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: patient recorded as having no known allergies to drugs attending: chief complaint: fever, abdominal pain major surgical or invasive procedure: 1. debridement of abdominal wall abscess history of present illness: mr. is a 39 year-old male with h/o prader-willi syndrome, t2dm, htn, s/p trach and peg, recent treatment for c. diff, recent treatment for vap and uti, and recent initiation of hd arf on cri of unclear etiology, who presents from rehab after experiencing fever and diffuse abdominal pain. on , his temp was found to be 100.5, with slight tachycardia to 105. he was given 1 dose vanc iv at hd on for erythema and discharge from g-tube site, and restarted on po vanco for suspicion of c. diff, although pt had no diarrhea. his vent settings had been stable at ps 15/5 on fio2 35% with rr 20-24 and vt 300-400ml with mod white secretions, but on , rt noted increased secretions and decreased vt to 240-300ml with temp climbing to 102f. cxr was reportedly non-diagnostic large body habitus. bcx were sent on , which had no growth after 24h. sputum was also sent for culture, and gram stain demonstrated many gnr and mod gpr, with 5-10 pmns/hpf and 0-5 epis/hpf. ua was turbid and positive for uti, with ucx pending. wbc was found to be elevated to 32, with elevated alk phos to 500s. given one dose ceftaz 2gm on and sent to ed for further evaluation. . per rehab notes, mr. has bilateral heel decubs. he also is thought to have possible dvts, but with inconsistent exam, d-dimer, and inconclusive lenis. he is being anticoagulated, but found to be subtherapeutic on coumadin 7.5mg po qd, and was being treated with iv heparin bridge. . in the ed, initial vs were t 102.4f, bp: 124/93, hr: 121, rr: 29, sao2 96% his initial labs were notable for an elevated wbc to 32.5 (83% pmn, 5% bands) with lactate 1.8, a mild transaminitis (ast 59, alt 73), elevated alk phos at 1178 with a normal tbili of 0.8, and normal amylase/lipase. inr was elevated at 1.8. cxr was uninterpretable. due to his morbid obesity, mr. could not undergo ct scan, and had no informative imaging done. he was given vancomycin and cefepime, and transferred to the for further management. . mr. was last discharged from on after a prolonged stay for arf of unclear etiology. after multiple failed attempts at hd access in or, had cut-down tunneled l ij perma cath placed. also had acetinobacter pna and klebsiella uti during this admission, s/p unasyn x 14 days, ending . covered prophylactically for recent c. diff with po vanc, ending . past medical history: prader willi syndrome morbid obesity t2dm cri with baseline creatinine 1.8-2.0 osa mental retardation hypothyroidism status post tracheostomy and peg tube placement social history: resident at rehab. no smoking, ethanol or drug use. family history: family history of diabetes. physical exam: vs: tmax: 100.9 yesterday afternoon, tc: 97.8 bp: 128/41 hr: 86 ac 450x16 fio2 0.35 sao2 99%, peep 8 general: morbidly obese aa male, sleeping, arouses to voice but not responding to questions. heent: nc/at, jvd unable to appreciate habitus. neck: trach c/d/i. pulmonary: clear anteriorly cardiac: distant hs, rr, nl. s1,s2 no rub appreciated. abdomen: obese, soft, foley catheter taped into place in former peg site. dressing soaked with clear drainage. no clear tenderness. absent bowel sounds. extremities: 1+ ble edema, abd wall edema. pertinent results: 02:11am pt-18.9* ptt-33.8 inr(pt)-1.8* 02:11am plt count-329# 02:11am neuts-83* bands-5 lymphs-4* monos-5 eos-1 basos-0 atyps-1* metas-1* myelos-0 nuc rbcs-2* 02:11am wbc-32.5*# rbc-3.37* hgb-8.3* hct-27.1* mcv-81* mch-24.5* mchc-30.4* rdw-18.7* 02:11am free t4-0.5* 02:11am tsh-38* 02:11am albumin-2.7* calcium-9.0 phosphate-4.9*# magnesium-1.9 02:11am lipase-22 ggt-687* 02:11am alt(sgpt)-59* ast(sgot)-73* alk phos-1178* amylase-27 tot bili-0.8 02:11am glucose-182* urea n-50* creat-4.3* sodium-138 potassium-4.8 chloride-95* total co2-28 anion gap-20 02:21am lactate-1.8 03:30pm ptt-51.4* brief hospital course: plan: 1) shock: patient was admitted in septic shock secondary to abdominal wall abscess surrounding his g tube insertion site. patient's additional sources included acinetobacter pneumonia, vre in abdominal wound, pseudomonal pneumonia, and yeast in the abdominal wound. for antibiotics, patient was started on a course of caspofungin, tobramycin, and daptomycin. given patient's obese body habitus, most radiological imaging is not useful in this patient. patient completed a two week course of antibiotics s/p or debridement. 2) respiratory failure: patient was started on a trach during his last admission and per his family would like to maintain current settings. patient had moderate secretions during this admission and was started on daptomycin and tobramycin for treatment of acinetobacter and pseudomonal pneumonia. 3) renal failure: during , patient developed renal failure of unclear etiology and has been on hemodialysis since . during this admission, patient initially required cvvh due to poor renal function and then was transitioned back to hemodialysis without complications. 4) h/o dvt: this diagnosis was made clinically, due to patient's calf pain and inability to obtain adequate imaging. patient was supratherapeutic while taking coumadin and heparin. given the risks of maintaining patient on heparin or coumadin, coumadin was discontinued. 5) anemia: likely secondary to renal failure and chronic phlebotomizing. patient's hct remained stable during this admission. 6) t2dm: has always been poorly controlled (hba1c 11.2 ). patient's blood sugars however have been adequately controlled with current regimen of glargine 60u with breakfast and sliding scale insulin. pt's sliding scale upon discharge was to start with 8units of regular insulin from 121-160 and then increasing by 4 units for every 40 increase in bg above 160. 7) hypothyroidism: patient's tsh suggests hypothyroidism, although unclear the accuracy of the diagnosis since thyroid levels were assessed while patient was already in the icu. patient was initially started on just levothyroxine po 75 which was then converted to iv levothyroxine 150 for improved absorption. 8) fen: patient was maintained on nepro full strength with beneprotein, 40 gm/day at a goal rate of 45 ml/hour. residual check: q4h hold feeding for residual >= : 150 ml flush w/ 50 ml water before and after each feeding medications on admission: mv 1 cap po qd heparin iv gtt at 1800u/hr coumadin 7.5mg po qd bupropion 75mg po qd lactinex x 2 albuterol-ipratropium mdi 8 puffs q4h vitamin c ssi, lantus 24u qd, lispro 6u with lunch levothyroxine 100mcg iv calcium acetate 667mg x 2 po tid with meals oxycodone-acetaminophen 5-325mg po q4-6h prn nepro 45ml/hr discharge medications: 1. bupropion 75 mg tablet sig: one (1) tablet po daily (daily). 2. ascorbic acid 90 mg/ml drops sig: one (1) po daily (daily). 3. albuterol-ipratropium 103-18 mcg/actuation aerosol sig: four (4) puff inhalation q6h (every 6 hours). 4. acetaminophen 325 mg tablet sig: one (1) tablet po q4-6h (every 4 to 6 hours) as needed. 5. miconazole nitrate 2 % powder sig: one (1) appl topical qid (4 times a day) as needed. 6. lansoprazole 30 mg susp,delayed release for recon sig: one (1) po daily (daily). 7. epoetin alfa 4,000 unit/ml solution sig: one (1) injection qmowefr (monday -wednesday-friday). 8. b complex-vitamin c-folic acid 1 mg capsule sig: one (1) cap po daily (daily). 9. fluoxetine 20 mg capsule sig: one (1) capsule po daily (daily). 10. insulin glargine 100 unit/ml solution sig: one (1) 60 units subcutaneous q breakfast. 11. insulin regular human 100 unit/ml solution sig: one (1) injection q achs: please administer insulin according to the following sliding scale. if bg 141-200, please give 8 units. if bg 201-240, give 12 units. if bg 241-280, give 16 units. if bg 281-320, give 20 units. if bg 321-360, give 24 units. if bg 361-400, give 28 units. . 12. levothyroxine 100 mcg tablet sig: three (3) tablet po daily (daily). disp:*90 tablet(s)* refills:*2* discharge disposition: extended care facility: northeast - discharge diagnosis: 1. septic shock 2. abdominal wall debridement s/p abdominal abscess surrounding g tube insertion site 3. pseudomonal and acinetobacter pneumonia discharge condition: fair. patient is alert, interacting appropriately, and tolerating tube feeds and dialysis. discharge instructions: - please take all medications as prescribed. - please follow-up with your primary care physician 1-2 weeks after discharge. followup instructions: - please follow-up with your primary care physician 1-2 weeks after your discharge. procedure: other endoscopy of small intestine enteral infusion of concentrated nutritional substances hemodialysis percutaneous [endoscopic] gastrostomy [peg] excisional debridement of wound, infection, or burn excisional debridement of wound, infection, or burn transfusion of packed cells transfusion of other serum rigid proctosigmoidoscopy other immobilization, pressure, and attention to wound injection or infusion of oxazolidinone class of antibiotics diagnoses: anemia in chronic kidney disease urinary tract infection, site not specified unspecified acquired hypothyroidism sepsis hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease pneumonia due to pseudomonas septic shock intestinal infection due to clostridium difficile morbid obesity pressure ulcer, heel streptococcal septicemia diabetes with renal manifestations, type ii or unspecified type, not stated as uncontrolled hypotension of hemodialysis chronic respiratory failure tracheostomy status infection and inflammatory reaction due to other internal prosthetic device, implant, and graft nonspecific elevation of levels of transaminase or lactic acid dehydrogenase [ldh] prader-willi syndrome pneumonia due to other specified organism 

Answer: The patient is high likely exposed to