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: nsaids (non-steroidal anti-inflammatory drug) attending: chief complaint: fever major surgical or invasive procedure: right ureteroscopy with laser lithotripsy and stent exchange() history of present illness: 81 yo m with recurrent utis, dm, afib, cp, sent to the ed from his with fever. he has a chronic indwelling foley and was recently admitted for klebsiella urosepsis. at his , fever workup revealed a uti with reported klebsiella, as well as diarrhea concerning for c. diff. he was asymptomatic. mr. lives at altenheim (. in the ed, initial vitals 98.7 86 157/81 16 99%, and he then spiked to 101.0. he was given meropenem and flagyl. on admission, vitals were 99.1 85 119/57 23 99%. this morning, the patient feels well and is without complaints. he denies any abdominal pain or suprapubic tenderness. he also denies ha, blurry vision, chest pain, or cough. he states that he has had his urinary catheter in for "a long time" but is unable to be more specific. he states that it was supposed to be removed soon. past medical history: - t2dm - hypotonic hyposensitive bladder with urinary retention and chronic indwelling foley - atrial fibrillation (chads2 = 4. not on coumadin due to fall risk) - cerebral palsy - dchf (lvef 55% ) - hypertension - dyslipidemia social history: patient is a limited historian. lives in facility. wheelchair bound. non-smoker. does not drink alcohol. family history: non-contributory physical exam: admission physical exam vitals: tc 99.4 tm 99.9 bp 170/60 hr 92 rr 18 sao2 98% on ra general: alert, oriented, no acute distress. speech difficult to understand. cv: irreg irreg, no murmrs lungs: cta b/l abd: soft, non tender, non distended gu: foley in place ext: no edema discharge physical exam: vitals: t 98.0 144/78 hr 76 rr 20 sao2 96% on ra afebrile since general: alert, oriented, no acute distress. speech difficult to understand due to dysarthria. cv: irregularly irregular, no m/r/g lungs: ctab, moving air well, respirations are unlabored. abd: obese, soft, non tender, non distended gu: foley in place. (+) scrotal edema. no bowel sounds auscultated. no "bag of worms" sign. suture coming out of urethra. ext: trace pitting edema rn notes: stage 2 sacral ulcer present. pertinent results: microbiology ============ 12:36 pm urine source: catheter. **final report ** urine culture (final ): mixed bacterial flora ( >= 3 colony types), consistent with skin and/or genital contamination. 1:26 am blood culture source: venipuncture. **final report ** blood culture, routine (final ): no growth. blood culture (): pending cbc trend ========= 07:15am blood wbc-8.5 rbc-3.41* hgb-10.6* hct-30.5* mcv-89 mch-31.0 mchc-34.7 rdw-14.5 plt ct-356 07:40am blood wbc-7.5 rbc-3.35* hgb-10.3* hct-29.7* mcv-89 mch-30.6 mchc-34.5 rdw-14.5 plt ct-349 10:00pm blood wbc-22.8*# rbc-3.33* hgb-10.5* hct-29.5* mcv-89 mch-31.4 mchc-35.4* rdw-14.3 plt ct-295 05:56am blood wbc-18.3* rbc-3.24* hgb-10.3* hct-29.6* mcv-91 mch-31.9 mchc-34.9 rdw-14.4 plt ct-198 04:51am blood wbc-17.0* rbc-3.12* hgb-9.7* hct-27.7* mcv-89 mch-31.1 mchc-35.1* rdw-14.6 plt ct-158 06:40am blood wbc-13.2* rbc-3.09* hgb-9.5* hct-28.4* mcv-92 mch-30.8 mchc-33.5 rdw-14.9 plt ct-194 06:25am blood wbc-11.3* rbc-3.17* hgb-9.9* hct-29.0* mcv-92 mch-31.1 mchc-34.0 rdw-14.9 plt ct-239 05:40am blood wbc-13.3* rbc-3.19* hgb-10.1* hct-29.6* mcv-93 mch-31.5 mchc-34.0 rdw-15.2 plt ct-236 07:20am blood wbc-12.2* rbc-3.21* hgb-10.3* hct-29.6* mcv-92 mch-32.0 mchc-34.6 rdw-15.5 plt ct-274 06:45am blood wbc-9.5 rbc-3.07* hgb-9.7* hct-28.8* mcv-94 mch-31.7 mchc-33.7 rdw-15.6* plt ct-280 05:37am blood wbc-8.6 rbc-3.11* hgb-9.7* hct-28.9* mcv-93 mch-31.3 mchc-33.6 rdw-15.9* plt ct-300 chemistry trend =============== 07:15am blood glucose-190* urean-15 creat-0.8 na-133 k-4.3 cl-99 hco3-25 angap-13 07:40am blood glucose-192* urean-16 creat-0.8 na-135 k-4.5 cl-103 hco3-23 angap-14 05:56am blood glucose-299* urean-24* creat-1.2 na-135 k-6.0* cl-103 hco3-15* angap-23* 04:51am blood glucose-188* urean-31* creat-1.4* na-137 k-3.7 cl-106 hco3-19* angap-16 05:30pm blood glucose-161* urean-31* creat-1.3* na-135 k-3.7 cl-102 hco3-21* angap-16 06:25am blood glucose-197* urean-27* creat-1.1 na-133 k-3.9 cl-104 hco3-19* angap-14 05:40am blood glucose-178* urean-23* creat-0.9 na-132* k-3.5 cl-103 hco3-20* angap-13 07:20am blood glucose-169* urean-18 creat-0.8 na-139 k-3.7 cl-107 hco3-22 angap-14 06:45am blood glucose-148* urean-15 creat-0.8 na-137 k-4.7 cl-109* hco3-18* angap-15 05:37am blood glucose-104* urean-14 creat-0.8 na-136 k-3.8 cl-104 hco3-27 angap-9 06:27am blood lactate-6.1* 05:01am blood lactate-2.3 liver enzymes trend =================== 10:00pm blood alt-32 ast-80* ck(cpk)-85 alkphos-72 totbili-0.3 11:19am blood ck(cpk)-289 04:51am blood alt-1703* ast-3740* alkphos-76 totbili-0.4 06:40am blood alt-1010* ast-802* ld(ldh)-403* alkphos-82 totbili-0.5 06:25am blood alt-702* ast-303* ld(ldh)-270* alkphos-86 totbili-0.5 05:40am blood alt-490* ast-125* ld(ldh)-229 alkphos-86 totbili-0.6 07:20am blood alt-393* ast-62* ld(ldh)-274* alkphos-87 totbili-0.5 06:45am blood alt-285* ast-53* ld(ldh)-473* alkphos-84 totbili-0.4 cardiac enzymes trend ===================== 10:00pm blood ck-mb-2 ctropnt-0.37* 05:56am blood ck-mb-3 ctropnt-0.33* 11:19am blood ck-mb-3 ctropnt-0.31* cxr: there is mild cardiomegaly. the aorta is unfolded. no chf, focal infiltrate, or effusion is identified. brief hospital course: primary reason for hospitalization ================================== mr. was admitted with fever and suspected to have uti. although no culture-proven urinary pathogen isolated, we decided to treat given history of catheter-associated utis. given previous multi-drug resistent utis, was given iv meropenem and he improved. was set to be discharged on but had a previously-scheduled outpatient urological procedure (stent exchange and lithotripsy), so we decided to allow for this while in house. unfortunately, he became septic in the pacu following the procedure and had rapid ventricular response to his atrial fibrillation requiring a two day stay in the icu which was complicated by acute kidney injury, acute liver injury, and cardiac demand ischemia. upon returning to the floor, he was treated with iv antibiotics for urosepsis and po antibiotics for c. diff colitis and he improved, with details as below. #) urosepsis: as above, met multiple sirs criteria (hypotension, tachycardia, fever) while in pacu on so was transferred to the icu for treatment. his course was unfortunately complicated by acute liver injury, acute kidney injury, and elevated troponins all likely from his hypotension which are resolving or resolved at the time of discharge (creatinine back to baseline, liver enzymes downtrending, troponins returned to .) returned to the floor on . although no blood or urine cultures grew definitive pathogens, treated for presumptive bacteremia, given previous mdr utis, indwelling foley, and systemic inflammatory response syndrome following urological instrumentation, a transient bacteremia was suspected. given iv meropenem from with a 14 day course ending . #) catheter-associated urinary tract infection: no urinary pathogen isolated on this admission (cultures grew > 3, suggestive of contamination) given recent history of previous admission for multi drug resistant klebsiella uti resulting in urosepsis, we treated him empirically with meropenem. also has a prior history of vancomycin sensitive enterococcus. cultures growing mixed flora from and could possibly be true results rather than contamination given chronic indwelling foley. monitored for return of symptoms since % of klebsiella ca-utis are resistent to carbapenems, but he steadily improved. #) c. difficile colitis: c. diff negative at but positive at . reported diarrhea at , but this has much improved over the course of his hospitalization. given po metronidazole but switched to po vancomycin at the suggestion of id. planned for course lasting two weeks after finishing other antibiotics, finishing #) atrial fibrillation: had episode of rapid ventricular reponse in setting of sepsis with resolved with treatment. continued on digoxin while here. not on coumadin due to fall risk per atrius records. chads2 score is 4. given thromboembolic risk of 8.5% per year, would consider starting anticoagulation. a recent prospective study at the showed that "patients on oral anticoagulants at high risk of falls did not have a significantly increased risk of major bleeds." ("risk of falls and major bleeds in patients on oral anticoagulation therapy." the american journal of medicine. .) #) diabetes mellitus: glipizide and metformin held in setting of sepsis. started on insulin drip for elevated blood sugars with an anion gap and ketonuria concerning for dka. anion gap closed and patient was transitioned over to an insulin sliding scale. upon return to the floor, was restarted on po meds and insluin was discontinued with good response in blood sugars. medications on admission: the preadmission medication list is accurate and complete. 1. acetaminophen 650 mg po q6h:prn fever 2. aspirin 325 mg po daily 3. calcium carbonate 500 mg po bid 4. digoxin 0.25 mg po every other day 5. furosemide 20 mg po daily 6. lisinopril 5 mg po daily 7. multivitamins 1 tab po daily 8. omeprazole 20 mg po daily 9. simvastatin 10 mg po daily 10. timolol maleate 0.5% 1 drop both eyes 11. vitamin d 400 unit po bid 12. bisacodyl 10 mg po/pr daily:prn constipation 13. finasteride 5 mg po daily 14. glipizide 10 mg po bid 15. metformin (glucophage) 1000 mg po bid 16. milk of magnesia 30 ml po q6h:prn constipation 17. tamsulosin 0.4 mg po hs 18. trazodone 25 mg po hs:prn insomnia discharge medications: 1. bisacodyl 10 mg po/pr daily:prn constipation 2. aspirin 325 mg po daily 3. calcium carbonate 500 mg po bid 4. digoxin 0.25 mg po every other day 5. finasteride 5 mg po daily 6. furosemide 20 mg po daily 7. glipizide 10 mg po bid 8. lisinopril 5 mg po daily 9. metformin (glucophage) 1000 mg po bid 10. milk of magnesia 30 ml po q6h:prn constipation 11. multivitamins 1 tab po daily 12. omeprazole 20 mg po daily 13. simvastatin 10 mg po daily 14. tamsulosin 0.4 mg po hs 15. timolol maleate 0.5% 1 drop both eyes 16. trazodone 25 mg po hs:prn insomnia 17. vitamin d 400 unit po bid 18. meropenem 500 mg iv q6h 19. vancomycin oral liquid 125 mg po q6h cdi failed flagyl 20. acetaminophen 650 mg po q6h:prn fever discharge disposition: extended care facility: center discharge diagnosis: urosepsis acute kidney injury acute liver injury cardiac demand ischemia nephrolithiasis sacral ulcer clostridium difficile colitis atrial fibrillation diabetes mellitus cerebral palsy discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: out of bed with assistance to chair or wheelchair. discharge instructions: dear mr. , it was a pleasure taking care of you at . you were admitted with a fever and were found to have a urinary tract infection. you were improving, but you likely developed an infection in your blood after your urological procedure which transiently damaged your kidneys, liver, and heart, which are recovering upon discharge. please follow up with dr. urology as scheduled. followup instructions: name: dr. department: - urology address: , phone: appointment: tuesday 2:15pm name: , p. location: address: , , phone: please discuss with the staff at the facility a follow up appointment with your pcp when you are ready for discharge. md procedure: venous catheterization, not elsewhere classified ureteral catheterization transurethral removal of obstruction from ureter and renal pelvis central venous catheter placement with guidance diagnoses: hyperpotassemia abnormal coagulation profile acute kidney failure with lesion of tubular necrosis urinary tract infection, site not specified congestive heart failure, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute and subacute necrosis of liver unspecified septicemia hyposmolality and/or hyponatremia severe sepsis atrial fibrillation other and unspecified hyperlipidemia disorders of phosphorus metabolism atony of bladder intestinal infection due to clostridium difficile chronic systolic heart failure pressure ulcer, lower back do not resuscitate status urinary catheterization as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure accidents occurring in residential institution calculus of ureter infantile cerebral palsy, unspecified infection and inflammatory reaction due to indwelling urinary catheter other specified retention of urine mixed acid-base balance disorder pressure ulcer, stage ii infection and inflammatory reaction due to other genitourinary device, implant, and graft other acute and subacute forms of ischemic heart disease, other diverticulum of bladder 

Answer: The patient is high likely exposed to