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: aspirin / nifedipine attending: chief complaint: fever, malaise, wound infection major surgical or invasive procedure: patient left ama history of present illness: 40 yo male paraplegic s/p complications of gun shot wound injuries including r aka, l bka, chronic osteomyelitis, mrsa, and iron deficiency anemia presents with 1 wk purulent r infected leg wound drainage. he lives at home, without nursing services and states his brother helps change his dressings daily. he has h/o multiple admissions for infection with prior elopement. he has often required a picc line. he was febrile in ed and has vancomycin hanging on the floor, unasyn 3mg was given, as well as total of 3mg iv dilaudid. in er t101 hr122 bp123/64 rr18 100%ra at 2:15 am, when he arrived on med floor t98.3, bp 95/57, 98, 18. blood pressure at 8:35a was sbp 82/48. he is complaining of pain in right wound and deeper in (may represent pain). in he had (+) bcx for corynebacterium species. this has been documented in bone and wound infections in the past. it was apparently reported after he was discharged from hospital. efforts were made at contacting him but were unsuccessful. past medical history: (per omr): 1. right aka and left bka secondary to osteomyelitis - biopsy of bone on --mrsa, corneybacterium, bacteroides, got two weeks vancomycin/flagyl back in and left ama - admitted and got course of vancomycin/flagyl and left ama - admitted for the same, pulled out own picc and left ama - admitted eloped with picc in place - admitted /08 eloped with picc in place prior to completing abx course - admitted and eloped with picc - admitted received vanc/unasyn eloped after picc removed - admitted received vanc/zosyn, eloped with picc line in place - admitted /08 decision at this point was for no further abx, to have ortho eval as last line - pt eloped prior to eval - admitted with fevers and wound pain; not given antibiotics because of concern for development of resistance and lack of efficacy of interrupted antibiotic tx, as patient was not willing to undergo continuous tx. eloped. - admitted with fevers and wound drainage of his leg. he received vancomycin/zosyn then switched to vanc/unasyn and discharged to to complete 6-week course of antibiotics. - admitted - with fevers and rle wound drainage. - admitted - with fevers rle wound drainage, no antibiotics were given per received ertapenem/linezolid while in house but recommended to start 6 week course of iv antibiotics, which pt declined. - admitted with fevers, was treated for 5 weeks with vanco and meropenem and then pulled his picc and left ama on - admitted for fevers and eloped on - admitted and eloped on 2. paraplegia secondary to gunshot wound 3. neurogenic bladder/bowel, suprapubic catheter - h/o of resistant pseudomonas uti (sensitive only to tobramycin) 4. s/p colostomy "rectal problem" 5. sickle cell trait 6. psoriasis 7. history of esbl klebsiella uti 8. history of mrsa 9. history of cva in , right facial droop 10. hepatitis c positive 11. hepatitis b exposed (hbsab pos, hbcab pos, hbsag neg) social history: (per omr and pt): patient is s/p a gun shot wound after completing high school and has had le paralysis since that time. he smokes cigarretes per day. he denies any history of alcohol intake. he used heroin and cocaine (states that he snorts it and has not used iv drugs) and cocaine. most recent snorted cocaine use 2 weeks prior when relative died. currently living with his brother. family history: pt denies any one in the family with frequent skin infections. there is no history of premature coronary artery disease, dm, htn or cancer physical exam: lying in bed, face down, states he's in pain. doesn't engage in eye contact, no foul smells, but open, un-dressed cratered r aka wound is draining obvious puss. t98 bp 98/48 --> 82/48, hr 98, rr 18 spo2 98% ent - pt would not permit, states is in pain jvp flat, no , neck supple chest - would not permit, states is in pain lung - cta bilat back - multiple scars\ abd - no tenderness on flanks ext - large cratered r aka stump with purulent drainage, l bka stumped in gauze dressing w/o drainage. pt would not allow inspection of r stump because of pain neuro - alert x 3, coherent speech, moves upper extremities skin - full assessment deferred by patient psych - calm pertinent results: 04:10am blood wbc-9.4 rbc-3.04* hgb-6.6* hct-21.2* mcv-70* mch-21.7* mchc-31.1 rdw-22.1* plt ct-716* 03:00am blood wbc-16.5* rbc-3.20* hgb-6.8* hct-21.7* mcv-68* mch-21.4* mchc-31.5 rdw-22.5* plt ct-903*# 03:00am blood neuts-83.5* lymphs-12.3* monos-2.6 eos-1.4 baso-0.3 04:10am blood pt-14.1* ptt-29.4 inr(pt)-1.2* 04:10am blood esr-90* 04:10am blood urean-15 creat-0.8 na-138 k-4.3 cl-102 hco3-28 angap-12 03:00am blood alt-7 ast-21 alkphos-137* totbili-0.2 03:00am blood lipase-12 04:10am blood calcium-8.1* phos-4.0 mg-1.4* 04:10am blood calcium-7.7* phos-3.2 mg-1.3* 07:57pm blood crp-64.4* 07:57pm blood tobra-2.5* 07:57pm blood vanco-18.2 02:54pm blood tobra-7.0 03:00am blood asa-neg acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg 03:09am blood lactate-1.0 02:31pm urine color-straw appear-clear sp -1.009 09:08am urine color-yellow appear-clear sp -1.011 02:31pm urine blood-mod nitrite-neg protein-tr glucose-neg ketone-neg bilirub-neg urobiln-neg ph-6.5 leuks-lg 09:08am urine blood-lg nitrite-pos protein-tr glucose-neg ketone-neg bilirub-neg urobiln-2* ph-6.0 leuks-lg 02:31pm urine rbc-5* wbc-5 bacteri-few yeast-none epi-2 transe-1 09:08am urine rbc-33* wbc-83* bacteri-many yeast-none epi-1 transe-1 02:31pm urine casthy-1* 09:08am urine casthy-3* 12:30pm urine bnzodzp-neg barbitr-neg opiates-pos cocaine-pos amphetm-neg mthdone-pos 3:20 am blood culture blood culture, routine (preliminary): staph aureus coag +. consultations with id are recommended for all blood cultures positive for staphylococcus aureus and species. final sensitivities. oxacillin resistant staphylococci must be reported as also resistant to other penicillins, cephalosporins, carbacephems, carbapenems, and beta-lactamase inhibitor combinations. rifampin should not be used alone for therapy. sensitivities: mic expressed in mcg/ml _________________________________________________________ staph aureus coag + | clindamycin-----------<=0.25 s erythromycin---------- =>8 r gentamicin------------ <=0.5 s levofloxacin---------- 4 r oxacillin------------- =>4 r rifampin-------------- <=0.5 s tetracycline---------- <=1 s trimethoprim/sulfa---- <=0.5 s vancomycin------------ 1 s aerobic bottle gram stain (final ): gram positive cocci in clusters. reported by phone to # 12:10pm. 12:19 pm swab source: right stump. gram stain (final ): 1+ (<1 per 1000x field): polymorphonuclear leukocytes. 4+ (>10 per 1000x field): gram negative rod(s). wound culture (preliminary): due to mixed bacterial types (>=3) an abbreviated workup is performed; p.aeruginosa, s.aureus and beta strep. are reported if present. susceptibility will be performed on p.aeruginosa and s.aureus if sparse growth or greater.. pseudomonas aeruginosa. moderate growth. beta streptococcus group g. rare growth. staph aureus coag +. rare growth. sensitivities: mic expressed in mcg/ml _________________________________________________________ pseudomonas aeruginosa | amikacin-------------- =>64 r cefepime-------------- =>64 r ceftazidime----------- =>64 r ciprofloxacin--------- =>4 r gentamicin------------ =>16 r meropenem------------- =>16 r piperacillin/tazo----- =>128 r tobramycin------------ 8 i brief hospital course: 40year old paraplegic c/b neurogenic bladder/spt, r aka, l bka with h/o recurrent wounds infections and chronic stump osteomyelitis presented wtih 1 week of purulent discharge from r aka. febrile and hypotensive on arrival. went to micu where he was stabilized with fluids and antibiotics. was also found to have a uti and id service actually felt this was more likely urosepsis rather than wound sepsis. his initial ucx was contaminated but repeat ua was negative. he was initially placed on vancomycin and tobramycin per id recs. his blood cx (1 of 2 sets from ) grew mrsa. his wound grew pseudomonas. again, since id did not feel wound was truly infected (colonization), tobramycin was d/c'd on per id recs. he was kept on vanc for the mrsa bsi. the patient left against medical advice on , despite recommendations to stay for an echocardiogram. the patient understood the risks of leaving. diagnoses: 1. mrsa bactremia 2. septicemia due to bacterial uti 3. probable stump infection (wound) 4. iron deficiency anemia 5. neurogenic bladder medications on admission: none discharge medications: left ama discharge disposition: home discharge diagnosis: urosepsis infected stump wound discharge condition: patient left ama discharge instructions: patient left ama followup instructions: patient left ama procedure: venous catheterization, not elsewhere classified diagnoses: urinary tract infection, site not specified unspecified viral hepatitis c without hepatic coma sepsis pressure ulcer, lower back iron deficiency anemia, unspecified cocaine abuse, episodic below knee amputation status paraplegia infection (chronic) of amputation stump above knee amputation status methicillin resistant staphylococcus aureus septicemia pressure ulcer, stage ii chronic osteomyelitis, pelvic region and thigh neurogenic bladder nos amputation of limb(s) causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation 

Answer: The patient is high likely exposed to