subclavian. subclavian line to be replaced ir . patient also has peripherial line. . medications on admission: 1. warfarin sodium 1 mg qd 2. simvastatin 40 mg qd 3. insulin regular human 100 unit/ml . 4. b complex-vitamin c-folic acid 1 mg qd 5. metoprolol tartrate 25 mg 6. lisinopril 5 mg qd 7. glipizide 5 mg 8. calcium acetate 667 mg tid with meals 9. sevelamer hcl 800 mg po tid discharge medications: 1. warfarin sodium 5 mg tablet sig: one (1) tablet po daily (daily). disp:*60 tablet(s)* refills:*2* 2. glipizide 5 mg tablet sig: one (1) tablet po qpm (once a day (in the evening)). 3. glipizide 5 mg tablet sig: 1.5 tablets po qam (once a day (in the morning)). 4. calcium acetate 667 mg tablet sig: two (2) tablet po tid w/meals (3 times a day with meals). 5. lisinopril 10 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 6. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 7. sevelamer 800 mg tablet sig: one (1) tablet po tid (3 times a day). 8. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 9. b complex-vitamin c-folic acid 1 mg capsule sig: one (1) cap po daily (daily). 10. vancomycin 1,000 mg recon soln sig: one (1) gram intravenous at hemodialysis for 6 weeks: have vancomycin level checked and if level <15 give 1g vancomycin. disp:*qs * refills:*0* 11. outpatient lab work have pt, ptt levels checked. your doctors be adjusting your coumadin based on this. 12. outpatient lab work have vancomycin level drawn at hd sessions and if level <15 administer 1 gram vanco. discharge disposition: home discharge diagnosis: 1. line infection 2. tunnelled catheter placement discharge condition: stable discharge instructions: continue taking all medications as prescribed. return to the hospitals if you have any further fevers, nausea, vomiting, shortness of breath or other concerning symptoms. have your vanco level checked and dosed at hemodialysis. have your inr checked each week and called to dr. to adjust your coumadin dosage. followup instructions: provider: , md where: building ( complex) phone: date/time: 10:00 provider: west,room two gi rooms where: gi rooms date/time: 10:00 provider: , md where: phone: date/time: 9:00 procedure: diagnostic ultrasound of heart hemodialysis venous catheterization for renal dialysis diagnoses: thrombocytopenia, unspecified nephritis and nephropathy, not specified as acute or chronic, in diseases classified elsewhere abnormal coagulation profile severe sepsis infection with microorganisms resistant to penicillins coronary atherosclerosis of unspecified type of vessel, native or graft aortocoronary bypass status diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled polyneuropathy in diabetes methicillin susceptible staphylococcus aureus septicemia pulmonary collapse hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure alkalosis septic shock infection and inflammatory reaction due to other vascular device, implant, and graft diabetes with renal manifestations, type ii or unspecified type, not stated as uncontrolled home accidents diabetes with ophthalmic manifestations, type ii or unspecified type, not stated as uncontrolled background diabetic retinopathy 

Answer: The patient is high likely exposed to