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: the patient is a 64-year-old female with a history of hypertension, type 2 diabetes, subarachnoid hemorrhage status post left middle cerebral artery clipping, left craniectomy, and vp shunt, who presents from nursing home with decreased responsiveness per her daughter for the past few days. the patient was diagnosed with proteus urinary tract infection on . she was started on amoxicillin 500 mg p.o. t.i.d. x7 days, but the sensitivity also showed proteus resistant to ampicillin. the fingerstick blood sugar prior to had been 538 for which she was given 12 units of insulin on the date of presentation. she was also found to have a temperature of 100.3 at . on arrival to the emergency room, she was thought to have urosepsis, and was given one dose of vancomycin iv given her history of mrsa, but no additional antibiotics. she was also found to have a sodium of 164, which when corrected was 170 and a glucose of 463. she was treated with 2 liters of normal saline. past medical history: 1. hypertension. 2. type 2 diabetes. 3. subarachnoid hemorrhage in status post a left middle cerebral artery aneurysm clipping status post a left craniectomy due to mass effect. 4. status post a peg and tracheostomy in . 5. status post a vp shunt in . 6. gpc meningitis in , which has coag-negative staph x3. vp shunt was then removed and replaced. 7. congestive heart failure. 8. tracheal stenosis/severe tracheomalacia. 9. anemia. 10. colonization with mrsa and vre. 11. hypernatremia. 12. nonverbal baseline. medications on admission: 1. prevacid 30 mg p.o. q.d. 2. glucophage 1000 mg p.o. b.i.d. 3. glyburide 5 mg p.o. b.i.d. 4. dilantin 200 mg p.o. t.i.d. 5. captopril 25 mg p.o. t.i.d. 6. hydralazine 50 mg p.o. t.i.d. 7. lopressor 50 mg p.o. t.i.d. 8. free water flushes 300 cc via peg tube t.i.d. 9. tube feeds 70 cc an hour. 10. zantac 150 mg p.o. q.d. 11. sliding scale insulin. 12. senna 2 mg p.o. q.d. 13. vicodin 1-2 tablets q.4h. prn. 14. amoxicillin 500 mg p.o. t.i.d. she was on day #4 for her uti. allergies: no known drug allergies. social history: lives at nursing home. family history: noncontributory. physical exam on admission: temperature 100.3, heart rate 113, blood pressure 122/74, respiratory rate 26, and oxygen saturation 100% on 4 liters of oxygen. in general: the patient is an african-american female with her mouth open, awake, alert, nonverbal at baseline, in no acute distress with her head at 45 degrees. heent: pupils are equal, round, and reactive to light, sclerae are anicteric. extraocular muscles are grossly intact. mucous membranes dry. neck: supple, healed tracheostomy site. heart: tachycardic, regular rhythm, rapid, positive s1 and s2, grade crescendo systolic ejection murmur at the right upper sternal border. grade holosystolic murmur at the apex. chest: lungs were grossly clear to auscultation bilaterally, poor inspiratory effort. abdomen: soft, nontender, and nondistended, no masses or hepatosplenomegaly, positive peg tube site in place, positive bowel sounds. extremities: no edema, warm, 2+ distal pulses, no rash. neurologic: awake, alert, eyes open, nonverbal. does not follow simple commands. extremities with normal tone and bulk. reflexes: 1+ in the biceps bilaterally, 0 in the patella bilaterally. babinski's equivocal. winces to pain. laboratory values on admission: white blood cell count 7.8, hematocrit 33.4, platelets 140. sodium 164, potassium 3.9, chloride 123, bicarb 32, bun 54, creatinine 0.9, glucose 463, lactate 3.0. pt 12.7, ptt 22.5, inr 1.1. urinalysis revealing moderate leukocyte esterase, large blood, 30 protein, 100 glucose, trace ketones, and no nitrites, greater than 50 epithelial cells. chest x-ray revealed no evidence of congestive heart failure or pneumonia. an ekg showed sinus tachycardia at 117 beats per minute, normal axis, t-wave inversions in lead iii, no st segment changes. an abg was obtained on 4 liters of oxygen by nasal cannula: ph 7.37, co2 55, oxygen 169. impression: the patient is a 64-year-old female with a history of multiple medical problems, who presents with urosepsis. hospitalization course by system: 1. fluids, electrolytes, and nutrition: the patient was found to be severely hypernatremic with an initial sodium of 164, which when corrected for the hyperglycemia, it was 170. she was given normal saline boluses. she was started on maintenance fluid of d5 normal saline with 20 meq of potassium for 2 liters, and then this was run continuously. ultimately, her sodium corrected to within normal limits and is 138 at the time of this dictation. patient was also started on free water boluses via her peg tube, which initially were 500 cc q.4h. and decreased to 250 cc q.4h. by the time of discharge. her tube feeds were started and she was given promod tube feeds with fiber and reached her goal of 55 cc an hour by the time of discharge. 2. endocrine: the patient has a history of type 2 diabetes. she was initially placed on an insulin drip, which was discontinued on . her admitting blood glucose was greater than 400 and had decreased to the 200 range by the time of discharge. her metformin was restarted and gradually increased her home dose of 1000 mg p.o. b.i.d. 3. genitourinary: the patient was admitted with a urinary tract infection. the urine culture was found to be sensitive to ceftriaxone, and therefore the patient was started on 1 gram of ceftriaxone iv q.d. it is suggested that she continues for a full two-week course given that this is a complicated urinary tract infection obtained while the patient had a foley in place. her repeat urine culture was negative. the patient had a renal ultrasound performed to rule out obstruction, which was questionable for emphysematous pyelonephritis. therefore, cat scan of the abdomen and pelvis was obtained, which revealed no pleural effusions, minor bibasilar atelectasis, no hepatic or splenic lesions, correct position of the g tube, all other organs within normal limits, but multiple bilateral renal stones with largest and left upper pole of the kidney measuring 5 mm, no air in the left kidney, no hydronephrosis, and no obstruction, and positive hardening artifact. 4. cardiovascular: the patient had an echocardiogram performed due to her murmurs found on exam. she was found to have a normal left atrium, and mild symmetric left ventricular hypertrophy and an ejection fraction of 70%, 2+ tricuspid regurgitation, trivial mitral regurgitation, mild pulmonary artery systolic hypertension. she was restarted on her hydralazine, which was increased to 50 mg p.o. t.i.d. she is also restarted on her captopril 25 mg p.o. t.i.d. she was evaluated repeatedly for tachycardia, and her baseline was ultimately felt to be in the low 100s. this responded well to intravenous fluids, as well as pain medication (her vicodin was restarted). 5. neurology: the patient returned to her baseline mental status at the time of discharge as per her daughter. a cat scan was performed of the head, which was negative for any acute changes. discharge condition: good. discharge status: extended care facility. discharge diagnoses: 1. urosepsis. 2. hypernatremia. 3. hyperglycemia. 4. tachycardia. medications on discharge: 1. captopril 25 mg p.o. t.i.d. 2. ceftriaxone 1 gram iv q.24h. to be completed on . 3. colace 100 mg p.o. b.i.d. 4. hydralazine 50 mg p.o. t.i.d. 5. vicodin 1-2 tablets p.o. q.4-6h. prn agitation. 6. insulin-sliding scale. 7. lansoprazole 30 mg p.o. q.d. 8. metoprolol 50 mg p.o. t.i.d. 9. metformin 1000 mg p.o. b.i.d. 10. senna one tablet p.o. b.i.d. prn. followup: the patient is to followup with dr. at , her primary care physician weeks for follow-up appointment. , m.d. dictated by: medquist36 d: 10:36 t: 10:37 job#: procedure: enteral infusion of concentrated nutritional substances transfusion of packed cells diagnoses: thrombocytopenia, unspecified urinary tract infection, site not specified congestive heart failure, unspecified unspecified septicemia hyperosmolality and/or hypernatremia infection and inflammatory reaction due to indwelling urinary catheter 

Answer: The patient is high likely exposed to