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: shellfish / zolpidem attending: chief complaint: urosepsis major surgical or invasive procedure: none history of present illness: 87 y/o m from reb with h/o cad s/p cabg, chf (unknown ef), a.fib, ppm, h/o gi bleed, anemia, cri, dm, urinary retension, prostate ca p/w decreased urine output, hypotension and fever to 104. had 3x loose stool prior to admission, noted low uop from foley, bp 80/40s at rehab, also vomited x 1. patient noted to be at baseline mental status, a+o x3. given levofloxacin at nh. . in the ed vs t 102.8 bp 70/30-->90-100s hr 65 o2 sat 94% 4l, started periperal fluids, given ceftriaxone x 1, vanco x 1 for ?mrsa otitis externa. labs notable for wbc of 27, hct 21, guiac neg in ed. received one unit of blood in the ed. past medical history: - urinary retention - prostate ca - cad s/p cabg - chf ?ef - ppm - a.fib on coumadin - hoh with hearing aid - mrsa otitis externa - squamous cell ca - copd - crf - pvd - dm - recurrent utis - htn social history: lives at reb, girlfriend is hcp, has one son. family history: nc physical exam: vs: 100.0 hr 65 bp 82/35 rr 14 100% 2l gen: elderly man, nad, labored breathing skin: many echymosses, thin skin heent: op clear, dry, pale, anicteric, perrl, eomi neck: unable to asses jvd, supple cvs: nl s1 s2, irregular, rrr, no m/r/g abd: obese, soft, ventral hernia easily reducible, active bs, nt ext: warm, trace edema neuro: awake, confused, hoh, follows commands pertinent results: 06:25am blood caltibc-135* vitb12-785 folate-9.9 ferritn-1126* trf-104* 10:10am blood glucose-148* urean-105* creat-3.6* na-130* k-4.8 cl-93* hco3-23 angap-19 05:19am blood glucose-126* urean-46* creat-1.2 na-144 k-3.8 cl-107 hco3-29 angap-12 05:19am blood pt-22.2* ptt-30.4 inr(pt)-2.2* 10:10am blood neuts-96.0* bands-0 lymphs-1.9* monos-1.2* eos-0.8 baso-0.1 10:10am blood wbc-27.4* rbc-2.37* hgb-7.4* hct-21.7* mcv-92 mch-31.0 mchc-33.9 rdw-18.5* plt ct-230 05:19am blood wbc-15.7* rbc-2.59* hgb-7.7* hct-23.8* mcv-92 mch-30.0 mchc-32.5 rdw-18.8* plt ct-267 . blood cultures: klebsiella pneumoniae | escherichia coli | | ampicillin------------ =>32 r ampicillin/sulbactam-- 8 s 16 i cefazolin------------- 32 r 8 s cefepime-------------- r <=1 s ceftazidime----------- r <=1 s ceftriaxone----------- r <=1 s cefuroxime------------ r 16 i ciprofloxacin--------- =>4 r =>4 r gentamicin------------ <=1 s =>16 r imipenem-------------- <=1 s <=1 s levofloxacin---------- =>8 r =>8 r meropenem-------------<=0.25 s <=0.25 s piperacillin---------- 32 i piperacillin/tazo----- <=4 s <=4 s tobramycin------------ <=1 s 4 s . cxr moderate cardiomegaly is unchanged. small bilateral pleural effusions, probably stable. pulmonary vascular congestion is unchanged. transvenous right atrial and right ventricular pacer leads in standard placements, unchanged. no pneumothorax. brief hospital course: hospital course, by problem: . #urosepsis: patient started on vanco and zosyn in icu. bp responded to fluids. per hcp and family pt was dnr/dni and did not want any cvl. blood cultures grew out gnr eventually speciated as klebsiella and e coli, which were both sensitive to zosyn; ua markedly positive. pt defervesced and wbc improved. bb and ace-i initially held d/t hypotension but then restarted. will complete a total of a 14 day course of iv abx. . #? otitis externa: no significant otitis noted on exam but pt had h/o mrsa otitis. as there was no evidence of ongoing infection, vanco d/c'd. . #elev inr: inr up on admission. coumadin held and vit k given. inr trended down and coumadin restarted at 5mg. he was transfused for hct in low 20s but hct remained in 20s. no evidence of bleeding and iron studies show acd. . #arf: cr over 3 on admission. with hydration and treatment of sepsis trended down steadily to 1.2 upon d/c . #anemia: hct noted to be low on admission (21.7); the patient was given 2u prbc with elevation to 24.9; hct remained stable during rest of admission. labs consistent with anemia of chronic disease. epogen should be started as an outpt along with iron. . #chf: the patient developed volume overload in the setting of volume resuscitation. once bp stabilized, lopressor and captopril readded, along with po lasix. he can be further diuresed at rehab. lopressor and captopril should be titrated as bp/hr allow. . #speech/swallow: pt had ?aspiration event while in house. speech swallow consult obtained; recommended obtaining a video swallow. this showed mild-moderate oropharyngeal dysphagia characterized by reduced base of tongue retraction, hyolaryngeal excursion, and laryngeal valve closure resulting in moderate-severe vallecular residue which builds up over time. this residue is more significant with solids than liquids andputs the pt at increased risk for penetration and aspiration. as such, s/s team recommended: diet be restricted to pureed solids and thin liquids with po meds crushed in purees. strict aspiration precautions and swallowing strategies should be followed. pt would benefit from follow up by speech/swallowing therapy at rehab to determine appropriateness for a repeat video swallow study for possible diet upgrade. . recommendations: 1. pureed solids and thin liquids. . 2. po meds crushed in puree, wash down with sip of liquid. . 3. strict aspiration precautions including: a) swallow twice for every bite. b) alternate between sips and bites. medications on admission: - senna - tylenol - warfarin 5 mg daily - simvastatin 10 mg daily - trazadone 150 - lexapro 10 mg daily - pantoprazole 20 mg daily - iron - combivent - amoxicillin mg prn - colace - lasix 60 mg po daily - loperamide - lisinopril 10 mg daily - toprol 50 mg daily - phenazopyridine 100 mg tid - levofloxacin 250 mg po daily - ceftriaxone 1 gram iv x 1 discharge medications: 1. olanzapine 5 mg tablet, rapid dissolve sig: one (1) tablet, rapid dissolve po qhs (once a day (at bedtime)) as needed. disp:*qs tablet, rapid dissolve(s)* refills:*0* 2. simvastatin 10 mg tablet sig: one (1) tablet po daily (daily). disp:*qs tablet(s)* refills:*2* 3. captopril 12.5 mg tablet sig: one (1) tablet po tid (3 times a day): please titrate as bp allows. disp:*90 tablet(s)* refills:*2* 4. furosemide 40 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 5. warfarin 5 mg tablet sig: one (1) tablet po hs (at bedtime). disp:*30 tablet(s)* refills:*2* 6. lexapro 10 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 7. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 8. piperacillin-tazobactam 4.5 g recon soln sig: 4.5 gm intravenous q8h (every 8 hours): to continue through . disp:*qs gm* refills:*0* 9. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid (2 times a day). disp:*30 tablet(s)* refills:*2* 10. ferrous sulfate 325 (65) mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 11. epoetin alfa 4,000 unit/ml solution sig: 4000 (4000) u injection qmowefr (monday -wednesday-friday). disp:*qs u* refills:*2* 12. trazodone 150 mg tablet sig: one (1) tablet po hs (at bedtime) as needed for insomnia. disp:*30 tablet(s)* refills:*0* 13. insulin regular human 100 unit/ml solution sig: sliding scale injection asdir (as directed). disp:*qs qs* refills:*2* discharge disposition: extended care facility: for the aged - macu discharge diagnosis: 1. urosepsis secondary to e. coli/klebsiella bacteremia 2. anemia of chronic disease 3. congestive heart failure 4. acute renal failure, resolved 5. atrial fibrillation secondary diagnoses: h/o urinary retention h/o prostate ca cad s/p cabg ppm hoh with hearing aid h/o mrsa otitis externa h/o squamous cell ca copd crf (unclear baseline) pvd type 2 dm h/o recurrent utis hypertension dyslipidemia discharge condition: stable, normal o2 sats on ra discharge instructions: please contact your primary care provider should you have any fevers, chills, night sweats, shortness of breath, chest pain, or any other complaints. followup instructions: please fllow up with your primary care doctor within one week. procedure: venous catheterization, not elsewhere classified transfusion of packed cells diagnoses: anemia in chronic kidney disease urinary tract infection, site not specified congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified severe sepsis chronic airway obstruction, not elsewhere classified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation personal history of malignant neoplasm of prostate aortocoronary bypass status septic shock long-term (current) use of anticoagulants retention of urine, unspecified cardiac pacemaker in situ septicemia due to escherichia coli [e. coli] infection and inflammatory reaction due to indwelling urinary catheter 

Answer: The patient is high likely exposed to