Emily Scarratt captains England from outside centre with regular captain Sarah Hunter starting from the bench.
But a great team try eased the pressure on England with winger Lydia Thompson touching down after receiving the ball from Danielle Waterman. Next up they face the U.S. on Thursday, perhaps their hardest pool stage match but another they will be expected to come through, and Middleton has now blooded 27 of his 28-strong squad in Ireland.
England responded with a similarly well-worked try from Thompson, the winger's 29th in worldwide rugby, and just before the break flanker Marlie Packer's storming run set up skipper Amy Cokayne for another to make it 22-8 at half-time.
Tamara Taylor strolled over shortly after the restart - Scarratt swiftly followed suit - but Italy had a second try when Elisa Giordano squeezed over following a powerful driving maul. Zoe Aldcroft, 6. Izzy Noel-Smith, 7. Waterman helped herself to a quickfire double before Thompson scored her 30th England try and Wilson-Hardy finally got her name on the scoresheet late on to give England the same points total they scored against Spain.
England notched their second straight 10-try win in defence of their World Cup title by over-powering Pool A rivals Italy 56-13.
England coach Simon Middleton made 10 changes to the side which started in Wednesday's opening game, but the defending champions showcased their strength in depth by running in another 10 tries.