Italy looked to be heading for its second defeat in three matches under Giampiero Ventura when Buffon rushed out of his area and failed to tackle Vitolo, who finally made the most of Spain's dominance by slotting into the empty net.

The host may have been aggrieved that it did not get to play over 20 minutes against 10 men with Diego Costa fortunate to escape a second yellow card when he kicked the ball away after referee Felix Brych's whistle - Julen Lopetegui immediately replacing him with Alvaro Morata.

However, Italy got the equaliser in the 82nd minute when De Rossi, who missed the opening qualifier against Israel through injury, calmly slotted home from the spot after Sergio Ramos fouled Eder, though the official only gave the penalty following advice from his assistant behind the goal.

Spain was therefore unable to avenge its last-16 defeat to Italy at UEFA EURO 2016, while a first-half injury to Jordi Alba will provide cause for concern ahead of Monday's (AEST) match against group leader Albania.

Ventura could be without Riccardo Montolivo, who was also forced off before the interval, when he takes his side to Macedonia at the weekend.

The returning Andres Iniesta, back in the side after overcoming the knee injury that kept him out against Liechtenstein, got away the first effort on target in the 11th minute, but his tame left-footed effort was straight at Buffon.

Spain continued to smother Ventura's side and Gerard Pique had a pair of chances to break the deadlock, the latter headed comfortably into the arms of Buffon from six yards midway through the half.

Injuries saw Alba replaced by Nacho and Montolivo substituted for Giacomo Bonaventura, while Costa was shown a yellow card for putting a hand in Leonardo Bonucci's face before half-time.

Lopetegui's team picked up where it left off after the restart and in the 55th minute it took thelead.

A lapse in concentration from Mattia De Sciglio played Vitolo onside following an incisive pass form Sergio Busquets, forcing Buffon to race off his line to try to intercept.

However, the goalkeeper failed to connect with the ball in his attempted challenge, leaving the Sevilla forward to slot into an empty net.

Costa was let off the hook by Brych, who opted not to show him a second yellow card, and the Chelsea man was hauled off for Morata seconds later.

Vitolo had a chance to double his and Spain's tally in the 68th minute but was unable to hit the target from 15 yards after a clever pass from Koke.

It proved costly as Italy were awarded a penalty and De Rossi confidently sent Spain goalkeeper David de Gea the wrong way with eight minutes remaining.

Andrea Belotti was denied a first senior international goal by the assistant referee's flag in the closing stages as Spain held on to maintain its record of having not lost a World Cup qualifier since 1993.