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Background  Evidence on the changes in the absolute counts of monocyte subpopulations in sepsis is missing.    Methods  Firstly, absolute counts of circulating CD14 pos /HLA-DR pos /CD45 pos  monocytes were measured by flow cytometry in 70 patients with Gram-negative sepsis and in 10 healthy volunteers. In the second phase, immunophenotyping was performed and the absolute count of circulating inflammatory monocytes and of circulating CD14 dim /CD16 pos /CD45 pos  patrolling monocytes were measured in another 55 patients and 10 healthy volunteers. Measurements were repeated on days 3, 7, and 10. Results were correlated with survival after 28 days.    Results  Greater numbers of CD14 pos /HLA-DR pos /CD45 pos  monocytes were found on day 1 in survivors compared to nonsurvivors ( p  = 0.030). Receiver operating characteristic (ROC) analysis showed that a cutoff higher than 337 cells/mm 3  on day 1 could discriminate between survivors and nonsurvivors with a positive predictive value (PPV) of 91.1%. Logistic regression including Sequential Organ Failure Assessment (SOFA) score and Acute Physiology and Chronic Health Evaluation (APACHE) II score showed that an absolute count greater than 337 cells/mm 3  was independently associated with unfavorable outcome (odds ratio (OR) 0.19,  p  = 0.050). The absolute counts of inflammatory and of CD14 dim /CD16 pos /CD45 pos  monocytes were greater in patients than healthy controls during the entire 10 days of follow-up. The absolute counts on day 3 of CD14 dim /CD16 pos /CD45 pos  monocytes were greater in survivors than nonsurvivors ( p  = 0.027). ROC analysis revealed that the cutoff at 27 cells/mm 3  could discriminate between survivors and nonsurvivors with PPV of 94.1%. Logistic regression including age, SOFA score, and APACHE II score showed that an absolute count greater than 27 cells/mm 3  was independently associated with unfavorable outcome (OR 0.06,  p  = 0.033). Logistic regression analysis showed that intra-abdominal infection on day 1 was predictive of low CD14 dim / CD16 pos /CD45 pos  count on day 3.    Conclusion  Circulating counts of inflammatory and patrolling monocytes are greatly increased in Gram-negative sepsis. Absolute counts of CD14 pos /HLA-DR pos /CD45 pos  monocytes on day 1 and CD14 dim /CD16 pos /CD45 pos  monocytes on day 3 are independently associated with final outcome.    Trial registration  ClinicalTrials.gov,  NCT01223690 . Registered retrospectively on 18 October 2010.    Electronic supplementary material  The online version of this article (10.1186/s13054-018-1977-1) contains supplementary material, which is available to authorized users.

Increases in inflammatory and CD14dim/CD16pos/CD45pos patrolling monocytes in sepsis: correlation with final outcome