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: history of present illness: the patient is a 63-year-old female with a past medical history of end-stage renal disease (on hemodialysis) secondary to lithium toxicity, papillary thyroid cancer (status post tracheostomy complicated by vocal cord paralysis), and methicillin-resistant staphylococcus aureus pneumonia with positive surveillance cultures, with a recent admission last week for fevers, hypertension, shortness of breath, and leukocytosis. the patient was treated with gentamicin, flagyl, and vancomycin. however, on hemodialysis day three, after the original admission, all cultures were negative, and her temperature had resolved. therefore, the antibiotics were discontinued. however, she was to continue receiving vancomycin for one week after discharge. however, it appears that she had not been receiving the vancomycin. today, the patient was admitted with a fever of 103.1 degrees fahrenheit, and her usual arm and hand pain after hemodialysis. review of systems was otherwise negative. however, the patient does have diffuse abdominal pain which is not getting any better but is unchanged from before. in the emergency department, the patient received intravenously gentamicin, 500 mg of flagyl, and vancomycin times one. she received a 500-cc normal saline bolus and her blood pressure medications, and her blood pressure remained stable after that. past medical history: 1. methicillin-resistant staphylococcus aureus pneumonia. 2. end-stage renal disease. 3. papillary thyroid cancer; status post tracheostomy. 4. intention tremor secondary to lithium. 5. osteoporosis. 6. crohn's disease; status post ileostomy. 7. recurrent right upper extremity arteriovenous graft thrombosis and pseudoaneurysm malformation. 8. history of upper gastrointestinal bleed secondary to nonsteroidal antiinflammatory drugs. 9. hypoparathyroidism. 10. an echocardiogram in showed an ejection fraction of 60%. social history: the patient is a resident at . family history: family history was noncontributory. medications on admission: 1. oxycodone 10 mg on monday, wednesday, and with hemodialysis. 2. renagel 800 mg by mouth three times per day. 3. atrovent meter-dosed inhaler. 4. salmeterol meter-dosed inhaler. 5. phos-lo 617 mg by mouth twice per day (on tuesday, thursday, saturday, and ). 6. subcutaneous heparin twice per day. 7. mucinex 600 mg by mouth twice per day. 8. lithium 700 mg three times per week after hemodialysis. 9. at hour of sleep. 10. ambien at hour of sleep. 11. duragesic patch 125-mcg q.72h. 12. elavil 75 mg by mouth at hour of sleep. 13. nephrocaps on tuesday, thursday, saturday, and . 14. tylenol as needed. 15. premarin 0.625 mg by mouth once per day. 16. synthroid 0.125 mg by mouth every day. 17. midodrine 5 mg once per day (with hemodialysis). 18. maprotiline 125 mg on tuesday, thursday, saturday, and . allergies: 1. penicillin (causes lip swelling). 2. cephalosporins (cause lip swelling). 3. clindamycin (causes an unknown reaction). 4. motrin (causes an unknown reaction). 5. ciprofloxacin (leads to lip swelling). 6. percocet (causes nausea and vomiting). physical examination on presentation: physical examination on admission revealed the patient's temperature was 101.6 degrees fahrenheit, her heart rate was 70s to 80s, her blood pressure was 80 to 110/40 to 60, and her oxygen saturation was 97% on room air. in general, the patient was irritated. she was alert and oriented times three. head, eyes, ears, nose, and throat examination revealed the pupils were equal, round, and reactive to light and accommodation. the extraocular movements were intact. cardiovascular examination revealed a regular rate and rhythm. no murmurs, rubs, or gallops. pulmonary examination revealed coarse breath sounds throughout; anterior and laterally. the abdominal examination revealed well-healed scars present. the abdomen was diffusely tenderness to palpation. extremity examination revealed she had no cyanosis, clubbing, or edema. no palpable cords. examination was nonfocal. pertinent laboratory values on presentation: laboratories on admission were significant for a potassium of 6, a bicarbonate of 30, and a creatinine of 4. her white blood cell count was 31.4. her lactate level was 5.4. pertinent radiology/imaging: a chest x-ray was read as normal. concise summary of hospital course by issue/system: the patient was admitted to the intensive care unit for blood pressure monitoring. her blood pressure responded to fluid resuscitation. 1. infectious disease issues: the patient was started on broad spectrum antibiotics. imaging of her abdomen was unremarkable. an echocardiogram showed no valvular vegetations. several days into her admission, her blood cultures from her hemodialysis line grew xanthomonas maltophilia which were felt to be the organism causing her likely line sepsis. the patient responded to antibiotics appropriately and was continued on vancomycin and gentamicin which were to be dosed and given during her hemodialysis for the next two weeks. 2. cardiovascular issues: her blood pressure remained stable during her hospitalization. 3. pulmonary issues: the patient was continued on tracheostomy care medications and pulmonary toilet. 4. end-stage renal disease: the patient was continued on her regular dialysis schedule. 5. psychiatric/bipolar issues: the patient was continued on her lithium. 6. endocrine/hypothyroidism issues: the patient was continued on her synthroid. 7. musculoskeletal issues: for her cervical radiculopathy, she was continued on her pain medications. discharge status: the patient was to be discharged to the (which is an extended care facility). condition at discharge: condition on discharge was stable. discharge instructions/followup: 1. the patient was instructed to take all medications as prescribed. 2. the patient was instructed to be on two weeks of antibiotics for her line infection. 3. the patient was instructed to follow up in the pain management center on . 4. the patient was instructed to follow up with dr. on . 5. the patient was instructed to follow up with her primary care physician and was to call to schedule an appointment. final discharge diagnoses: 1. bacteremia. 2. hypothyroidism. 3. peripheral neuropathy. 4. chronic renal failure. medications on discharge: 1. oxycodone 10 mg on monday, wednesday, and with hemodialysis. 2. renagel 800 mg by mouth three times per day. 3. atrovent meter-dosed inhaler. 4. salmeterol meter-dosed inhaler. 5. phos-lo 617 mg by mouth twice per day (on tuesday, thursday, saturday, and ). 6. subcutaneous heparin twice per day. 7. mucinex 600 mg by mouth twice per day. 8. lithium 700 mg three times per week after hemodialysis. 9. at hour of sleep. 10. ambien at hour of sleep. 11. duragesic patch 125-mcg q.72h. 12. elavil 75 mg by mouth at hour of sleep. 13. nephrocaps on tuesday, thursday, saturday, and . 14. tylenol as needed. 15. premarin 0.625 mg by mouth once per day. 16. synthroid 0.125 mg by mouth every day. 17. midodrine 5 mg once per day (with hemodialysis). 18. maprotiline 125 mg on tuesday, thursday, saturday, and . 19. vancomycin and gentamicin (to be dosed at hemodialysis). , m.d. dictated by: medquist36 procedure: hemodialysis diagnoses: other septicemia due to gram-negative organisms infection and inflammatory reaction due to other vascular device, implant, and graft bipolar i disorder, most recent episode (or current) unspecified ileostomy status tracheostomy status 

Answer: The patient is high likely exposed to