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: urosepsis. major surgical or invasive procedure: picc line placement. history of present illness: mr. is an 87 year old spanish speaking male recently admitted for elective right iliac aneurysm repair on . pt had experienced witnessed loc while ambulating. of note, had experienced similar episode syncope 3 weeks prior, found to be bradychardic by pcp, atenolol stopped. on this occaision, he complained of low back pain, came to ed,found on ct r common iliac artery aneurysm with old contained rupture. transfered here to or emergently for repair. had aortic stent graft with extension into r external iliac artery. stable post op with dc on . on pt developed fever to 104, burning urination, lower abdominal pain, rigors and went to where he had blood/ucx and got levoquin. he syncopized there in setting of valsalva (was on commode post valsalva complaining of dizziness, with bp initially unobtainable but improved on lying down. given immediately recently post op from transferred here for further care. at ed got blood and ucx, cxr and ekg. zosyn but not vanc given, sent to icu as developed an o2 requirement of 4l and persistently hypotensive despite 3l iv.vitals at time of transfer were bp 150/110, hr 90, 94% ra, afebrile, 20. . blood and urine cultures pending after abx at both and . . in the icu, pt became persistently hypotensive to the 80s. received total 5.5 l ivf, with improvement of systolic bps from 80s systolic to 120's systolic by icu day 1. patient did not require pressors. his uop was low/concentrated with stable cr. he was febrile to 104.2, defervescing over his icu course with tylenol, ivf and abx. wbc peaked to 12.9 o/n then declined. his afib was well rate controlled in 70s. he was restarted on his outpatient coumadin 3mg initially given subtherapeutic inr, then increased to 5mg given his subtherapeutic inr of 1.5 in setting of abx. he was eventually weaned from o2 and considered stable for transfer to the floor. past medical history: 1)dementia 2)afib 3)cva x 3 4)htn - baseline bp 140s. 5)cad 6)scars on abdomen suggest prior surgeries 7)dm- list on problem list from osh, but pt and family deny social history: originally from in . lives with daugher in , has 17 children -patriarch of community. former tobacco and alcohol, none currently. aox3 mild memory loss-occaissionally forgets namesx2 years. independent with adls. walks without a cane, but does have trouble with stairs and occ getting out of a chair. gets home vna several times a week for meds/blood draws. quit smoking in , used to drink heavily, none >10 years. family history: non-contributory. physical exam: vitals: t: 98.9 (104.2) bp: 87/52 p: 87 afib r: 11 o2:100% on 4l general: sleeping but easily arousable, answers simple questions in spanish, no acute distress heent: sclera anicteric, mmm, oropharynx clear neck: supple, jvp not elevated, no lad lungs: minimal diffuse crackles cv: irregularlly irregular, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, mildly distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly groin: well healed scars bilaterally, small hematoma on right, no bruits ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema skin: no rashes, warm at torso, thighs, cold hand/feet pertinent results: 02:46pm glucose-96 urea n-13 creat-0.8 sodium-138 potassium-4.4 chloride-111* total co2-22 anion gap-9 02:46pm calcium-7.9* phosphate-3.6# magnesium-2.5 02:46pm wbc-11.9*# rbc-2.91* hgb-8.4* hct-26.6* mcv-92 mch-28.8 mchc-31.5 rdw-16.0* 02:46pm plt count-153 02:46pm pt-17.2* ptt-30.4 inr(pt)-1.5* 12:07am lactate-1.2 12:00am neuts-88.1* lymphs-7.6* monos-3.9 eos-0.2 basos-0.2 12:00am urine color-yellow appear-cloudy sp -1.020 12:00am urine blood-lg nitrite-pos protein-100 glucose-neg ketone-tr bilirubin-sm urobilngn-4* ph-5.0 leuk-mod 12:00am urine rbc-* wbc->50 bacteria-mod yeast-none epi-0-2 12:00am urine wbcclump-mod cultures: blood culture blood culture, routine-pending inpatient blood culture blood culture, routine-pending inpatient stool ova + parasites-final inpatient stool fecal culture-final; campylobacter culture-final; ova + parasites-final; clostridium difficile toxin a & b test-final inpatient mrsa screen mrsa screen-final inpatient mrsa screen mrsa screen-final inpatient blood culture blood culture, routine-pending emergency blood culture blood culture, routine-pending emergency urine urine culture-final {escherichia coli} emergency echo: : the left atrium is dilated. left ventricular wall thickness, cavity size, and global systolic function are normal (lvef>55%). regional left ventricular wall motion is normal. the right ventricular cavity is mildly dilated with mild global free wall hypokinesis. the ascending aorta is moderately dilated. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. mild (1+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. moderate to severe tricuspid regurgitation is seen. the estimated pulmonary artery systolic pressure is normal. there is no pericardial effusion. impression: mildly dilated/hypokinetic rv with moderate to severe tricuspid regurgitation. normal regional and global lv systolic function. mild mitral regurgitation. cxr: : no pulmonary edema or pneumonia seen. 2. right upper lobe pleural thickening and linear opacities, of uncertain etiology, possibly atelectasis related to restrictive pleural thickening or bronchiectasis. pa and lateral views of the chest are recommended for further assessment. renal us : comparison: cta aorta/bifem of . findings: the right kidney measures 10.1 cm. the left kidney measures 11.3 cm. there is no hydronephrosis, stones, or mass bilaterally. the bladder is moderately well distended and appears normal. impression: no hydronephrosis. brief hospital course: mr is an 87 yo m with h/o cad, htn, recent iliac artery repair and readmission for uti, admitted with hypotension concerning for sepsis of uro- or surgical source. # sepsis: pt was admitted to the icu with fever to 104 and hypotension from baseline 140s to sbp 80s-90s with maps in mid 60s. he responded to ivf without requiring pressors. he was initially started on broad spectrum antibiotics with levoflox, zosyn and vancomycin. cultures from hospital and revealed esbl positive e.coli. his antibiotics were narrowed to zosyn however he spiked a fever on zosyn and was thus switched to meropenem with clinical improvement. he had a new o2 requirement briefly due to volume overload, but was tapered to room air by the time he reached the regular floor. his urine output was good on the floor, his foley was discontinued, with initial incontinence which subsequently resolved. he should complete a 14-day course of meropenem to end on . # syncope: he experienced last week episode thought to be due to bradycardia and bb discontinued. however, symptoms on admission resembeled orthostatic hypotension post valsalva in the setting of sepsis. he was monitored on telemetry, was not found to be orthostatic on exam, did not have any bradychardic or syncopal episodes here. plan for outpt holter monitoring to be orchestrated by pcp by dr . # afib: he had previously been on atenolol as an outpatient however he had been bradychardic with syncope, and his atenolol had been discontinued. he was found to be in rapid afib, for which he was started on low dose metoprolol, with good control of his heart rate and he remained asymptomatic from his afib. he was found initially to be subtherapeutic with an inr of 1.5 with possible interference from antibiotics, so his coumadin was increased from 3mg to 5 mg, and his inr remained in the therapeutic range. at time of discharge his coumadin dose is 4 mg; this dose should be continued until inr/ptt levels are checked two days after discharge. # cad: he had a history of coronary artery disease. his ekg did not reveal any changes, and his aspirin and simvastatin were continued. he remained dnr/dni through the course of his hospitalization. medications on admission: medications at home: atenolol 50mg daily held bradychardia &syncope (dc' ) coumadin 3mg (decreased during last hospitalization ? aspirin 325mg daily aricept 5mg simvastatin 10qd tylenol prn pain . medications on transfer: 1. piperacillin-tazobactam 4.5 g iv q8h 2. vancomycin 1000 mg iv q 12h 3. warfarin 5 mg po daily16 4. aspirin 325 mg po daily 5. simvastatin 10 mg po daily 6. donepezil 5 mg po hs 7. heparin 5000 unit sc tid 8. acetaminophen 325-650 mg po q6h:prn pain 9. ibuprofen suspension 600 mg po q8h:prn pain/fever discharge medications: 1. donepezil 5 mg tablet sig: one (1) tablet po hs (at bedtime). 2. simvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 3. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 4. warfarin 4 mg tablet sig: one (1) tablet po once a day. 5. meropenem 500 mg recon soln sig: one (1) recon soln intravenous q6h (every 6 hours). 6. sodium chloride 0.9 % injection 7. heparin, porcine (pf) 10 unit/ml syringe sig: one (1) intravenous prn (as needed) as needed for line flush. 8. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid (2 times a day). discharge disposition: extended care facility: care and rehab discharge diagnosis: primary: complicated urinary tract infection. secondary: iliac artery aneurysm atrial fibrillation coronary artery disease hypertension dementia discharge condition: vital signs stable. afebrile. discharge instructions: you were admitted to the hospital because you had a urinary tract infection. you were treated with intravenous antibiotics and improved a great deal. you will continue to receive intravenous antibiotics to completely cure your infection. . we increased your coumadin from 3 mg daily to 4 mg daily. we added irtepenem to treat the infection. we added metoprolol for blood pressure and heart rate control. . please return to the hospital or see your doctor if you have flank or abdominal pain, chest pain, problems with your urination, diarrhea, constipation, shortness of breath, nausea, vomiting, headache, fever, chills, sweats, muscle pain, joint pain, weight loss, or any other symptoms that are concerning to you. followup instructions: -please schedule follow-up with your primary care physician in in weeks. if you do not have a primary care physician, schedule to see a physician at : . - (nhb) phone: date/time: 10:30 - , md phone: date/time: 11:10 procedure: venous catheterization, not elsewhere classified diagnoses: coronary atherosclerosis of native coronary artery urinary tract infection, site not specified unspecified essential hypertension unspecified septicemia iron deficiency anemia secondary to blood loss (chronic) severe sepsis atrial fibrillation personal history of tobacco use occlusion and stenosis of carotid artery without mention of cerebral infarction other and unspecified hyperlipidemia other late effects of cerebrovascular disease septic shock long-term (current) use of anticoagulants other postprocedural status abdominal aneurysm without mention of rupture occlusion and stenosis of multiple and bilateral precerebral arteries without mention of cerebral infarction atherosclerosis of native arteries of the extremities, unspecified syncope and collapse diseases of tricuspid valve delirium due to conditions classified elsewhere urinary incontinence, unspecified other musculoskeletal symptoms referable to limbs 

Answer: The patient is high likely exposed to