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 68 year-old black female well known to our service status post abdominal aortic repair with an aorta bifemoral status post right abf limb removal with interposition saphenous vein graft secondary to infection, status post left fem with jump graft to fem to tibial peroneal artery with vein presents with a three day history of left foot pain with onset of coldness and numbness within the last 24 hours. she was seen at and was diagnosed with acute ischemic foot. iv heparin 5000 unit bolus and a 1000 units per hour was started at 1600. it was discontinued at 1820 for transfer to the main land. review of systems: positive for numbness, coolness and pain. she denies any other interval changes since last hospitalization in of this year secondary to left thigh abscess. she denies chest pain, shortness of breath. she is nondiabetic. allergies: no known drug allergies. past medical history: coronary artery disease, hypertension, hypercholesterolemia, peripheral vascular disease, history of mrsa, sacroiliitis, infected right abf limb secondary to mrsa, status post removal. past surgical history: abdominal aortic aneurysm repair with an aorta bifemoral in , right abf limb with removal with interposition graft in , left fem in , left jump graft from fem to peroneal artery in , right breast biopsy in , i&d of left thigh abscess in . medications on transfer: lipitor 20 mg q day, colace 100 mg b.i.d., lopressor 25 mg b.i.d., ferrous sulfate 325 mg q day, aspirin 81 mg q.d. social history: the patient lives with her son. the remaining review of systems is unremarkable. physical examination: the patient was afebrile. this is an alert black female complaining of left foot pain. heent examination was unremarkable. pulse examination shows an intact carotid, brachial and radial pulses bilaterally with bilateral carotid bruits. femoral pulses were 2+ on the right and absent on the left by palpation of doppler. there were no bruits. popliteal pulses were absent bilaterally. on the right, the dp was dopplerable. the pt was absent by palpation and doppler. the pedal pulses and popliteal pulses on the left were absent by palpation and doppler. chest was clear to auscultation bilaterally. heart was a regular rate and rhythm. normal s1 and s2. there were no murmurs, rubs or gallops. abdomen was benign. there was no bruits, masses or organomegaly. right foot toes were cool. the left foot was cold to the ankle and cool from the ankle to mid calf. the foot was modeled. there was no capillary refill. the foot had diminished dorsiflexion and plantar flexion. the left first toe strength was and the left foot strength was . the left leg had moderate amount of weakness of with elevation on off bed. neurological examination except for the motor sensory on extremities were unremarkable. hospital course: the patient was admitted to the vascular service. she was made npo, iv hydration normal saline at 80 cc per hour was begun. interventional radiology was requested to see the patient for anticipated intervention. the patient's admitting laboratories were white count 15.8, hematocrit 33.9, platelets 456, electrolytes 137, 4.6, 103, 19, 22 and 0.7. pt/inr were normal. ptt 26.7. the patient was taken to angio. initial arteriogram demonstrated hydronephrotic obstructed right kidney. left limb graft open. has stenosis at the aorta anastimosis. this was dilated 6 mm with a 15 mm residual gradient clot in the fem graft. tissue plasminogen activator was continued. follow up thrombolysis arteriogram demonstrates successful recanalization of the left common femoral with access of the catheter to the fem graft injection of the at at the level of the distal anastomosis demonstrated complete occlusion. they were not able to identify the distal run off. the catheter was removed at this point. at this time the patient became hypoxic, hypertensive and tachycardic. emergency head ct was obtained to rule out intracranial hemorrhage, which was negative. the patient was transferred to the sicu for continued monitoring and care. the patient was given 1 gram of vancomycin prior to any interventional work on the night of admission. infectious disease was consulted regarding antibiotic coverage for positive blood cultures from the sheath. she had been started on ceptaz 1 gram q 8 hours and gentamycin 80 iv q 8 hours. vancomycin 1 gram q 12 hours was continued. blood cultures obtained on the second 2/2 bottles grew gram negative rods, anaerobic bottle growing gram positive cocci. identifications and speciation pending. infectious disease recommended continued antibiotics as they were for both a history of mrsa and enterococcus infection. the abdominal pelvic ct was reviewed and they felt that the graft could be a possible site of infection along with a right hydronephrosis. at this point was consulted. urology felt this was a chronic hydronephrosis and had not changed from previous abdominal ct. the urine cultures were pending. urinalysis showed only 0 to 2 white blood cells. they felt at this point given this picture that the hydronephrosis was not the etiology of her bacteremia. urine culture on was negative and urine specimen from the right kidney gram stain showed no bacteria and no polys. the white count peaked at 25.5. the patient did require intubation at the time of her hypertension, tachycardia and was extubated on sicu day three. blood cultures were poly microbial and predominantly gi flora, flagyl was added to the antibiotic regimen on . a right nephrostomy tube was placed on . this was removed after urine cultures were proven to be negative. the patient returned to angio on retrieval of foreign body at the time of line change and loss of guidewire. the guidewire was removed from the inferior vena cava with a snare and a ij triple lumen catheter was placed and continued to show improvement with diminished white count of 17.0, hematocrit was 23.8 and no transfusion was given secondary to patient's jehovah's witness beliefs. she was transferred to the vicu for continued monitoring and care. the left foot was stable and showed some improvement with diminishment in pain, but not complete relief of pain. the patient was beginning to wiggle her toes. the patient continued to show clinical improvement and was transferred to the regular nursing floor on hospital day number seven. iv heparin and coumadinization were continued. abdominal ct and pelvic and upper left leg were obtained, which showed a diminished collection in the inguinal area. no discreet collection noted. multiple diverticuli, no free fluid in the pelvis. white count continued to defervesce. her renal numbers remained stable. her heparin was adjusted for ptt of 60 to 80. her lopressor was adjusted for her persistent tachycardia. physical therapy was requested to see the patient and begin ambulation and case management was requested to see the patient regarding rehabilitation screening. her flagyl was discontinued on . she is continued on her ceptaz 1 gram q 8 hours, gentamycin 80 mg q 12 hours, vancomycin 1 gram q 12 hours. her cultures are as follows, 8/2 cultures blood grew enterococcus cloacae, klebsiella, pneumonia, mrsa and enterobacter buccalis. the enterobacter was sensitive to ceptaz, ceftriaxone, gentamycin, _______, penicillin, tobra and bactrim. the enterococcus was sensitive to ampicillin, gentamycin, penicillin, vanco. resistant to streptomycin and cipro. the staph aureus mrsa was sensitive to gent, rifampin, tetracycline and vanco. klebsiella was pan sensitive. repeat cultures on grew the same organisms and on blood cultures were no growth. at the time of dictation her white count was 16.7 with hematocrit of 25.0 and platelets 339. her bun was 9, creatinine 0.7, k 4.0, gentamycin levels on peak was 5.9, trough 2.6. final recommendations regarding antibiotic course of therapy will be determined just prior to discharge from infectious disease. the patient's heparin drip was discontinued on . coumadin 5 mg q day was begun. lopresor was adjusted to 50 mg t.i.d. discharge medications: coumadin 5 mg q.d. goal inr is 2.0 to 3.0, gentamycin 100 mg iv q 12 hours, this was begun on and a trough and peak were pending after the third dose. lopressor 50 mg t.i.d., colace 100 mg b.i.d., antibiotics are ceftazidime 1 gram q 8 hours and vancomycin 1 gram q 12 hours. percocet tablets 5/325 one q 4 to 6 hours prn for pain, zantac 150 mg b.i.d., procrit 40,000 units subq q week. dressings include nephrostomy dressing, which should be changed on a daily basis. ambulation as tolerated, full weight bearing, essential distances with healing sandal. pt/inr should be checked on a daily basis until the patient is therapeutic with an inr between 2.0 and 3.0. no heparin, so no ptt. the patient should follow up with dr. in two to three weeks or post discharge from rehab or prn as needed. discharge diagnoses: 1. left foot ischemia status post tissue plasminogen activator with improvement. 2. right hydronephrosis etiology unknown status post right nephrostomy tube. 3. polymicrobial bacteremia treated. 4. hypertension controlled. 5. peripheral vascular disease. , m.d. dictated by: medquist36 procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube angioplasty of other non-coronary vessel(s) injection or infusion of thrombolytic agent arteriography of femoral and other lower extremity arteries percutaneous nephrostomy without fragmentation diagnoses: coronary atherosclerosis of native coronary artery pure hypercholesterolemia unspecified essential hypertension cardiac complications, not elsewhere classified bacteremia hydronephrosis atherosclerosis of native arteries of the extremities, unspecified atherosclerosis of autologous vein bypass graft of the extremities 

Answer: The patient is high likely exposed to