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: sulfa (sulfonamides) / oxacillin / heparin agents attending: chief complaint: sepsis major surgical or invasive procedure: placement of tunneled dialysis line endoscopy history of present illness: 70 yo m with history of esrd on hd, multiple mrsa line infections, atrial fibrillation, and cad who is admitted to the micu for dialysis line repair. . he was recently admitted to micu for pneumonia from . vent settings at simv 4/500/40% fio2, peep 5 ps 15. he has a 3 lumin quentin catheter in rt subclavian, according to oral report this was a temporary catheter and he was scheduled to have a replacement performed here. . he has not been febrile at , he has had clear blood cultures there. he has not had any evidence of infection per their report. past medical history: 1. as above 2. esrd (unclear etiology) on hd m/w/f s/p r cadaveric tx ' at , failed ', removed 3. staph aureus (sensitive to ox, resistant to pcn) sepsis, recent line infections; micro data 4. htn 5. afib 6. ddd pacemaker 7. cad - mild 40% prox lad on cath ' 8. lue dvt 9. left tkr ' 10. hypothyroidism 11. hx of tuberculosis as child, ppd neg 12. peg tube placed . social history: retired dentist, was living in with wife, kids, and , denies etoh/tob. family history: both parents died in 90's, healthy. physical exam: vs: temp 101, pulse 70, bp 114/48, rr 20, 99% on simv + ps tv 500 rr 10, fio2 0.40 peep 5, ps 15 gen; alert, responsive with eyes, male, trached, non-verbal neck: tracheostomy in place chest: right sided sub-clavian quentin catheter in place, site c/d/i cv: rrr, s1s2 normal, no m/r/g lung: anterior: coarse rhonchi bilaterally abd: soft, nt, nd, +bs, g-tube in place, surgical scars extrema: - edema, dp 2+ b/l pertinent results: 04:39pm wbc-18.1*# rbc-3.89* hgb-11.4* hct-35.1* mcv-90 mch-29.4 mchc-32.6 rdw-17.6* 04:39pm plt count-252# 04:39pm glucose-149* urea n-39* creat-2.7* sodium-139 potassium-3.9 chloride-98 total co2-31 anion gap-14 04:39pm calcium-9.3 phosphate-2.0* magnesium-2.0 05:47pm pt-23.2* ptt-42.3* inr(pt)-3.9 cxr: 1. tracheostomy tube balloon overinflation. clinical evaluation is recommended. 2. marked interval improvement in pneumonia compared to , with small residual opacities in the right mid lung zone and left lower lobe. 3. small left pleural effusion, markedly improved compared to . ct spine: there are multiple large, presumably calcified subcarinal lymph nodes. has the patient had prior granulomatous disease? also, there is some soft tissue density along the posterior aspect of both hemithoraces. is there evidence on prior imaging studies for pleural effusions? ct cap: 1. no intra-abdominal, retroperitoneal or pelvic hematoma. 2. minor consolidation in the dependent portion of the lower lobes unchanged compared to recent ct. 3. moderate left colonic diverticulosis without sign of acute complication. 4. end-stage native kidneys. other findings previously described on ct of are unchanged. brief hospital course: 70 yo m with history of esrd on hd, multiple mrsa line infections, atrial fibrillation, and cad who is admitted to the micu for dialysis line placement, but was found to be febrile and hypotensive on admission, now with resolved fever and wbc count, grew mrsa in blood, now culture negative and clinically improved. 1. fever/sepsis - mr. has a history of mrsa line infections and currently had mrsa bacteremia/sepsis on admission. this was felt to be likely related to line infection, and quentin was d/c'd after ir placed new groin line and inr was reduced with ffp. however the line tip culture was negative (after treating through the line for 5 days). l knee film showed small effusion, and mr. refused a tap by the ortho team. l ankle film showed mild soft tissue swelling, no bony injury, no evidence osteomyelitis. sputum cultures were negative, and he is anuric. ct abd/pelvis/spine shows no source of sepsis. it was thought that he may have an endocarditis that was the source of his recurrent infections. a tte was negative. a tee was felt to be too risky given esophageal narrowing on egd. therefore he will be treated for suspected endocarditis given inability to perform tee. he needs to receive six weeks vancomycin from for empiric treatment of endocarditis. vancomycin will be dosed by level with his hd. surveillance blood cultures have been negative since /08/5, and he should receive repeat surveillance cultures once vancomycin course completed. . 2. hypoxic respiratory failure: mr. has been vent dependent since . he was admitted on assist control ventilation,a nd has been weaned down to pressure support ventilation as low as , with short trach mask trials prn. speech and swallow was consulted for a passy muir valve so that the patient can talk. he had poor nifs initally (-16), and these have improved to ??? on discharge. he should continue to wean further at rehab as tolerated with hope of breathing independantly again. . 3. access for hemodialysis - mr. was transfered to have his access revised however he was febrile and bacteremic, and a new temporary line was intially placed after he was afebrile for >24 hours. after surveillance blood cultures were negative, a new tunneled groin line was placed for hd on his l side. . 4. anemia: mr. is chronically anemic due to his esrd. he is on aranesp and iron as an outpatient. he was on epo, and fe supplements while hospitalized. he was transfused 1 unit prbcs on after his line placement, and his hemtocrit was otherwise stable. . 5. esrd: mr. has anuric renal failure. he was hemodialysed three times a week while hospitalized. . 5. atrial fibrillation: mr. has a history of atrial fibrillation and hit. he is intermittently v-paced. his pacer appeared to be pacing on his t waves on admission. cardiology was consulted and said it was safely pacing. they interrogated his pacer and it was functioning properly. he was continued on amiodarone. he was on an argatroban gtt until after his line was placed, at which time coumadin was rtestarted for long term outpatient anticoagulation. on discharge he is therapeutic on coumadin and off argatroban. . 6. fen: mr. was on tubefeeds at goal per nutrition recs. these were held for his line placement only. his tube feeds can be increased as needed to maintain his weight. . 7. access: mr. old left sc line was initially used until he was afebrile and a r side temporary groin line was placed. this line was then used for meds and lab draws until dc. his new tunneled line was used by renal for hd and vancomycin only. 8. ppx: mr. was on pneumoboots, ppi, and argatroban drip - bridged to coumadin . 9. full code: dnr/dni was discussed, but mr. has not wanted to change his code status, and did not want to discuss with his family. . 10. communication was with mr. and his wife, who is also his health care proxy. . 11. dispo: mr. came to from and will go once coumadin therapeutic and argatroban off. pt/ot were consulted and worked with mr in bed. now that he has a tunneled line and his temporary groin line is out, he can be out of bed, and work more extensively with pt to rebuild his strength. medications on admission: coumadin 3 mg po q m/w/f/s coumadin 2 mg /tu/th eucerin oint novolin ss cordarone 200mg daily senokot liquid vitamin b12 1000mg daily protonix 40mg daily feosol 325mg daily colace aranesp 60 mcg syringe benadryl prn ativan prn tylenol prn renagel 800 mg tid discharge disposition: extended care facility: - discharge diagnosis: primary: mrsa bacteremia with septic shock secondary: end-stage renal disease on hemodialysis hypertension atrial fibrillation history of multiple deep vein thromboses hypothyroid l total knee replacement peg tube in place discharge condition: stable, afebrile, with clear surveillance blood cultures. discharge instructions: please notify care facility care-givers if fevers, chills, nausea, vomiting, or any other health concern. followup instructions: please follow up for hemodialysis three times a week as directed by the renal team. pls wean vent as tolerated. pls check r groin site on and since fem line was pulled from there on procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more other endoscopy of small intestine enteral infusion of concentrated nutritional substances hemodialysis venous catheterization for renal dialysis venous catheterization for renal dialysis transfusion of packed cells infusion of vasopressor agent diagnoses: anemia in chronic kidney disease severe sepsis atrial fibrillation methicillin susceptible staphylococcus aureus septicemia hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease acute and subacute bacterial endocarditis infection and inflammatory reaction due to other vascular device, implant, and graft anticoagulants causing adverse effects in therapeutic use knee joint replacement diabetes with renal manifestations, type ii or unspecified type, not stated as uncontrolled fitting and adjustment of cardiac pacemaker chronic respiratory failure attention to tracheostomy effusion of joint, lower leg 

Answer: The patient is high likely exposed to